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Home My WebLink AboutBrown, Dorothy 77170Cl CAMA i DREDGE i FILL 77170 gENERAL PERMIT Pnrfous� - v» pew Modification Complete Reissue Partial Reissue Date previous p Wu*d __ -. As authorized by the State of North Carolina, Department of Errnronmenrnl Qualiry �/ and the Coastal Resources Commission in an area of environmental concern purwar,t to I SA NCAC d7i t 1160 -- - -' Applicant Name at Project Location: County On flow Address 6 Street Address/ Stare Road/ Lot #(s) tg5Rjve n ik L Cam- f �j*7 -- State VPJ � Phone #110)71Qf0S31 E-Mail Authorized Agent..Erindl Affected - CW w _�*A -AS PTS AEC(s): OEA "His __ W U6A WA ORW: yes ( fi6 PMA yes Type of Project Activity PW;don,w,au, __.4 _%c _ _ Fmed %d«mtst �jK � --_ Floating f�tatfpttrrtai __ weWth &A&- k ROW *Wt, r -1>- ¢- O&C yards tin — --- Beach _ r "vmtww Lwv& — SAV M`t se.a yrs no - a9o-�Nri:ez' Rsa YR m ��'tT Photra� Rs m - 1 {.- t Aar rzs A ceding per-im nosy be rerRra6 br i Note Local P mod7 sescial CQ asoets t •�*'-._ extaaar: �rosetaeinelpsssa �+-__. cII Stbdivisbn "'r any sue; Fey ry ztP / Phone # ( I ROW 8aeirt Adj. Wtr, Body New ►�*- I ✓ ah Closest Mai, Wir. Body f Jd )OC Sec ,isam, or bees � pr&'V it" Basra ^ies. t *4 ,',, CAMA r Ni(" 7 7 i f i A rc D gENERAL PERMIT ew Modifieatiou Compiete Re' `Pww "mue beta pr *Ued Ai authorized by the State of Norih Carolltta: Depwonent of E Mal quality aid d the Coastal Rmsourm Comm(ss' t in ut area of emk toocara P omit to ISA .�..... Appka awe rt#� ercNarne Project LKc+{GOn {./�FPfitY Address • - V-_ bfL'�Jift.. ^.�.'.. Street AddrosU Staot Road/ Lot #(I) I t(� r [A city, kA state¢~ f r, zIY t�l Phone A' (�I�)i�'��',,�t�n-'F E-M�hail (j Authorized Agent Efir� `f i W?. Llbf}' .) ('" C 104 Affeted CW aNW `�,F(TA 'AS PTS AEC(s): Of^ H"f IN URA :. t iA PWS. Type of Project? Actirity s -o of ;� 177 City f e� �x ZIP kit ^ } Phone # { } PA-✓ r kit h„ Adj. Wtr Body {r.16t45t Maj. Wkr. Rudy 5_�ir_ flV 1 .1 N AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: DO r6 mil" )V Mailing Address: Phone Number: 1J�- � 1 Email Address: U b awn 34�562 I a L6m I certify that I have authorized on n etf l n %i n � CQ 115-b f r hl 6 11) , — l Agent / Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: Lci lace 2XI5�11�_ at my property located at in an,�5160J_County. I furthermore certify that I am authorized to grant, and do in fact grant permission to Division of Coastal Management staff, the Local Permit Officer and their agents to enter on the aforementioned lands in connection with evaluating information related to this permit application. ((�� Property Owner Information: OD Gk� 331� Sig tune D n,r 1j G Al awn Print or Type Name pc�n� Title RECEIVED Date SEP 16 2020 This certification is valid through 1 1 DCM-MHD CITY � '"s' 'i?1, Ti ��. .. _..-n- � _.� s.': i,,.i } �. 1 'fie;• �. IS � I!7 _. .. __ � �Il R" ,r.d• . �. �It11 �YY'a� �♦J ,.��y r�. �:Y tz ,� ♦ r- }I c r A'r ♦ 'y .� 1 ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to Dort+ 1 U s property located at 1 `1 J E� 1 V e -Y '7 lyr _J i i I�-J (Address, Lot, Block, R ad, etc.) on I�l -LU �j \(2-lr ,in SL CA Ee%Y-V N.C. (Waterbody) (City/Town and/orCounty) The applicant has described to me, as shown below, the development proposed at the above t pll location. (47 TtO I have no objection to this proposal. y Doi I have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (Individual proposing development must fill in description below or attach a site drawing) WAIVER SECTION I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin must be set back a minimum distance of 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 wish to waive the 15' setback requirement. Die, I.0 149) 1 do not wish to waive the 15' setback requirement. (Pr�oopperty Owner Information) 'Valid for one calendar year after signature" it Property Owner 's4 / / / r G TaneNber/email address Date' (Revised Aug. 2014) I - L tar. jF-4 lv+ rt- 4.j Ltv If A4 A Oak. LIj I., I le"o, 1 r I'- IL .1 Lj let w1k. ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to D G n-H-) � C 2) rd (y j1 s property located at 1 `I J f2� I V e Y 51 GI C J r ISl C (Address, Lot, Block, Read, etc.) on�.in `ne, Eef rN.C. (Waterbody) (City/Town and/orCounty) The applicant has described to me, as shown below, the development proposed at the above to ation. tint Ql 6W I have no objection to this proposal. �)(1� I have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (individual proposing development must fill in description below or attach a site drawing) WAIVER SECTION I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin must be set back a minimum distance of 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.) �'t�l 11--Lk I do wish to waive the 15' setback requirement. D�� K W • I do not wish to waive the 15' setback requirement. (Property Owner Information) (A acent Property Ownne/r�II formation) Telep one Number/email address as Date* (Revised Aug. 2014) *Valid for one calendar year after signature* • -- -�� .�(„ - �I�al''. i� }I � .Ij F 'il I.!I I�', • �,,�, -L "�' • ��• 1} I � • y I.1 L� . ' �1 n'}I uSl " �1J Ii II ITS AU4siid J)r.