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HomeMy WebLinkAbout19802D - Dombroski *. AMA AND DREDGE AND FILL 1� 01 �12 —b = GENERAL PERMIT o as authorized by the State of North Carolina Department of Environment, Health,and Natural Resources and the oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC 7/-1. /2OU Applicant Name rl. T l O n Ijos k-, ) le- Phone Number gi0 4)7S'()9(-5‘3 Address 101 ToM AvOUC/ NO / City C.el t4)C l 0rt State/ Nv Zip acJ� '7Zy Project Location (County, State Road,Water Body,etc.) rl /O (uJ 0 u►r+1 i C A/IdW ,e k-. j-Ofcs -Dr, dP_,) , .Sne-nds RCir9 KW.) C�Aol W;C<<- Type of Project Activity Ne,,A) , 'I duct, ci f l0-A-1 y d oC L a14UAiS mAX m A 1 13r: rncu,red 0 -4-iN1, ] s-it v e4-ur,J E PROJECT DESCRIPTION SKETCH C-C,IA e\CI(4tiCk A (SCALE: ) Pier(dock) length (S O. X. N � 5' (J Zrie J V ■ Groin length aQi 1w' number A Bulkhead length 0 max.distance offshore Basin,channel dimensions Npcu cubic yards Boat ramp dimensions itt. Other 10‘ K o1C) ' . Co'w-red roc_ l _ V ,,( w;-v(n A (0 K )(� �. �; v V ."7ti f W J v et,,_ 71' Aorc.i°nr,.,, f 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, n Cear-e-44(c" ) /\ imprisonment or civil action; and may cause the permit to be- come null and void. o ' 1 rfal1C2-C)-- 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- (.w.dw l0 1g99 A-1,\;,Q 6, I�1 9"( 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 �1 12 o(} objections to the proposed work. attachments GENERAL PERMIT COMPUTER FORM APPLICANT NAME: .T . 1)o M3ros ka Jr . ADDITIONAL NAMES: AEC DESIG: P T/ E t t) DEVELOP AREA: _0 2- PROJ DESC: P _ 1 2. (Will only take 6) — (Will only take 1) WORK: p 15"0'X b ► n � 1 so,(Will only take 4) IV I x ea, o�O1 X I O' MAINT: ro5. (Will only take 4) By P: b t.J 75.0 01t) 9 Co (will only take 6) n (A) ao0 ACTION EXPIRATION DREDGE&FILL REQUIRED: I /6 /99 4 /(p q/ CAMA MAJOR DEVEL REQUIRED: [ c hxh 5 -, ..v.i;optt;Atir ti oiiord ^o3 140413 ,',4,� o 16 Z = % . I.Q0' pasvdo.�id /Z .66 of /zoo . 7791 -# f?9o'" 16 .fn•AYq •it,I d?.S s 5 v 1 `!s`to h • zwdc+u_. i . . . - 4) 9z•SE Y6,t! Li7d& 6N _ p,lp,r{{ Is ooe i K ,W S nillid 40 d01 rv0 AvoLs r � -- T S�� " s� ,�3s o�+d )1704 i A— --0 N.tJo.2 p (/ o r(a.Anti J1°'(.5 f?�d o lc 7E1 +• V Y79 �1,— a� iz i lob b ( 10 1 . E-yf-r-- ' E,9.4, w /2A —_....--------------7 A.; 5 4 �aU. - a ��l !. 1e :________1 ' . . ; DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORK Name Of Individual Applying For Permit: 4. T anc 6co.s ; J Address Of Property: .-o f /,42 ' C4 .4 /c. s Jei e 4'c/r ror-r-y (Lot or Street#, Street 6r RoaAs/oc‘Vi , y & County) I hereby certify that I own property adjacent to the above-referenced property. The individual applying for this permit has described tolie as shown on the attached drawing the development they are proposing. A description or drawing, with dimensions, should be provided with this letter. I haV:› objections to this proposal. Jf you have objections to what is being proposed, please_ write the Division of Coastal Management, 127 North Cardinal Drive, Wilmin5on, North Carolina, 28405 or call 910 395- 390() within 10 clays of receipt of this notice- No response is considered the same as no objection if you have been notified by Certified Mail NV RIVER 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 arness 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. • ctst)j I fir) nor wish to waive the 15' setback requirement. 41Ficsir • , Si nature Date idi r ��Name 79 6,z NCDENR NORM-1 C.WOUNA DEPARTME.Hr OF Telephone Number With Area Code ENVIRONMENT AND N4lJfiAL RESOURCES DIVISION OF COASTAL MAN4GEMDEN'T A S'FNT RIPARIAN PROPERTY OWNER N.OTWICATIONAVAIVER FORM • Name Of liidividu it Applying For Permit: fr,T. ti70 Address Of Prop,ty: /o f A?a ('Asia;c!( $6,,,es e.4.15 y 44Sf awn /� , /1��, (Lot or Street#, Street'or load, City & County) I hereby certify that I own property adjacent to the above-referenced property. The individual applying for this permit has described to itie as shown on the attached drawing the development they are proposing. A description or drawing, with dimensions, should be provided with this letter. 1,) I have no objections to this Po ro sal. P If you have objections to what is being proposed, please_ write the Division of Coastal Management, 127 Norm Cardinal Drive Wilmin5on, North_Carolina, 2E405 or call 910 395- ' 900 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' setb..ck requirement. I wish to waive the 5' st-Jack requu emeun. ila-AAS•-k U. /4 /IS) 9 Ar41,11?IrrA Sis.nature Date wit?' Print Name NCDENR 91 Telephone Number With Area Code NORTHOUNA D . i-OF ENVIRONMENT AND NATURAL RESOURCES FUNCTION=> A NEXT PERMIT=> GENERAL PERMIT ENTRY/UPDATE RRD16 PERMIT NO: GP19802 DISTRICT: I COUNTY: ONSLOW AEC DESIG: PT EW APP FEE: 50 . 00 REGIONAL REP: RUSSELL APPLICANT NAME: DOMBORSKI, JR, A.T. MAILING ADDRESS : 107 TOM AVE CITY: CASTLE HAYNE STATE: NC ZIP: 28429 LOCATION: CAHDWICK SHORES DRIVE WATER BODY: CHADWICK BAY LOCATION ADDRESS : (WHEN DIFFERENT FROM MAILING) CITY: SNEADS FERRY STATE : NC ZIP: DEV AREA: 0 . 02 PROJECT DESC: P-12 STATE PLANE COORD X: Y: WORK: pr 150 5 00 0 pr 6 16 00 0 to 20 10 00 0 0 0 00 MNT: 0 0 00 0 0 0 00 0 0 0 00 0 0 0 00 IMP: ow 750 ow 96 ow 200 0 0 0 ACTION EXPIRATION DREDGE AND FILL: 01 06 99 04 06 99 CAMA MAJOR DEVELOPMENT: MESSAGE: INV ACTION DATE, PF1=HELP PF2=MAIN MENU PF3=PERMIT MENU PF4= PREVIOUS SCREEN PFS=ADD NAMES ATD CONSTRUCTION CO., INC. CENTURA BANK 16 9 2 910-675-0983 WILMINGTON,NC 28401 107 TOM AVE. 66-85/531 CASTLE HAYNE, NC 28429 PAY TO THE n J 5.4, r ORDER OF LS] /�tr11 DOLLARS l ATD CONSTRUCTION CO.,INC. r I MEMO _ AUTHORIZED SIGNA E PR • "I'0 L690 20 1:053 vial 50i:02 ? 2 L340960 - - -- -- -- �''P ��{�C� u SECI�HITY FEA'fIIUES INCLUDED.DETAILS ON BACK.n