HomeMy WebLinkAbout78779A_Tchclekian, Kevork_20201106# ix
9 L/CAMA / 0 DREDGE & FILL N9 78779 B C D
GENERAL PERMIT Previous permit
V" 7-IModification Complete Reissue -.:Partial Reissue Date previous permit issued
As authorized by the State of North Carolina. Department of Environmental Quality
and d-ie Coastal Resources Commission in an area oferivironn-wental concern pursuant to 15A NCAC
_4RA'Aft
Applicant Name,_YeSt,-rJ<_
Address 3_4-ci-
City_SQA��trl_,S
Phone* E-Mail
OCW OIEW W'PTA OES YM
Affected USA ? 1WA
Oc" OHHF 0*1
AEC(s)� I
0 PWS.
W ORyes / nno PNA R/ no
Project Location: County_ Aw'.,
Street Address/ State Road/ Lot ft) 3 J hap Lae,&
SubdMdan
clty_Gc r,�S ^t ,� ZIP
Rx" * (—) River Basin ±qji,,�,_-
A4 Wtr, " C.,J_ b2 &4,
Cknest Mai, Wtr.
Type of Project! Activity _AJUj I
16 1
{Scoam T
Pier (dock)
Fed
_T
4 -
Pladwrn(s),,
Floating Pladorm(s)
4
Finge-rp—(s)_
4�_ t
Gmin le wh
rtumber
1-1
BvikNead/ 44Riprap
4,_a_r
4
avx distwxe offshore
_4
max distance ofthors
-4
. . ........
Basin. charmed
+ 4
cubic yards
goo
Boat rwnp
47,
S4
+
Beach Wdox
: 1 A
Odw
" 4
Shoreline LwIth
.1 T
SAV not sum Yes -4 1 1-
It
+
Moratorium: Yes no A
Photos no
Oy-
Wawer Attached! Yes
A building permit may be required by: See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction)
Notes/ Special Conditions (kAkL-_J g&q&
-9x4 ti.& 4. Jefize
Sig ""'P#istrsadtomplht+�s an afpamtk'°'�.
Appilcation FeWs) Cheek 0
V",
N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date O
Name of Property Owner Applying for Permit:
Mailing Address:
ed EKU::�
ShC)K - tJc. `1� `�1
I certify that I have authorized (agent) aRj 1't� to act on my
behalf, for the purpose of applying for and obtaining all C^^Att M--A Permits necessary to
install or construct (activity)
at (my property located at)
This certification is valid thru (date)
Owner Sipature
Date
■ Complete items 1, 2, and 3.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
_or on the front if space permits.
1. Article Addressed to:
l!ORV-) M(J(eNk Ven
I
bUrc SPA 1LA1)11
1111111111111INS 111111111111111ill ill I'll
9590 9402 6011 0069 6670 11
2. Article Number (Transfer from service label)
7020 0090 0001 7618 0755
PS Fans 3811, July 2015 PSfJ 7530-02-000-9t)53
■ Complete items 1. 2, and 3.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
_or on the front if space permits.
tL. lcle Addressed t0:
',7)L(YAyCi
'�� � } ❑ Agent
_ � . \ to ❑ Addressee
B. [P�eived by (Printed Name) C./Dante of
D. Is delivery address different from item 1? 0 Yes
If YES, enter delivery address below: 4-No
3. Service Type
-: Pnor,� Man ExpressA,
LI Advt Sk}r>sture
i=: Registered MaO711
G Adult Signature Restricted Delvery
G Reastered Maii Restr cted
QCertW,ed MaitD
Cieii.er,
f7 CarMW Mau lYoWncte7 Delivery
❑ Retvrn Receipt for
D Collect at Delvery
M "Oandise
ZI COWct on Delvery Restricted DBuv" 0 &9n3ture Gmtfmmation""
ihsuW Ma!
G si nature Confirmation
Matt Restrcted Delivery
Restrcted Delivery
Domestic Return Receipt
A. Signaturb
X l f _ -- ❑t
S. Receives! �e , J C, eat Deli
D. is ery address d,fferer�t Nqn item t? O Y
If YES, enter delivery address below: [f No
1i111 �f 111I �111111N I�N1111111I11111� 111111 3. SerdW iceSq Type >i P^arty Ma6 Express�t:
C1 Adult Siynrdure Re�st� Mak'�'
Ma009 Rest f.ted Dine y Mail Restricted
Reirvery
9590 9402 6011 0069 6670 28 Q Cawsed MW Restricted Doh wy ❑ Return Rat to
❑C VO&onD&Weiy Merchandise
7020 0090 0001 7618 0779 -m Der VeyResicted ' `'" dr®co,trma•`,�
L: S"ture ConfutnaGon
VW Restricted DdNery Restricted Delivery
PS Form 3811, July 2015 PSN 7530-02-000-9053
Domestic Return Receipt
r
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION FORM
CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERED
I hereby certify that I own property adjacent to S3�T TLC `c 4 ekldans
(Name of Property Owner)
property located at
�^ c1 (Project Sibs: AOd'dress, Lot, Block, Road, etc.) C ��9 , ,
in ��1( c w ..ti �,+-
(Waterbody) (CitylTown and/orCoun
Agent's Name #: [� ,�Y� l 1 a r 1 it Mailing A dress: C' /�%v q 7)-
Agent's phone #: .5 f .� C 21 C 1(�
He/She has described to me as shown below the development he/she is proposing at that location,
and I have no objections to the proposal
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must fill in description below or attach a site drawing)
J S
CLA�- Ov-c r wO�..r- `�
C;ve.r VLn 1
If you have objections to what is being proposed, you must notify the Division of Coastal Management
(DCM) in writing within 10 days of receipt of this notice. Correspondence should be mailed to 401 S.
Gruen St., Ste 300, Elizabeth City, NC, 27909. DCM representatives can also be contacted at (252) 264-
3901. No response is considered the same as no objection if you have been notified by Certified Mail.
(Property Owner Information)
*nature
-i�g-n-a`Ta
Print or Type NameISU --�
l�
Ctty/5teftq* )
q 0'�,) 11 r C�
Teiephone'Number / Email Address
'11hid for one calendar year after signature'
(Adjacent Property Owner Information)
Signature'
Print or Type Name
Aftftg Addraaa
Cily/5f�s2ip
Telephone Number / Emad Address
Date'
Revised Jan 2017
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