HomeMy WebLinkAboutGrass, Michael 73943CAMA / ❑ DREDGE & FILL No. 73943
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�NERAL PERMIT Previous permit# A B D1
�qw ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As authorizeAy the State of North Carolina, Department of Environmental Quality -7# ll ( ) i and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
j CJRules attached.
Applicant Name ' { �( .1' t i Project Location: County ( re r e-
Address / �; ('' / ' i Street Address/ State Road/ Lot #(s)
City ;',/ o / State ZIP
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A building permit may be required by: M o 1. - ❑ See note on back regarding River Basin rules.
( Note Local Planning jurisdiction) / - r %
Notes/ Special Conditions- � %' (r t I �C �n�. '- �� u /1 I r 4' 1 c I /ii
Agent or Applican(Printed Name
Sig turn ** Please read compliance statement on back of permit **
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Application Fee(s) Che {5
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Date
ANIA / ❑DREDGE & FILL No. 73943 A B ! C , D
ENERAL PERMIT Previous permit# �>
w ❑Modification ❑Complete Reissue ❑Partial Reissue Date pre+++vii---o---u���s )permit issued
As authorized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources Commi ion in a area o environmental concern pursuant to 15A NCAC (�
/� f /' �ules_attj�hed.
Applicant Name ( t � 1 Project Location: County C�GYTe.
city /VL v rf c
Phone #
Authorized Agent
ref Street Address/ State Road/ Lot #(s)
27�G2 0 /06 puAC
Affected ❑ CW ❑ EW El PTA '7tS ❑ PTS
A
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❑ PWS:
CIRW: (yes/ no PNA yes (no)
Subdivision
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Phone # ( ) ver Basin
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Agent or Applicant Printed Nam
Sure ** Please read compliance statement on back of permit
I**
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Application Fee(s) Check #
CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONNVAIVER FOR r r
Name of Property Owner. 4'Y () _ 1- s (',p1 Rr / '
Address of Property:
My 50�, ir. eY I'e
G, (Lott or Street#, Street or Road, City & County)
Applicant phone#: 0✓�- 3 `T -a9f1 Mailing Address/ EWd S044
t—w re l7
I hereby certify that I own property adjacent to the above referenced property_ The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing. A de scrinti n or drawing, with dimensions must be provided with this letter.
--V—/I have no objections to this proposal. I have objections to this proposal.
lfyou haveobjections to what is being proposed, you mustnotify the®ivisionofCoastalManagement
(DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is
available at www.nccoastatmangementneticontacf-dcm.htm or by calling 4-888-4RCOAST. No
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, or lift 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.)
zI do wish to waive the 15' setback requirement.
I do not wish to waive the 16 setback requirement.
(Property per Information)
�. ' �aa
Signature at
�✓ cJOh% � � �II//
Print or Type Name %1 b�n l S `fig
for so�h���r. J ✓✓
Mailing Address
t--mPr�,61 UlP RIC X511
C%ustatemp
Telephone Number
,2292 IN
Dale
Signature
wcvae` Gtress
Print or Type Name
�bLl(�(n SG0.k(A Qri�
Mailing Address
City/statemp
0111 `i
Telephone Number
3
Date
CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONANAIVER FORM
Name of Property Owner: Nk i (- Cc. A ` , M-Y T-
Address of Property: `b Ll0 U 5 c HVA \�) r `Ve; C h z ��u� Z1� �([ 'I
(Lot or Street #, Street or Road, City 8 County)
Applicant phone#: CIM--lilt—U19 Mailing AddressS.CQ yjte 'Vzy j ill
lAe W lick M �k C
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions, must be provided with this letter.
I have no objections to this proposal. _ I have objections to this proposal.
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. Contact information for DCM offices is
available at www.nccoastaimangement.neticontact dcm.htm or by calling 1-888-4RCOAST. No
response is considered the same as no obiect/on If you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, or lift 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.
J
I do not wish to waive the 15' setback requirement.
Owner Information)
Signature)
MiCl 'g\ (;'1eSr'
Print or Type Name
5 U W-e gVtr Tr-AtA
Uniting Address
1\1e W
City/State2ip
%5'-
Telephone Number
31S
Signature
Z)4Nrel I? Cu34r"C
Print or Type Name
Mailing Address
6,, pie%/ 1's/'-, yc zsr57y
Crty/State2ip
33 C, -- z53 — y65 Z
Telephone Number
3A lze;ih
Dare note