76432D - Mansfield

Y`CAMA/ ❑DREDGE & FILL N9 76432 A B
§ENERAL PERMIT Previous permit# Q2/SIS,
(New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued nal
-ized by the State of North Carolina, Department of Environmental Quality 7' f I O
:oastal Resources Commission in an area of environmentalconcern pursuant to 15A NCAC n
(� ❑Rules attached.
t Name �P)•f�./ 0�"(4. ► W\(),U`Q- MAY\SCe' Project Location: County I w�$(NI C�L
�jp� ,, ( Street Address/State Road/Lot#(s)
S DU*ct,f\- State Nc., ZIP ' 8 ` lot 62SU 1,)6J61er Pod lap
(-4-''''-----' E-Mail .----"-- Subdivision s/...'--
ed Agent M(, Q‘11.1i,XSw" 11.A0.ri,n12, City So l>0(V ZIP 2 S146
❑CW Y.pw ) PTA ❑ES ❑PTS Phone# ( 90) `4 y 3 River Basin C F
❑OEA ❑HHF ❑IH ❑UBA ❑WA Adj.Wtr. Body `,'0.,a U-. ,c e... .I. -- r
❑ PWS: Iti V`.+ W
yes /) PNA yes / no Closest Maj.Wtr. Body
'Project/Activity _i_y<k0.A V r7G .- L tc -
(Scale: ' = ,
:k)length „7.
uform(s) / /4A / •
Platform(s) / ' qs / , .' ' Adill 1 1
ier(s) 1 `. i ir, I i I r
1 1 /1at4 CliC"'"..\
i/Riprap length ____ ,
distance offshore 0.rr
x distance offish re 01 IP °'Y M ,
cannel I �► �1 to • ,�5' • mf
II
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)ic yards _ Att,r;.ter._ mar, �a�t�
se/ oatlift I Z,X 1't ic......, i L.._._._.. f �.._... —..4•
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iIldozing tfra---- ti }
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Length 9.00‘
not sure yes ,� � .t ' I
cum: n/a yes o I (�__.._1 L,FiK
Yesg _ 9 IwN �
Lau'
\ttached: yes no '1, y I 1 {v a
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(
ig permit may be required by: ft.trSW tCA- ((juW'' I See note on back regarding River Basin n
Local Planning lurisdiction)r, ,. A --, i

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•
Check
en(Name) Name of Permit Holder Vendor Check Number amount Permit Number/Comments Receipt or Refund/Reallocated
mn3 ColumM Column.) Column.) Column7 Column.) Column9
Bulkheads LLC Dale Ardizzone Wells Fargo 23505 $ 200.00 GP#77858D KE rct.10790
Kelly and Tano Failla Charlotte Metro 1719 $ 200.00 GP#77853D BB rct.11543
rine Construction LLC Linda Weber BB&T 5930 $ 200.00 GP#76597D BB rct.11533
NC LLC Richard Reuhland BB&T j 1117 $ 200.00 GP#76484D BB rct.11544 __
nst/Daniel Shirley Jordan Messick SunTrust 5385 $ 600.00 GP#76543D PA rct.10267
1st/Daniel Shirley_ .Melissa Hardin •SunTrust 53661$ 200.00,GP#76577D PA rot.10266
LLC Rebecca Taylor Wells Fargo 1025,$ 200.00 GP#77835D PA rct.10269
truction,LLC Kevin Driscoll Navy Federal CU 1167 $ 200.00 GP#76587D PA rct.10264
ipany Roger Hudson First Bank 1446 $ 200.00 GP#76544D PA rct.10268
rine Construction LLC Alison Marshal BB&T 5964 $ 200.00 GP#76487D BB rct.11549
same The Fidelity Bank 6413,$ 200.00 GP#764830 BB rct.11547
actors Inc. Webster Trask PNC Bank •
8787 $ 200.00 GP#76477D KE rot.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 _
:il Gary Godwin BB&T _ _ 2002 $ 200.00 GP#76448D Ben rct.10298 _
:tors LLC Chris and Nancy Sweeney FCB I 9243.$ 200.00 GP#76436D Ben rct.10297
actors Inc. Pipers Neck 29,LLC •PNC Bank I 8788 $ 200.00 GP#76478D KE rct.10791
1ne Construction LLC Beverly and Patrick Wright Rev.Ti BB&T 5951 $ 400.00 GP#76485D BB rot.11548

AGENRAUTHORRATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: T?e,i'Y 6Dav E* -e. WirrA
Mailing Address: 105 I B clen :6- a Lin
1/ti.1W-a/4 rvC & t
Phone Number: q 14 'I 3o c
Emal Address;
I certify that I have authorized c mavt kv... .s .tlt/(ces
Agent I Centaractor
to act on my begat(, for the purpose of applying for and obta CAMA
permb
necessary for the following Proposed development; 1tW15ti 11 10)4
at my pity located at 1,f) ► ra W&lds.-.
inWnsw«le-County
furthermore certify that l am authorized to grant, and do in fact
grant
Oivts�ion of Coastal Management staff the Local Permit Officer andtheirr agents
to
to
on the aforementioned lands in connection with evaluating information related to this
permit application
Property Owner Information:
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O NER TA EM T
I hereby oerUfy that I own property adjacent to 4- 46,l ere— YY1Einc rc l d •s
property located at (,S I t Wcc c- Rylci L., °V 4 O h
on I Cry t Ic_. �'�d^� �sock.Road, secs)
aterbody) NW N C-
(ct[y�rTown andlor County)
The applicant has described to me, as shown below, the deveiopment proposed at the above location
I have no objection to this propose/.
I have objections to this proposal
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing chnitikipmsnt must fill in description b&ow or attach a sit**wino
9-.e. All-4644 dirAtiL2 i 5
1h i-a► 11 ©\c--pc bam--/
WAIVER SECTION
understand that a per.dock,
minimum diathate of mooring pings, breakwater, boathouse, lift, or groin must be set back a
the setback, you of ) my area of riparian access unless waived by me. (If you wish to waive
appropriate blank below.)
I do wish to waive the 15'setback requirement
I do not wnsh to wales the 1S setback requirement
(Property Owner Information) Millicent Prrope�r y)wnsr InTtfttnatTon))404
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hM described b mo.et show below.Mho develepsent emPoMd M th *bow beam
!hove ho**,marsb this propel*
art is MY proposal.
Adt�N� N IYIOIdt AM1MI Or_ PROPOSED
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