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: [
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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
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6N
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S nillid 40 d01 rv0 AvoLs r � -- T S��
" s� ,�3s o�+d )1704 i
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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