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Home My WebLink About56550D - Scalyy�,es�r2v�..'aw;•- .,r'�:r �-w�sry..�-..- �+�'.•�T�''.KaR'a"�_'-n.,�... _ s, n.o- _ _ - .: .. �. ry .. _ _.. _ -,y ... CAMA / ❑ DREDGE & FILL :f 5 E N E RAL PERMIT Previous permit # dew 7Modification ❑Complete Reissue El Partial Reissue Date previous permit issued zed by the State of North Carolina, Department of Environment and Natural Resources -7 4) %��/ (i �astal Resources Commission in an area of environmental concern pursuant to 15A NCAC / es attached. Name Project Location: County & fAZ j State _ ZIP , (7,,,,��J L S'r1'�1tG(J Fax # (—) ,d Agent P ❑ CW SAW L-f "A Q-ES ❑ PTS ❑ OEA ❑ HHF ❑ IH ❑ URA ❑ N/A C PWS: ❑FC: fes / no PNA yes �--no j Crit.Hab. yes / no Project/ Activity OWN 4a l ( N'P Street Address/ State Road/ Lot #(s) 12 6 U 4i[ Li Subdivision City /c/ 1 d e ap4 ZIP7 Phone # ( ) M River Basin I-0,'n h Adj. Wtr. Body 2,- A _ O' 1411 I AI (n, Closest Maj. Wtr. Body ,J L✓ G✓ v, (Scale:=L ■111■111■1:■®1::11■111�11111■11■11■ - ■■■■■■■■■■�'71F =:ii I■■■■■7��1■■■■■■■■■■ `Emu ■11 MEN 11■MAIN IMAM I 1 0 NONE so ■B■■■■■■m■■ ■■■1 tN■o■■m■n■N■■■■■B ■■■■■■■M■a■M■■■ Mr■■ 1�■N■■■■■■■■■■ ■■■■MOWMNN!�!lltl■■ 1MM■■■ I■!■■li■■■■■■■■■■ ■■■■■■ %AhA is MMA ME IMMMf MbW'✓•il CMMMl1■MM■■ • ■ ■iaR13■■■■■■■■■■■■■■■■!1■■iil0lf■■I�tL'' ig permit may be required by: A[ fj ❑ See note on back regarding River Basin rt I -1 1- ILI, A�A NCDENR North Carolina Department of Environment and Natural Resources Division of Coastal Management Beverly Eaves Perdue, Governor James H. Gregson, Director Dee Freeman, Secretary Date Z to Name of Property Owner Applying for Permit: Mailing Address: 3�a c, n1c.L-'zj DZ k A Ale 2 elM I certify that I have authorized (agent) j r, �(�'� to act on my behalf, for the purpose of applying for and obtaining all CA MA Permits necessary to install or construct (activity) Al E W LC k- ho4 ]6 at (my property located at) 194 _Y14 j2 / QJ, This certification is valid thru (date) /2/f/Jc) 10-Dec-C9 12.22 PM First Citizens Bank 919-363-4611 21 I.9 2010 11;34flM Rioky/CimdmHewett; S1QB427471 p.l ADJACENTp�oIBT (MJRAp 00jUNoUNGSMMOAHOU E) i hereby certify tbat I awn property A�ficent to .ft —`s . . . , , (N*me of rrop t'9 0wnar) pmporty located at (Lot, $loalcjAoms W.) :� •t in ��(rTreaywwwnlkndlortounfy) on , (Waterbody')3zdo Applicant's phone #I Iffa? A&Aing Add rom, � �Zo > Ic has deaeribad to mo, as shown below, tho development he 1s proposing at that location, and, I hlsva ao objeotions to his Proposal-1 underatsnd that a picrlmooring pI Ur P 1 boatlift / boathouse must ba sot bank at minlmum distanes of iiffeen tact (15) iron my araa of riparian sores unless waived by me, (if you M514 to Yraiva the setback, you must Initial tbs apprapriete blank below.) I do no ,%ish to waive 0" r rr.1 l "wish to waivo that astbaok requirement. rrNW WrYMr.....Ir..............�.•.... r r. r... r.. ..... r ra...... rar .r w�NMr•..rrYw. ur.rraaT.rrrrw.tr.i...rrr•rr• . iz<��;s�'x'a� �1y1�1QR D'»�'Y.YI�i� o� 1�1�Q�.QSEA D1�y1��OPNlEIKT: , (Vo be fIlred to by b1dtVidH4f prvpo,Tfr19 develoPrnanV _.r�M/r.w..rWlrrr.a...rw�r.r..r...wrrr.err..r.�rrrurw..u.rrrr.ana+Nr.a.rrra..�+r rr.rw w-..�HMa/M (Information for FfarerV owvnerAppl'ying CWparian )?rnperty owner Yttformatto ) For 1?armi.,tl Q Pe Nftiling Address ,w Cltyy/gt�zi Signature rrhit or'IIype Name r� A at." v4A, ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIER/MOORINGPILRVG"OA7'L,IFTIBOATHOUSE) I hereby certify that I own property adjacent to _ 5 (Name of Prop rty Owner) property located at (Lot, Block,,tond, etc.) rV on C n_l . inr17�t1i1� ��-f , N.C. (Waterbody) (Town and/or County) wiling Address: 3Zd dlYA �r Applicaet'a phone #: �%� � � "uM AK He has described to me, as shown below, the dcvelopment he is proposing at that location, and. I have no objections to liis proposal. I understand that a pier/mooring pilings / boatiift I boathouso must be set beck a minimum distance of fifteen feet (15`) from my area of riparian access unless waived by mo, (£i you wish to waive the setback, you must initial the appropriate blank below.) gq not wish to waive &--4-114'2 wish to waive that setback requirement. DESCWPIJON A.NP/OR DI AWING OF rROPOSEI� DEVELOPMENT: (To be fIlled in by individual proposing development) (Information for Property Owner Applying for Permit) ,3,V 0 Ae Pe Mailing Address Mw AA / City/5tatelZi (Riparian property Owner Information) signature Print or Type Name 22q a 9 qr�a Telephone Number Telephone Number . icant: G e A ell , Permit #: ;vibe below the HABITAT disturbances for the application. All values should match the name, and units of measurement id in your Habitat code sheet. tat 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) Dredge ❑ Fill ❑ Both ❑ Other S -331 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 0 Fill ❑ Both ❑ Other ❑ 2964 Wjj21531 — — ----- TIc en tt ColsmoDate e tu orInd0H 0-842-F$ 148t1oS tc ?8412-W0 37 Supply he Dollars Order of COMPANY NP ND'["U9 Aj 0 For 1-.0005 qa