HomeMy WebLinkAbout53116D - Wallace ;AMA/ ❑DREDGE & FILL e
ENERAL PERMIT Previous permit#
Jew LIModification El Complete Reissue ❑Partial Reissue Date previous permit issued
:ed by the State of North Carolina,Department of Environment and Natural Resources
,astal Resources Commission in an area of environmental concern pursuant to 15A NCAC 7/4/• 2 oa ipxures attached.
Name 1.49 t7 g k./
1Q/ I ACI- Project Location: County Oa y-✓.sti,ic%
/ //6, i i C Xe 17 i2- 0> e 'c/ Street Address/State Road/Lot#(s) / Z.,/N/e,.; S,
2(L /f.4c,nr State/7'C ZIP .2?o 7J—
O� Subdivision 77/-7246 Fax#( ) ZIPS Py�
:d Agent 11c t. Y L 1 4.5- City r( / #. 1.s L e ,9cA Y
I CW ❑EW ❑RZA LIES ❑PTS Phone# ( )
River Basin
❑OEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body ,'u A L O if i/iiiw (flat /err
El PWS: ❑FC: / L✓6✓
Closest Maj.Wtr. Body
res /;no PNA yes / _ Crit.Hab. yes / no ,%�
Project/Activity fly/A t f. L' '5 T,% �C iQi .1 tte f/a A', )r;c/c" 7 (/ ' P.-2 s
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ier(s)
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Tiber �� f WO I1 L
d/Riprap length 111111111= Val MINFTWEll111�
distance offshore —: � L Aix distance offshore —IL. f
cannel P_�'Aw MI Mini
bic yards ii4UJII] iIgj
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Tip -111=1111.111111.1111M1M111.1 --
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ne Length ii'
1frMerriIMIMI-es `_ho gs: notsure yes o EMEM■■—.M.
xium: n/a yes 7-no' 'F �� ��i�raM ■
INIMIIIMINE
yes C`r_ :, + . �aa�___ a '
IIMENIE
Attached: yes �`7ro
ding permit may be required by: 0C4tFrt., ...-r-i`i 6/,,c 4 . 1 !See note on back regarding River Basin
;/Special Conditions /02.4 _ 2 VI(Sy-L1 A/lo,.✓e d At "I/LI 7!/rJC"f. S7 Z I1C74/,-e 5 P2 t1 5-4
CLUTT R BUSTERS 7048883112 10/08/08 07:53pm P. 001
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P�c:th Carottna Crportrrlent( r.vl'rr ier.r and Nexa: 1=.&sxrcei
blvis+on of Coastal Management
:'"Nei, ;:_as! .Gown Gownv ,lamas H G;p4ott,Vrector 1'c'd`lam. Puss_" ,e,:rerlr,
Authorized Agent Consent Agreement
,j, e /_„ ell.5s f ,s tNereby 31.4N:i Zed to act on my beha 1
Pe'n a Nor* r A.e':t
raer tC oCtaln any CAMA aermit;el required fcr the proper), rated tje+aw The a:rtr c,r:iatlon is eiTfltra to the
cifi: a:trvit:es deserted bed ;n the attached sKetvh
:ATION OF PROJECT:
// 11 57
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?PERTY OWNER MAILING ADDRESS
c_ °
.. .� PHONE NO. 71-'Y ?2 L 210
rHORIZED AGENT MAILING ADDRESS.
�±LS'_....,1.,.....L.z!1--_..2-..ff`l. ;z _
—_...__________.��..__.. PHONE NO __ y�"�J1Vic? _� 3
-,ature of Property Owner _ _ __
Nature of Autnonied Agent , � Clv�r.a �
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY O\'‘ NER NOTIFICATION WAIVER FORM
Name of Individual Applying For Permit: jay L) C U(
ti
Address of Property: f ( 7) 11 () u
(Lot or Street#, Street or Road)
_LOC 1161 L Ail A _ ZL 1,4 „U4.7tek
(City and County)
I hereby certify that I own property adjacent to the above-referenced property. The indivic
applying for this permit has described to me as shown on the attached drawing the development t
are proposing. A description or drawing, with dimensions, should be provided with this letter
I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coo
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-3
within 10 days of receipt of this notice. No response is considered the same as no objectih
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier,dock,mooring pilings,breakwater,boat house or boat lift must t
bck a minimum distance of 15'from my area of riparian access-unless waived by me. (Ii
wish to waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
Date A� a _ 'A
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WESTERN! IMONEY INTEGRATED PAYMENT SYSTEMS,INC.-ISSUER
UNIONI IORDER Englewood, Colorado
08- 967068598
AGENT 333286 DATE 101408 .'-`11 AA' 82-40/1021
'TIME 1401 02
089670685985 LOCATION 00314 --10 *:3*
PAY EXACTLY TWO HUNDRED DOLLARS AND NO CENTS *******1434:0
PAY EXACTLY
PAY TO THE
ORDER OF /VC 0 giv # ,
( yv-4,0 hili.AS-HtaR'llrflgo/ / 1"-)fryg 7 yr-
FURCnAtteR,8.N! FOR OlieWeR
PU A BY SIONING YOU PORI!TO TATUM ON TM!MYERS!SIDE
Western Union Money Order end Design is a service mark of Western Union MOldingS,inC./Peye:de et Wells Fargo Bank n notion-Downtown,N.A.,Grand Junction,Colorado
I r—s Inn' nno t_nngqP, 71168 598 so -4;
SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
IN Complete items 1,2,and 3.Also complete ature
item 4 if Restricted Delivery is desired.
II Print your name and address on the reverse / I. ❑Addresee
so that we can return the card to you. B. Received ., (Pri ed Name) C. Date of Delive
• Attach this card to the back of the mailpiece, , JC _ _0Y
or on the front if space permits. 0 A- i. -l. /
D. Is delivery address different from item 1? ❑Yes
1. Article Addressed to:
c.- t If YES,enter delivery address below: 0 No
t7etiLiv?..) ,k.._—
'L 1104 �'1 0- (� 3. Service Type
f / �? /6 "7 0 Certified Mail 0 Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail 0 C.O.D.
4. Restricted Delivery?(Extra Fee) 0 Yes
2. Article Number - -
(Transfer from service label) 7007 3020 0001 5068 4676
PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540
SEND R: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
0
,1 Complete items 1,2,and 3.Also complete A. Sig re
item 4 if Restricted Delivery is desired. X 0 Agent
• Print your name and address on the reverse ❑Addressee
so that we can return the card to you. B. 4ceived by �rinted Name) �`6• Date of De ivery
• Attach this card to the back of the mailpiece, (
(62'g�7
or on the front if space permits.
D. Is delivery address different from item 1? ❑Yes
1. Article Addressed to: If YES,enter delivery address below: 0 No
f' I( ) ty,� a/fGivll f w�
?J` 6 P.c. LO1 fici 3. Service Type
l ��y� —JS °1, ill(' ❑Certified Mail El Express Mail
�lJ / yx 1/D(( CI Registered 0 Return Receipt for Merchandise
OI ( ❑ Insured Mail ❑C.O.D.
4. Restricted Delivery?(Extra Fee) 0 Yes
2, Article Number
(Transfer from service label) 7007 0220 0001 4610 2051
PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540: