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HomeMy WebLinkAbout18157D - Page 4 1 10 1 CAMA AND DREDGE AND FILL • GENERAL 1:.d 018157 -3) PERMIT as authorized by the State of North Carolina Department of Environment, Health, and Natural Resources and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC `7(--t 1Z0—c Applicant Name wlI t a r F.• Pc " 'Jr. °A CI* Q Phone Numbe(713) 84a j7$ Address ?c, e m( City {F( Nre ht. (S41-Q.10 State N G Zip ZS3 7 '1-- Project Locatjon (County, State Road, Water Body, etc.) 1 oL c- ADJ/r&- lir—Cly / 6C e Type of Project Activity I c ( . ^ , PROJECT DESCRIPTION SKETCH n ` . ' (SCALE: ( It= '�-b / ) Pier(dock) length Groin length O f ID/ —;.... • c SET BA 4 number WI-PM o lti-i to 1OX($' 4'11H , RDM krl Bulkhead length RATCoe_M J max.distance offshore i • ^"� A Basin,channel dimensions C., .. cubic yards + oI� Boat ramp dimensions DCC Other t'Lhhg - in i Ilt laziA)(;4----t- to x13.. ' This permit is subject to compliance with this application, site drawing and attached general and specific conditions. Any _ violation of these terms may subject the permittee to a fine, applicant's signature 2 imprisonment or civil action; and may cause the permit to be- come null and void. ...._ r(3-6 k --- This permit must be on the project site and accessible to the permit officer's signature permit officer when the project is inspected for compliance.The applicant certifies by signing this permit that 1) this pro- S- I 0 — 5 91 I e)= 1 0 CT ject is consistent with the local land use plan and all local issuing date expiration date ordinances, and 2) a written statement has been obtained from adjacent riparian landowners certifying that they have no attachments {.,_,1 + 6objections to the proposed work. . . . , . ______ eir\ I. .. c 2-.6$_2(SS21 APPLICANT NAME: (Ai i(( a r-tA p,,a ADDITIONAL NAMES: AEC DESIG N;?T DEVELOP AREA: . ( PROJ DESC:? - /2 (WM only lake (Will only take I) ORK: j 6 4 l t O only take MAINT: (will only take 4) • IMP: O CO J.- (will only lake 6) ACTION EXPIRATION DREDGE&FILL REQUIRED: C_AMA MAJOR DEVEL REQUIRED: O "j �' e I & DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM Name of Individual Applying For Permit: �; i l ar c- F cap, Jr Address Of Property: //AO, )ctlf r7�. (Lot or Street #, Street or Road, City & County) 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, should be provided with this letter. I have no objections to this proposal . If you have objections to what is being proposed , please write the Divisions of Coastal Management, 127 Cardinal Drive Extension, Wilmington, North Carolina, 28405, or call 910 395-3900 within 10 days of receipt of this notice. No response is considered the same as no objection if you have been notified by Certified Mail . WAIVER SECTION I understand that a pier , dock , mooring pilings , breakwater , boat house , lift or sandbags 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. I do not wish to waive the 15 ' setback requirement. Tcycf Signature Date Al; -5/o A a',Kf r Print Name i ��. Telephone Number With Area Code DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM Name of Individual Applying For Permit: (,},'//arm f gr Jr. Address Of Property: 7/Og G �� cP0.,� ti Dc Lon aectc� ,tJ. G. (Lot or Strut #, Street or Road, City & County) I hereby certify that I own property adjacent to the above- referenced property. The individual applying for this permit has rig-.scribed Lo me as shown oii the attached drawing the development they are proposing. A description or drawing, with dimensions, should be provided with this letter. I have no objections to this proposal . If you have objections to what is being proposed , please write the Divisions of Coastal Management, 127 Cardinal Drive Extension, Wilmington, North Carolina, 28405, or call 910 395-3900 within 10 days of receipt of this notice. No response is considered the same as no objection if you have been notified by Certified Mail . WAIVER SECTION I understand that a pier , dock , mooring pilings , breakwater , boat house , lift or sandbags must be set back a minimum distance of 15 ' from my area of riparian access unless waived by me. ( If you wish waive the �-t. k >y mu st ; nit a1 the appropriate b1 ank below. ) to v.r...uv.., Y u .. .- � rr- -r---- - - I do wish to waive the 15 ' setback requirement. I do not wish to waive the 15 ' setback requirement. Si n ture Date - -A. t.Jn r /, Jr1 geCLC Print Name �.�._. 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