HomeMy WebLinkAbout56506D - CahounCAMA / C316REDGE & FILL
GENERAL PERMIT Previous permit#
-iNew ' ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
prized by the State of North Carolina, Department of Environment and Natural Resources �7 /J /
�oastal Resources Commission in an area of environmental concern pursuant to I SA NCAC //7 // OlJ p` ��7• �2 ��
L94taTes attached.
it Namey p2 Project Location: County "Rx"ovJ w .0 k
U 6,4 S 7' _ _ � < Street Address/ State Road/ Lot #(s) Y3 Sc✓�
Z-P52 G State t' ZIP
Agent
❑ CW ; EW PTA ES ❑ PTS
❑ OEA ❑ HHF ❑ IH ❑ USA ❑ N/A
❑ PWS: ❑ FC:
yes i- no PNA yes /i4167
' Project/ Activity 1— c
ALA 1-6
Crit.Hab. yes / no
Subdivision
City, uL�c h ZIP 7
Phone # ( ) River Basin L v i
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Closest Maj. Wtr. Body A1w4v
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ding permit may be required
by: / /7� t! po,., (U 0,4 f n ❑ See note on
back regarding River Basin
�' 1 -t_L • c r '-,rvnn rr1Hr f "1'- i
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ADJACENT RIPARIAN PROPERTY OWNER STATMENT
(FOR A PIE"00JUNG PZL.;INC"OA7*L' TI. OA'Wof1SF)
I hereby certify that I pwtt property adjace(Namnt toe ai I'rvperiy tI}wttar)
►t R. GCS f z
op►x lot:ated at t=W �� ' 1 ,.,y....— t=
(Lot, Block, Road, etc.)
ont ��SiAt:.caNfl i--- ._• ir►
(AL
uD� . N 1-
wsterbodyj 2wn and/ County}
Applicant's pl+ooe �OMailing Address:
He, hU described to me, as shown below, the development he is proposiM at that location, and,1
havr. no objections to his proposal. I to dtsrstand that a pier/mooring pilings / boatiift I boathouse
must be setback a minimum distance of "tt en feet (15') from my area of riparian access unless
waived by me. (If you wish to waive the setback, you most initial the appropriate black
below.)
don t wish to waive
wish to waive that setback tequircnmt.
VESCRIPTION ANDIQR DRAWING OF PRC)P'[3StD DFVt.OPkZNT:
(-ro be filityd in.by indivldaal propas ng p(evelopmeott).
LO
----�................... _......
(Information for Property Owner Applying
for Permit)
z
Mailing Address
sty%State'Lip
(Riparian property Owner Informatioa)
Signature
Print or Type Name
""''"'""' Tbj�A�A/RA P.111mF1Nr
1V/11/3VIV MVN 1}i 5L 3+AA 171V LYy Vv14 "': VGNG KAr '.iVxV=+�'
,dvv— vva
.�i'il/2010 1356 3366740370 CALNQI- PASE K
ADJACENT RIPARIAN PROPEIM OWNtR STATEMENT
i bwfeby testify that I own proputy adjacent io !fit
(N0Am roperty owner)
i peitY located at �-. ' Zv � �• P. '? Fs+
(Lot, Block, Road, -etch.)
(Weterbody) (Town Andior unty)
,Ap licarttas n¢ �a7�8 MxltRag r'kddr+��� i�,...�-'�'►�' C@�_�•
tqx-
H6 has dcscribed tome, 23 sbown below, the deveiopmnt he is pcopas4 at Chet lecatten, and, l
havc no objaxions to his proyosal.
............
&NDIOR DRAWING OF PROPOSM DYMLoP14llENT'
(To 5e fdkd in.by property owner prop ping derefo+,p"CW)
,
Z_ _ 1 _--- - - -..... __ _ _.._.s.........._
(Inforn-adoA for Property Owner Applyieg allnarian P Dwoer'infvrmatian
for Perm.itl
I?5c5� 'DoN C-A
mailing Adtims _ (� Signature
In 22- 1'ruf�%Typ�,--Nam
City/State(Ztp AN -A5 PLA 0
�tie�phoiic N�umbcr �� 1 Tele��hooeNutt►be:
10,/ 1112810 13- S$ 3366740370 CAL-64�N
ff,.pJa
PAGE Ei3
ADJACENT RIPARIAN PROPIERTY OWNER STATEMENT
(FORA P.LERWOORING PILING&fOA?Li'FTS0AW0U-%V
I hereby certify that I own property adjacent to ' 1� `s
(� Namme.o Properly Oweer)
property located at
(Lot, Block, Road,, etc.) �
in Ic ra ��tA�s� 1�4,AY; Lo, N•C-
(Waterbody) (Town and/or County)
Appllesnfs pbone 403?0 Mailing Address.
He has described to me, as shown below, the development he is proposing at that loeatlon, and. I
have no objections to his proposal. I understand that a pierimaone$ pilings J ix:atlift! boethou58
mast be set back a minimum distance of fifteen feet tlrse T) from my aof riparian soatss wless .
wsived by me, (Ifyou wish to wive the setback, you must initial the appropriate block
below.)
1 aat wish to waive
—1 l2 wish to waive that setback requirement. ....MY.................�.
DESCRIPTION AND/OR DRA1'VxSO OF PROP68F,1D D)E'VtL0PM1NTc
rrd Dt fillei�d in by W dd4l propos. ; d�P�x*
.. ,r A
i ........ --.Y------ ------.--r-------
([n(ortnation for i'roperty Owner APplying AParjsn property Owner Info n)
for Permit)
! rSDSCAL'�3.. 1 - — -
Nlsalinz Address Sigltature
City/statelzip
ne Neunber
Prin�orTypo �Naame
Telephone Number
1(,1-1 1--.z:9110 15; ."-'(
Lt-VI-b-jHHKr'IHI."
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
scent ed to�~-k (A � t Ufa �'S
I hereby senify ttist I own property j C--- - , WO a perty twnorl
property located at -
(Lot, Block, Rood, We.)
��c�yu'adla' aunty?
(weterbody)
Ap�,Jjcmtls Anne
p;? D Mailing Addrew
E3e has described to ma, as shown below, the development he iS Proposing at that 10CAtion, SM, I
have no objections to his proposal.
...._... DESt RIMON "DJOR DRAWING OF pRopwxo DEVELOPM-W
(To be figed in by properq owner propmIniv dcwJvP0wn )
l
'Itif"mation for Property Owner A.ppWag (Ril&Fsaa Pro" QwntJ xa f rvnationj
for Pamit)
Mailing Address
City/Sta taip
( �� t,1 -
Sipature
*,al, %-o x,
Print oar Type Mme.
TPIenhene Number
licant' Aavloa ty
Permit # �—� -�� i'--p
cribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
id in your Habitat code sheet.
itat Name
DISTURB TYPE
Choose One
TOTAL Sq. Ft.
(Applied for.
Disturbance total
includes any
anticipated
restoration or
temp impacts)
FINAL Sq. Ft.
(Anticipated final
disturbance.
Excludes any
restoration
and/or temp
impact amount)
TOTAL Feet
(Applied for.
Disturbance
total includes
any anticipated
restoration or
temp impacts)
FINAL Feet
(Anticipated fina
disturbance.
Excludes any
restoration and/c
temp impact
amount)
�4"j
Dredge ❑ Fill ❑ Both ❑ Other
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Dredge ❑ Fill ❑ Both ❑ Other ❑
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Dredge ❑ Fill ❑ Both ❑ Other
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
N-H calhoulf — 66-30/5311 1310
,C 13 calhouH 069
4505 Domeaster ,Dr
1iree/tsboro, VC27406-9722
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