The URL can be used to link to this page

Home My WebLink About56535D - Smyth'ICAMA / TDREDGE & FILL GENERAL PERMIT Previous permit # �NeW, ,Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued )rized by the State of North Carolina, Department of Environment and Natural Resources h �/ Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC //�• ��OG EETMles attached. it Name Z Z UR G !'1 % Project Location: County Ed u ,4S IV/ c /( Street Address/ State Road/ Lot #(s) ,Sf9,-2 t State ZIP (- - -)-- __ 2 Fax #( ) ed Agent _ f �'�/-; Id d2aHo �. CW ❑ EW ❑ PTA ❑ ES ❑ PTS r' OEA [❑ HHF IH ❑ UBA ❑ N/A PWS: ❑ FC: yes / no PNA yes /� Crit.Hab. yes / no Subdivision City ZIP Phone # ( ) ^^River Basin L 4, Adj. Wtr. Body ,,4 ,a L tt / �y �y (nat Closest Maj. Wtr. Body /91 w G✓ Project/Activity /YPw %�,Q�vAI1Q Woocip✓ ��L��pAd OF Repe„ove le-'JI rp (Scale: / . LA ■ ■■■■■■■■■■■■■�■ NONE ■■■■■■■■■■■■ ■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■ ��r. ... MOMMM�IIIIII�01�AI/■1MENOMENE MMM�■ ■■■■■■■■■■imr■s iJmamo■■■■ ONE ■■■■■■ ■■■■■■■■■■■■■N■■■■■■■■■ ■■■■■■■■■■■■■■■ ■■w■■■■■■■■■■■■■■ MEN ■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■m■■■■■■■■■■■ ■ ■■■■■■■■■■■■■■■�■■■®■■■■■■■■■■■■�■ ■■■■■■■■■E■■■■■■■■■w■■■■■■■■■■■■■ CI EN 1101:IN MWIN=111=1=.1 IMMUNE :i_ ■■■■■■■■■■■■■■■� ■■■■1■ �■w�l�w�■■w®■■� ■■■■■■■■■■■■■■■�■r:�■■per■lsiiGi�■�R,i��■Il■� ■■■■■■■■■■■■■■■�■ 111■�Ir71�i�rM�/�!Q'i►WINE IN NO-W.21111111 rll.jml ai.mmmm■■■■■■■111■ii�i■■■■rww=== === ■■■■■■f MMIN ■■■■11■I■m■■■■1 liu7■■■■■■m ■■■■N 111■■■■ . ■ 11�1■■■ w��iw� ��1�! �w�� Jr�'liMm■■■■■ �/Q ■■■■ or I1J M■■L i N� �: i i�i M r■ iM i jB BSI �1 in ■■■�if�i1■■■ 1 C�� I■1 H ■11■� NLLMII 1■� ■I■■■■w■■■ ■■■■■■■■■■ 111101131111111111111 O■■■■■■■■ ■■■■■■■■■■ 11■ MT 1■1 w ■11■I■11■I ■1 ■■■■m■■■ ■■■w■■■■■ l i■ ■ 1■i q ■11■I ®I■11■I ■I N■■■■■■■■ • ■■ ■■■■■U ii■■■■■■■■■■■■■■w'i L'■■■■■■■■■ ■■■■■■■■■ ■■■■■m■■■■■■■■III ■■■■■��■■ ding permit may be required by: 7wp `d/,o„/s 4 Arq.1,1 El See note on back regarding River Basin 800-845-1120 Holci m ,nnnw.holcim.us /9 % :5�Ord �� -Drtae- C) A Pr►�o v o IL►�ct � l b �� as 4-1 P Sp&,'5:5; NCt��NR North Carolina Department of Environment and Natural Resources Division of Coastal Management Beverly Eaves Perdue James H. Gregson Governor Director Dee Freemc, Secreta AGENT AUTHORIZATION FORM Date: dame of Property Owner Applying for Permit: N me of Authoriz Agent for this project: Dwner's Mailing Address: i4b Phone Number (q i u) Agent's Mailing Addres.: .Phone Number. I certify that I have authorized the agent listed above to act on my behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to install or construct the following (activity): (my property located) at This certification is valid thru (date) e Property Owner Signature Date ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to t��s (Name of Property Owner) property located at .'95 54�0 r'd A", In __1) f— (Lot, Block, Road, etc.) On I � le+ 4. ar141 yin (4D1C��°/1 �PQc1-•—.�runs��,�1^�rN.C. (Waterbody) (Town and/of County) Applicant's phone #:91 D- 84.2- 2y7d Mailing Address: / 9 / He has described to me, as shown below, the development he is proposing at that location, and, I have no objections to his proposal. ---------------------------------------------------------------------------------------------------------------- DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: (To be filled in by property owner proposing development) 00 -------------------------------------- (Information for Property Owner Applying for Permit) (Riparian Property Owner Information) Mailing Address Li T 61 S ignature .. bu►ue-K ADJACENT RIPARIAN PROPERTY OWNER STATEMENT � 's I hereby certify that I own property adjacent to--- (N me f Property Owner) property located at LY �__C4 W (Lot, Block, Road, etc.) �. , in �� ! ,-N.C. on — (Waterbody) (Town and/or County) Applicant's phone tt:9 16- tMailing Address:_ g / ZY (Od He has described to me, as shown below, the development he is proposing at that location, and, I have no objections to his proposal. ----------------------------------------------------------------------------------- DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: (To be filled in by property owner proposing development) --------------------------------------------------------------------------------------------- (Information for Property Owner Applying (Riparian Property Owner Information) for Perin it) Mailing Address Signature 1 1, 1 J-.,-�,) o H ,.I- A i P- -)& q 6 L licant:* L- Z- vg /15�a6- s, y71y Permit #: 3� / ) 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/( temp impact amount) Dredge ❑ Fill- Both ❑ Other ❑ /L Dredge ❑ Fill ❑ Both ❑ Other J-0 s 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 ❑ 2670 E. MAE SMYTH 'l I, 66- 12 151531 C / PH:910-842-2470 Date 840 191 SWORDFISH DR HOLDEN BEACH, NC 28462',; (3 C $1�LUb� Pay to the N Order of —Dollars Golden Regal W WACCAMAW BANK C-IP aI�GC Supply, NC 28462 6P www.woaovwwbank For i:053 112 5 21:8000 L6468511'0 2670