HomeMy WebLinkAbout54467D - JonesI AMA / C�P,6REDGE & FILL 51
;ENERAL PERMIT Previous permit #
}New ❑Modification ICfomplete Reissue ❑Partial Reissue Date previous permit issued
rized by the State of North Carolina, Department of Environment and Natural Resources
:oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC �ZUO d- 2,,4LI2 o ev
24RWes attached.
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❑ IH ❑ UBA ❑ N/A
PWS:
❑ FC:
yes /tnb
PNA
yes /1,1157) Crit.Hab. yes / no
f Project/ Activity
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g distance offshore
ix distance offshore
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Project Location: County L�v- N.• t ,✓, c t
Street Address/ State Road/ Lot #(s) ,/ % 17110,, ,
Subdivision
City ZIP
Phone # ( )),�RRiver Basin L L. ey i
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Closest Maj. Wtr. Body
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-03-2007 10:02 From: To•E3429E306 r
Ct 'f1iF' E MAIL - RETUR 1WRECS - EOUFSTED
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The purpose of this form is to provide proper notice to you as an adjacent riparian property owner to the individual or
individuals listed below, The CAMA General Permit application prcmdures require that applicants provide the Division 4
Coastal Management confirmation that a written statement has been obtained signed by the adjacent riparian property owr
indicating that they have no objection to the proposed work os that the adjacent riparian property owners have been notifl
by cerrificd mail of the proposed work. Often these forms arc submitted to the adjacent riparian property owners by a mai
contractor or other individuals acting as an authorized agent on behalf of the applicant.
This form was sent to you by the following Individual or company designated by the applicant as an
authorized agent:
�3 rC �
Authorized Agent's Signature
- Z'9- /!�)
Date
Name of individual Applying For Permit. -S t eU e- -Nvv"'e— 5,
Address of Property Vt Ck
( Lot or Street *, Street or Road)
(City and County)
I hereby certify that I own property adjacent to the above -referenced property. The individual applying for this
has described to me as shown on the attgched drawing the development they are proposing. A description or dr
with dimensions, should be provided with this letter.
I have no objections to this proposal.
if you have objections to what Is being proposed, please write the Division of Coustni ylanagernei
Cardinal Drive Extension, Wilmington, NC 28405 or tail 910-796-7215 within 10 days of receipt of thin
No response is considered the same as no objection if you hove been notified by Certified M2iI.
WAIVER SECTION
l understand that a pier, dock. mooring pilings, breakwater, boat kouse or bout lift must be set
minimum distance of 15' from my area of riparian access -.unless waived by —rap. (If you wish to wi
setback, you most initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
t rin nnr %rich rn waive the 15' sethnck teouirement. A�A
owpnen Jones
1 u•+-o / a-04 / y P. 1
'T I VA
FAA
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beveryr Eaves PeNue, Governor dames H. GMson, Director Dee Freeman, Secretary
Date o Zo/D
Name off Property Owner Applying for Permit:
Mailing Address:
Zoo 7<::�,
I certify that I have authorized (agent) G 4L� -7t/ to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) _ &
UL-f« .,j=AJP
at (my property located at) M,
%/9-/-/
ZGT" z 38 C-fV'►z 14-
This certification is valid thru (date) o _v
ant: Sf CpJj ej J U�4?S Permit #:
'ibe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
i in your Habitat code sheet.
at 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 final
disturbance.
Excludes any
restoration and/o
temp impact
amount)
14/
Dredge ❑ Fill ❑ Both ❑ Other
2 Q
2 �/
Dredge ❑ Fill ❑ Both ❑ OtherA
12 �9
/2141
G
Dredge ❑ FillX 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 ❑
HOLDEN DOCK & BULKHEAub
GREGORY A & DOROTHY HOLDEN
910-842-9732 HIS NCDL 4576438 HERS 5202642
1502 STONE CHIMNEY RD SW
`;360
y 66-1215/ 84r
0
SUPPLY, NC 2846 $ 00/ O a
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BAN
S.p(ly N[, 28462
7530i�'036 -
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