HomeMy WebLinkAbout54402 - Bird]CAMA / ❑ DREDGE & FILL
GENERAL PERMIT Previous permit #
New ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
wized by the State of North Carolina, Department of Environment and Natural Resources
Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
Rules attached.
it Name 01L'A6nA a �sa-7 Project Location: County PC il i> L �L
!�--> t-Z Street Address/ State Road/ Lot #(s)
Q F Gri State ►.) L ZIP 1 i v�% ; Jp j p. n „c•�— E�,
( ) Fax # () Subdivision
ted Agent
❑ CW aEW C�PTA El ES ❑ PTS
❑ OEA ElHHF /❑ IH ❑ UBA ❑ N/A
❑ PWS: ❑ FC:
yes /!no> PNA yes /® Crit.Hab. yes / no
mgth
ember
id/ Riprap length
g distance offshore
ax distance offshore
hannel
ibic yards
m
'JS oath
lulldozing
ie Lwgth
not sure yes r o
;s: not sure yes O
rium: n/a yes
Yes
Attached: yes
City zip
zipZB`'�l
Phone # ( ) River Basin
Adj. Wtr. Body ,-> l t -
Closest Maj. Wtr. Bodyl*;NZ
0.0 ME &I N N M N 040
ing permit may be required by: �� Q� �� Cy ❑ See note on back regarding River Basin r
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGSBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to C L &J O` R Fk (+ /3 y (Zlp 's
(Name of Property Owner)
property located at i t y w I K 0 S A M ih%'X 6
(Lot, Block,
etc.)
on C R N Att - , in -- t-r% , N.C.
(Waterbody) (Town and/or County)
Applicant's phone #: 33 (o ' L`tn "UzfMailing Address: P-b - R C6 k Z"t L
SCRF <<r r�L L8`f'j-4
He has described to me, as shown below, the development he is proposing at that location, and, I
have no objections to his proposal. I understand that a pier/mooring pilings / boadift / boathouse
must be set back a minimum distance of fifteen feet (15') 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 not wish to waive
I do wish to waive that setback requirement.
-------------------------------------------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
L���'i .� Lah��osb PLA-NF --
,5.F P/ZJ��FILI� C.��� 5L?TgACIC N.�R w«� �i L K'�=v-►�
--------------------------------------------------------
(Information for Property Owner Applying
for Permit)
Pt,' (3 '-* -L-12 to
Mailing Address
-------------------------------------------------------
(Riparian Property Owner Information)
(� N--�c 0 C.
Signature
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to C L NJ 0�2 R N4 (+ /$ "LIZ� 's
(Name of Property Owner)
property located at I 1 `I ua I µ6SAMMci
(Lot, Block,
etc.)
on C R h► h` , in N.C.
(Waterbody) (Town and/or County)
Applicant's phone #: 3 3 43 ' 4'tO -10WMailing Address: 0.0 - R C6 X 1-4 L(o
S'JA F C..
He has described to me, as shown below, the development he is proposing at that location, and, I
have no objections to his proposal. I understand that a pier/mooring pilings / boatlift / boathouse
must be set back a minimum distance of fifteen feet (15') 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 not wish to waive
I do wish to waive that setback requirement.
-------------------------------------------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
cs?LA�
�3 �A1 L! (` i .F Loh►rib 0 L A F .�
a ,P 2� �` f L l J 6 ►`i s e7 A A cA-
-----------------------------------------------------------
(Information for Property Owner Applying
for Permit)
P a a-�-L-1zto
Mailing Address
(Riparian Property Owner Information)
12 cj
Signature
i - - L)._.
f esr
PROPQS�'t^
L1,x i6 .
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N
ti J
l�,�1�,1►'� 5
C�N�
7 o.�h
Vol
611
cep �y crl iil.ndt,:�
CRBYRDIII
4203 W Friendly Ave 336-855-1060 %dw 7427
Greensboro, NC 27410
66-162/631
�ct.. BRANCH 77576
P8)• to the Date
order of 01
WACHOvrA �`—
Wachovia Bank, N.A. -
wachovia.com
For C1� �JT%�OOV � 1
':O S 3 10 16 26I: 106 204 2 1 2 16
33,16 74 2
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