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Home My WebLink About56573D - DavisCAMA / I DREDGE & FILL i E N E RAL PERMIT Previous permit # New ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued zed by the;State of North Carolina, Department of Environment and Natural Resources D1stal Resources Commission in an area of environmental concern pursuant to 15A NCAC _'/1�,12 aG E Rules attached. Name hgvr r, �y.�. (t Z, +fed r9 ,ji. Project Location: County 3t?w, -j /'C � n . l . x c 4 _ _ Street Address/ State Road/ Lot #(s) S2 P,✓ZV Ce t State ' ZIP GEC 77 Fax # ( ) - :d Agent !r ' iZ 4,.� Q,r ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS ❑ OEA ❑ HHF IH ❑ UBA ❑ N/A ❑ PWS: ❑ FC: PNA yes X�w Project/ Activity Crit.Hab. yes / no Subdivision city 0(-P'o"-TS-ze br"oe-4 ZIP_ YY'�S Phone # ( ) River Basin Lv, ,c Adj. Wtr. Body (!�?,-A t U /TivQ/,/A✓ (ng Closest Maj. Wtr. Body 1�91ww (Scale: / ■■■■ ■■■■■■■� ■■■■■■■■■■■■■■■■■A■■■■� ■■■■■■■■■■■�i'�■■i■■■■ ■■■■1�■■■■■■■■■■ gth iber ■■■■■■■n■■■■■■■■■■■�■■■■1�■■■■■■■■■ Riprap length_ ■■■■■■■�1141■■■■■■■■■■■■tv■i�t7��i■■■■■■■■■■ distance offshore ■■■■■�ar�■■■■■■■■■■■■■z�■u■■■■■■■�■ Aistance offshore_ ■■■■r��■■■■■■■■■■■■■■1■■■■■s■�■■■■■■■ ■■■■■■■■■■■■■■R!��.��17■■■■■■■■■■■■■■■ X yards ■■■■'!■■■■■■■■t�11■■■■■■I■■■■1�■■■■■■■■■■ ■■■r■■■■■■■■■■�:_:��;__�■■■■N■■■■■■■■■■ ■■��■■■■■■■■■■■■■1 �� i►�■■■■■u■■■■■■■■■■ ■■■■■■■■■■ ■■■■■■■■■■■■■■■■1�■■■■■■■■■■ not sure yes n . ■■■■■■■■■■ ■■■■■■■■■■■■■■■■1�■■■■■■■■■■ not sure yes n ' ■yes ■■■■■■■■■ ■■■■■�■1'lZla■�■■11■■■■■■■■■ • ■■■■■■■■■r �■■i■■■■■■■■■■■rs�r��■■■■■■■■■ n ■■■■■■■v� ■■■■■■■■■■■■■■■YII■■■■■■■■■ ,... „ Min■■ ■■■■■■■■■■■■■■■■If■■■■■■■■■ ig permit may be required by: '?P C ii ❑ See note on back regarding River Basin ru r NCDENR. North Carolina Department of Environment and Natural Resources Division of Coastal Management ;verly Eaves Perdue James H. Gregson overnor Director AGENT AUTHORIZATION FORM Date: me of Property Owner Applying for Permit: Lv � S cL o� �s� LKorS vner's Mailing Address: lone Number (104) ISA-3121 Dee Freema Secretar Name of Authorized Agent for this project: VA\ �O- .-k iv\C Qak (Ve � Agent's Mailing Address: Phone Number i0 7J ;ertify that I have authorized the agent listed above to act on my behalf, for the purpose of applying r and obtaining all CAMA Permits necessary to install or construct the following (activity): ny property located) at Ta CIA, D % Le- E°c6 cL his certification is valid thru (date) (,� 1V2 - 2.olc) Date Property Owner Signature e 50 Ne paw-. Oc�, Ss1e Qeac�,T Nc L.),-) ?o r 4- CERTIFIED MAIL -- RETURN RECEIPT REQUESTED DIVISION Or COASTAL MANAGEMENT ADJACENT RIYA i'UAN PROPERTY OWNER STATEINIENT Name of Property Owner: Address of Property: _knew (Lot or Street 9, Street or Road, City & County) Applicant's phone #: I Mailing Address: O ua s l hereby certify that I own property adjacent to the above referenced property. The individual applying for this perrr has described to me as shown on the attached drawing the development they are proposing. A description of drawin with dimensions, must be provided with this letter. I have no objections to this proposal. I have objections to this proposal. If you have objections to what is being proposed, you must notify the Division of Coastal Management (DCM in writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive Ea Wilmington, NC 28405-3845. DCM representatives can also be contacted at (910) 796-7215. No response is considered the.same as no obiection if you have been notified by Certified Mail. WAIVER SECTION I understand that a pier, dock, mooring pilings, breakwater,.boathouse, or lift must be set back a minimum distance < 1 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 wish to waive the IS' set back requirement. I do not wish to waive the 15' set back requirement. (Property Owner Information) *,91 Si nature S v1�ar.` Print or Ty�Name ion) Signature Print or Type Ne I0 �SO lt� Mailing Address LY,crn r-A- Y`C `; - o a (, Mailing A dress N -7� . I � Z— i 0 1�c v �s Ocean 1s��. Qo�<-L,Yc 50 N e Ocec.s. Este (3eac�,7" )licant:�9Vr5 /`AM/` 4+•r rSc✓�c% Ct:rr �y e: y L�%a( Permit #: cribe below the HABITAT disturbances for the application. All values should match the name, and units of measuremen id in your Habitat code sheet. TOTAL Sq. Ft. FINAL Sq. Ft. TOTAL Feet FINAL Feet (Applied for. (Anticipated final (Applied for. (Anticipated fins itat Name DISTURB TYPE Disturbance total disturbance. Disturbance disturbance. Choose One includes any Excludes any total includes Excludes any anticipated restoration any anticipated restoration and/ restoration or and/or temp restoration or temp impact temp impacts) impact amount) temp impacts) amount) Dredge ❑ Fill ❑ Both ❑ OtherR �G Q Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ COMPLETE•N COMPLETE THIS SECTIONON DELIVERY C ■ Complete items 1, 2, and 3. Also complete A. Sign re item 4 if Restricted Delivery Is desired. X ❑ Agent ■ Print your name and address on the reverse ressee C so that we can return the card to you. B ■ Attach this to the back card of the mailpiece, C or on the front if space permits. s de address d m ern I? ❑ s 1. Article Addressed to: If Y , enter delivery address low: ❑ No so s s�-ra-+-�<-A QCL C T 1, 0 3. Service Type I Y� C ❑ Certified Mail ❑ Express Mail � ❑ ❑ V—J TtJv 1 l Registered Return Receipt for Merchandise C a 71 f i L—f ❑ Insured Mail ❑ C.O.D. v f 1 4. Restricted Delivery? (Extra Fee) ❑ Yes 2. Article Number (rransfer from service label) 7 010 18 7 0 0000 1098 9 214 Iliam G. McRatney (910) 754-3260 i2 Village Point Rd. S.W. Ulotte, NC 28470 ; nIc ID C A/R VY to 7266 66-1215/531 / 2 n .4 • 6 830 L Date sea. 1l Dollars 8 011. a _N WBAC�CAMAW Uo tet NC 28459 v.waccamafuball%["m 0531 L 2 15 21:1300009 230DP07 266