HomeMy WebLinkAbout54425D - Bass-JCAMA / rDREDGE & FILL
"ENERAL PERMIT Previous permit#
mew JModification El Complete Reissue ❑Partial Reissue Date previous permit issued
)rized by the State of North Carolina, Department of Environment and Natural Resources -J
Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC / �
'^ [7'Rules attached.
�+"
it Name L I RO f Project Location: County 9R V'V-r(-/ iC,,
/ O 7 � C�lr 44-rny Di?. Street Address/ State Road/ Lot #(s)
✓.J fS C c ti State/K ZIP2 rykz
Fax#()
ted Agent _ t e %�G �fiP,✓
❑ CW
OEA
❑ PWS:
yes /:_ rio
PEW L+"A QES ❑ PTS
❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ FC:
PNA yes t-W Crit.Hab. yes / no
Subdivision
City
ZIP
Phone # ( ) River Basin LG n
Adj. Wtr. Body�-
Closest Maj. Wtr. Body %a ! LvL✓
Project/ Activity Pic, v,q le !) a 1! eh 4" 1
(Scala!
k) length
r pier(s)
i length
number
,eRiprap length
avg distance offshore
max distance offshore
channel
-ubic yards
amp
ouse/ Boatlift
Bulldozing
0
line Length
not sure yes t ::
ags: not sure yes boy j
orium: n/a yes �o
s: no
r Attached: yes
ding permit may be required by: Awl do, A6PAcn Ell See note on back regarding River Basin
ns
35 10 00s30a Greg Holden 8429806 p. 3
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..r csap�nq is harteitr au�tlprd to atit cm*
* seder 1a c k" arty CAMA PWm*O MgL&W *won prape ft %60 Debw 71ts euih m iZ," i [s G,
spmr.0 , .1, Ms am d In lilt OWNted eifIt h.
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35 10 09:38a Greg Holden 8429806 P.1
..a OW—/. �GI
AD.J.,kCENT RtVANAN PROI rRTY OWNER SIXIIEN1 14T
(FUR a pll•K/d10c�R1-6lrL.j.N'C,S'jOA7LrFT?ff0,1TOO VS -•)
!ICI^-bv ccrtifyih.' 1 vw+-. �rvpCit) adjc.ccn: t�-�—..._
(1iamc of Property C -mi )
t,l3tock, rio,,a, ras.,�
1, ('A body) — ('town and.'or Cuunty) -
rjp,:tit:roV. phone ll'
r'S:�ilin� Atldrta9:
He hw dcNr-'1"cJ to mt, a', shown 1)e pow, the devcloprrcnt he 1$ ptoposirg 1r mz.
Piave ti0 0b;erlio n.s to ItIS t]ti�'fxiS�l. I U(ldl`,^scsnd ziL�t a pier/moortillR pil;t� s : t�u;uliC� 1 b�a'ls.�'aac
Le !s't hrcit * minilnull dig +t. c of - zecn fcct l s'1 (rCm my xrta Of -3n1c; s
Waled h; :nc, (11 . you wish tq w2ivo tl)c xC'Ulck, yt'+a nattSt iHitirl the anx►rdL'riat4 Utanl:
below.)
(1�i h(11' Wlrtt tU W:'IZVt
_OILJOIL I.in wts4j to wnira +cult s:cbxcic rcquirevx:1'- _ .............................�_..._--....- -
vy'sc.:iz11'Tl(7`►. -NWOR Ov t•Rcipos"m 0r,�1��.oY':�tF 1.
{Tn bcj iled in b) inG':vitlr�a! prnf�nrfng Qlwcln/un��R�i
,II .►�1 - �-.. -•
rg� ,a
(Infurntatiow (or �'cb[�crtti' Ov`ncr ,4pply'ioy;
for Vermit)
111.1fig AM
.itlL'iil'
(Rip.srisn Property Owtwr tnft)rniaeiuq►
Pr'nt Cr Tyrc `.unc
)5 10 09:39a Greg Holden 8423806 P•2
d .6y-1d prr-�
-L
:ADJACENT RJPARIAN PROPERTY, OWNER STATEMENT
(FOR A PIERIMOORING PILIAGSIBOATLIFTIBOATIIOUSE)
I hereby certify that I own property adjacent tc �� 1
(N; ame of Properly Owner)
property located at
.I-- -
Block, Road, etc.)
in
(Waterbo y) (Town andlor County}
Applicant's phone #:
Mailing Address:
He has described to .me, as shown below, the development he is proposing at that location, and,1
have no objections to his proposal. I understand that a pier/mooring pilings l boatlifft 1 boathouse
must be set back a minimum distance of fifteen feet 0 S') from my area of riparian access unless
waived by me. (If you wish to waive the setback, you must initial the appropriate blank
below.)
I do not wish to waive
I do wish to waive that setback requirerncnt.
-----------------------------------------
-- -
DESCRIY`nOli AND/ORDRAWING OF PROPOSED DEVELOPMENT:
(To, befilled irk by individual proposing development)
---------------------------------------------
(Information for Property Owner Applying
-------------------------------------------------------
(Riparian Property Owner Information)
r
��-
ignature
Print or Type Name
GREGORY A & DOROTHY HOLDEN
910-842-9732 HIS NCDL 4576438 HERS 5202642
1502 STONE CHIMNEY RD SW
SUPPLY, NC 28462
3561
66-1215/531
go
DD.°�
WACCAMAW
BANK
Supfiy, NC 28462
nnuru.wacco bonk,
1:0S3 L 12 LS 21:,B000 LS?S3000356
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llxl i c"-, WILDLIFE PORTRAITS®