HomeMy WebLinkAbout77622D - Brake CAMA / 11-DREDGE & FILL N° 77622 A B
E 1NERAL PERMIT Previous permit#
(New. E Modification El Complete Reissue El Partial Reissue Date previous permit issued ID/Pli
:ized by the State of North Carolina,Department of Environmental Quality
.oastal Resources Commission in an area of environmental concern pursuant to I SA NCAC 7H r I 200
1::)Rules attached.
t Name Ge_oc 5L DLI(‘CI ...0.-Ir ey‘ gitke,_ Project Location: County gruthswiC
Street Address/State Road/Lot#(s)
004k-e., State NC ZIP sm,4(42 t (05 Walct ek- Po'N4 L cko'
E-mail___ 4kk, s,Thruel,h_&en Subdivision ..,...-•"' t/1/4) I c res_L
ed Agent Mc N.Q.xceAr, Rokri v‘12_ City co.4.14.r A- ZIP
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AGENT AUTHORIZATION FOR CANA PERIT APP4CATlON
Name of Property Owner Rem Permt elearett.,-+- Yat 'l. /" e
Mailing Address: 105' 2_1 \, Ry-sdL t 5
,vc :� ta
Phone Plumber:
Email Address: 77 vi4cAd.C 0""
I certify that I have authorized tACTATheti5 'L rat(i(\ 52"/t
Agent t
to act on my behalf, for the purpose of applying for and obtaining ail CAMA permits
necessary for the following proposed development: I n(S+A-t i to lc
at my propertyr located at (D52. I 1AJlt Of-et r - Lv' 56-
in Ns A' C-IC courty
I furthermore certify that I am authorized to grant and do in fact grant permission to
Division of Coastal Management staff; the Local Pens*Officer and their agents to enter
on the aforementioned lands in connection with evaluating information related to this
permit application
Property Owner Information:
FfleT=J
Print& Type Naive
Title
I
Date
!" t2 £N RIPAR PROPER t'Y t7wy1:R STAT -ME r
I hereby lty that I own propeity etlacent to '
Property located ad WO t e1 of Property Owner) s
Mahe (Add mast
Lx�
an G S Csrt,G(� r • Biaclk, Road,e�c,lG
41"
} ( own andlbr county) k-N C
The applicant has described to me, as shown below, the development proposed at the above location
1 have no objection to this proposal.
I have objections to this proposal
DESCRIPTION AND»R DRAMIINO OF PROPOSED DEVELOPMENT
(Individual proposing development must NI In description P below or attach a site drawing)
h51 i 1 I O lc. .•,a -f- ! ti- -
/YfinalaraaI understand that a pier, dock, mooring piings, bier,
abe set back a
minimum distance of 15 from my area of riparian access unlesswaived, by me.I(If you wish to wa,ve
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
(Proper.y t tnformatton� er Infontw )
re
Ai4
Signature
7thoo N E tNEGK6
yt.,t Le‘. Print or t Na�"e
44172 Mol t r, tt...A eD
r �,.......__ 1 sa l-%
Check
m(Name) Name of Permit Holder Vendor Check Number amount Permit Number/Comment. Reo•Ipf Or Refund/Reallocated.
mn3 Column( Column& Column& Column7 Column& Column9 •
Bulkheads LLC Dale Ardizzone Wells Farc 23505 $ 200.00 GP#77858D KE rct.10790
Kelly and Tano Faille Charlotte Metro 1719 $ 200.00 GP#77853D BB rct.11543
Me Construction LLC Linda Weber B8&T 5930 $ 200.00 IGP#76597D BB rct.11533
NC LLC Richard Reuhland BB&T 1117 $ 200.00 GP#76484D BB rct.11544 _
ist./Daniel Shirley Jordan Messick SunTrust 5365 $ 600.00 GP#76543D PA rct.10267
1st/Daniel Shirley Melissa Hardin SunTrust 5366 $ 200.00 GP#76577D PA rct.10266
LLC Rebecca Taylor Wells Fargo 1025 $ 200.00 GP#77835D PA rct.10269
ruction,LLC Kevin Driscoll Navy Federal CU 1167 $ 200.00 GP#76587D PA rct.10264
tpany Roger Hudson First Bank 1446 $ 200.00 GP#76544D PA rct.10268
ine Construction LLC Alison Marshal BB&T 5964 $ 200.00 GP#76487D BB rct.11549 _
same The Fidelity Bank 6413 $ 200.00 GP#76483D BB rct.11547
'actors Inc. Webster Trask PNC Bank i 8787 $ 200.00 GP#76477D KE rct.10792
ervices,LLC Perry and Darlene Mansfield First Citizens Bank 3433 $ 200.00 GP#76432D Ben rct 10299
ervices,LLC George and Karen Brake FCB __ 3432 $ 200.00 GP#77622D Ben rct.10300
it Gary Godwin BB&T _ 2002 $ 200.00 GP#76448D Ben rct.10298
:tors LLC Chris and Nancy Sweeney FCB _ 9243 $ 200.00 'GP#76436D Ben rct.10297 actors Inc. Pipers Neck 29,LLC PNC Bank 1 8788 $ 200.00 GP#76478D KE rct.10791 __
Me Construction LLC Beverly and Patrick Wright Rev.Ti BB&T 5951 $ 400.00 OP#76485D BB rct.11548
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