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Home My WebLink About55814D - KeeneCAMA / ❑ DREDGE & FILL 5W IENERAL PERMIT Previous permit# New ❑Modification El Complete Reissue ❑Partial Reissue Date previous permit issued zed by the State of North Carolina, Department of Environment and Natural Resources I f oastal Yesources Commission in an area of environmental concern pursuant to I SA NCAC rt ��1 �� UU Rules attached. Name l i1�1�Y 1�l Project Location: County Street Address/ State Road/ Lot #(s) ,. �e+ State ZIPJ�Qq o `� �- 1-L.�- � I ` (p�(f Fax # ( ) Subdivi 'on HA � Aiyi . at` iL t C. VA ZIP---�- Bd Agent N � 'ti 2 q r ❑ CW W PTA ❑ ES ❑ PTS P ne # ��) 4 1 Z River Basin t t ❑ OEA HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body nat n PWS: ❑ FC: yes / no PNA yes /(no Crit.Hab. yes / no Closest Mal. Wtr. Body ' Project/ Activity ck) lenT�L ,(s) X { "1 ngth mber d/ Riprap length g distance offshore ax distance offshore hannel bic yards mp use/ Boatlift iulldozing WNCIn {&VS Aciigdyt1v (Scale: /_ DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM 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 CAvIA General Permit application procedures require that applicants provide the Divigt x Coastal Management confirmation that a written statement has been obtained signed by the adjacent riparian proputy lowito indicating that they have no objection to the proposed work or that the adjacent riparian property owners have been tom' by certified mail of the proposed work. Often these forms are submitted to the adjacent riparian property owners by a 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: / A ?&. 1. �x r s Signature Date Name of Individual Applying For Permit: C—/%��®L/1iG Address of Property: 9,0 6/ P/ cJ7— (Lot or Street 1, Street or Road) s-lt,or (Ciry and County) hereby certify that 1 own property adjacent to the above -referenced property. The individual applying for this permi ,4as described to me as shown on the attached drawing the development they are proposing. A description or drawing with dimensions, should be provided with this letter. I have no objections to this proposal. osal. tf you have objections to what is being proposed, please write the Division of Coastal 'Management, 127 ; arc inal Drive Extension, Wilmington, NC 28405 or call 910- 795-7Z 15 within 10 days of receipt of this notice. ' o response is considered the same as no objection if you have been notified by Certified Mail. WAIVER SECTIOiti understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must be set back a ainimurn distance of 15' from trey area of riparian access - unless waived by me. (If you wish to waive the 044ck, you roust initial the appropriate blank below.) I do wish to waive the 15' setback requirement. I do not wish to waive the 13' serback requirement. +nis. - Lti C 1 U tii: KL LL Ii 1 nJ✓ U L' S I E' D DIVISION OF COASTAL MANAGEMENT A DJACENT RIPARIAN PROPERTY OWNER NOTTFICATION/WAIVER FORM 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 procedures require that applicants provide the Division €i" Coastal Management confirmation that a written statement has been obtained signed by the adjacent riparian property ownm indicating that they have no objection to the proposed work or that the adjacent riparian property owners have beets no by certifQ mail of the proposed work. Often these forms are submitted to the adjacent riparian property owners by a 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' Authorized it's Signature /I Date Name of Individual Applying For Permit: Address of Property: (Lot or Street 4, Street or Road) (City ago Counn•) yy.F I tereb} certify that 1 own property adjacent to the above -referenced property. The individual applying for this permi as described to me as shown on the attached drawing the development they are proposing. A description or drawing jib dimensions, should b provided with this letter. 1 have no objections to this proposal. if -you have objections to what is being proposed. please write the Division of Coastal Management,_ 12', Cardinal Drive Extension, Wilmington, NC 28405 or call 910-796-7215 within 14 days of receipt ofthis notice. No response is considered the same as no objection if you have been notified by Certified Mail. WAIVER SECTION I understand that a pier, dock, mooring pilings, breakwater. boat house or boat lift must be set back a paininium distance of 15' fronts my area of riparian access - unless waived by me. (If you wish to waive the setback, you taunt initial the appropriate blank below.) I do wish to waive the 1 setback requirement. r I do not wish to waive t 1 5' setback requirement. North Carolina Department of Environment and Natural Resources Division of Coastal Management Whae1 =. Easley, Govemor James H. Gregson, Director V' HY= G. Ross r., Bate Na fProperty Owner Applying for Permit: Vg ' Mafia Address- $y Mr .,�c , certify that I have authorized (agent) �iy'`' G/ I �® s- to act oa l alf, for the purpose of applying for and obtaining all CA+%LA, Permits necessary to stab or construct (activity) ✓�,�/�� -my property located at)2 of'/ 9 S% This certification is valid thru (date) v� i3'. Owner Signature Dat C Division of Coastal Mgt. habitat Impact Computer Shoat >plicant: CA,4-6)'N ate: 1Y, t� /10 for the application. All values should match the name, and units of measurement escribe below the HABITAT disturbances >und in your Habitat code sheet. FINAL Feet TOTAL Sq. Ft. for. FINAL Sq. Ft. (Anticipated final TOTAL Feet (Applied for. (Anticipated final (Applied DISTURB TYPE Disturbance total disturbance. Excludes any Disturbance total includes disturbance. Excludes any labitat Name Choose One includes any anticipated restoration any anticipated restoration and/or restoration or temp impacts) and/or temp impact amount restoration or temp impacts temp impact amount) ow - 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 ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ 4- PILINGS AND MORE JOHN CASSIDY PH: (910) 327-2009 169 LAKE HAVEN DRIVE SNEADS FERRY, NC 28460 Po Ytorder o the 5749 66-30/531 457 Ilnte First CitizensDollars 8 a.�. Btc�iti ens.com 558)�� For ��li/yl/ � (on)1: 0 5 3-10 0 3 0 0 1: 0 0 I, 5 7 1 3 2 7 0 1 — ___------- ___ �,e 5749