HomeMy WebLinkAbout53936D - Warner CAMA / DREDGE & FILL F-'
GENERAL PERMIT Previous permit#
fclew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
orized by the State of North Carolina,Department of Environment and Natural Resources
• Coastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC 7 f" /- ('G
-Rules attached.
:nt Name i.: , c 4,9 e L. lAid9 a ,✓ P,C Project Location: County TER y i.Sc✓j c k
's f''''z pr1/ pS 7 S r L E^i Rd. Street Address/State Road/Lot#(s)/ L/_ L /c,
LCr+.5444A StateAjC_ZIP 2 7y!e
# ( )3) 2 -2 y t. Fax#( ) Subdivision
ized Agent City, °Ail L..(,,,_ 5,F9c A ZIP Z 7 L
_d Cw EW ETA L,ES PTS Phone# ( ) River Basin L y A
OEA HHF IH E UBA ❑N/A 7
): Pws: FC: Adj.Wtr. Body Cfy,,,,9 i a //i i" (nat
Closest Maj.Wtr. Body /9! II.)Galyes / no PNA yes / no Crit.Hab. yes / no
of Project/Activity n d d Li,„, t 4---1 rf f c., CX 1 S1L,,v." PR,Y9.1 c 2)G GEC
(Scale:
dock)length c,e(sit",
rm(s) —r - —
pier(s)
length i
number ,
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ead/Riprap length I
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avg distance offshore i �""� C�/ ^�9 Z
-nax distance offshore
channel
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amp
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ine Length $O . .. ■=1.1MI MEIMI EIMANINIIIIIIIII__
s:
g no sure yes
a not sure yes �_.. _.---
xium: n/a yes no II- �11
yes no 0 �4 ,• 4 ' • /O 1 .. {.'
Attached:k1 yes no I 4 i 4 1) d14 1 "
ling permit may be required by: /lb L d p,-, ,e'Q c 4 H See note on back regarding River Basin
,LSnpeial Cnnditinne .1311 _ . / I. _ 4 '71./ ,e -,- - . ,- . .
09 08:21a Ron Skubic 1-208-567-1640 P•2
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09 08:21a Ron Skubic 1-208-567-1640 P.3
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PI R,MOORING PILINGSBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to t k l�&ipo/C ti 1,*(4e1)ci
- • (Name of Property Owner)
' �
property located at �q 7 k...1 CAP
CN\) AL
(Lot,Block,Road,etc.)
on .rCU) ,in 4S`dP ?, C, 1 ,N.C.
(Waterbody) (Town and/or Count)
Applicant's phone#:33 t Z L ci 1 Mailing Address: j4 'Pq
) ,-8e t t
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 thata pier/mooting pilings I 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
J
e ca 'l �P�177 T do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
(Information for Property Owner Applying (Riparian Property Owner Information)
for Permit)
143 1 wrva -) a4m11/
J`1 ,..f 4-S,CW
MailingAddress �/ Signature
'c +.0Jr, ' L!•)u •(.. ,L I"llluh tut1L ^r} tc Alm; (9ti4
City/State/Lip Print or Type Name
09 08:21a Ron Skubic 1-208-567-1640 p.4
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/M00.R NG PELINGS/BOATLIFTYBOAT IIO USE)
I hereby certify that l own property adjacent to 1Iw,U 11
(Name of Property Owner)
property located at \43 LICP D ?O .O
.Rp AL0C
(Lot,Block,Road,etc.)
on C,U� 6 �
,in \- ' it \ .t_ 1" ,N.C.
�
(Waterbody) (Town and/or County)
3.422S\ 1 i .. o
Applicant's lone -
t Mailing Address: \.cQJ \ BCPc 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 theta pierlmooring pilings/boatliftI boathouse
must be set back a minimum distance of fifteen feet(15')from my area of riparian access unless
waived by me. (Ryon wish to waive the setback,you must initial the appropriate blank
below.)
/1 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)
TT ""N wr`
-------------- -
(Information for Property Owner Applying (Riparian Property Owner Information)
for Permit)
IA 3 LI *-cr,
Mailing Address
Signature
City/State/Zip / Print or Type Name
"3"-Z . -7gQ.1 910 542-6570
JANET L. WARNER 66-85/591 3 712
MICHAEL R. WARNER 0413003859
LIC. 6489459 �,,p
4602 FOREST GLEN RD. PH. 855-0269 DATE 10 In\v 1
GREENSBORO, NC 27410
PAY TO THE q
ORDER OF N �! I s. �°
WO un(11.12sA � ""'v& ¢C \ DOLLARS
RBC
Centura
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