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Home My WebLink About20014D - Ulisnik 4 .4 • CAMA AND DREDGE AND FILL * GENERAL N c 0200'14 — PERMIT as authorized by the State of North Carolina 0 Department of Environment, Health,and Natural Resources and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC '7/-1 . /2-00 Applicant Name tA)Ay 1J E U I I5 (1, K Phone Number 0)1 U 0(4,L1 Address LH— `1U\-.P S Rr)f\d City 41(1 re*S- r-1 State Ii(J Zip Project Location (County, State Road,Water Body,etc.)�e^C!r" (O U )4-1 i L+17 'f Ucl hr Y�-or 1 d -�-\_A•rnP' A . NO , N1',\1 Zte� ...d Type of Project Activity NCt I) (,U'1 C O`J�f r C i l'JGr1 t if-+ 10 1 X I 2 I PROJECT DESCRIPTION SKETCH (SCALE: 0(yT- ru ) Pier(dock)length Groin length number ! 1 Bulkhead length pcok)c)Se Gl �—� AG 0 [Arc ov -c ed max.distance offshore l Ps GX,S{,r•c1 Basin,channel dimensions r ( ali DU C I 1Yi5 1rvA. V.0cubic yards CO Boat ramp dimensions y Other i C"L r�rll (�121 V \% V ;% kncovcFt y y 4 y 4 y 1 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, J�{ /� imprisonment or civil action; and may cause the permit to be r applicant's signature come null and void. it r 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. r� �^' The applicant certifies by signing this permit that 1) this pro- ( ,C� ) 1 r'1-(ct l�-^�C- zo , 1-t99 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 (7 f1 I2OO objections to the proposed work. attachments 7Y, GENERAL PERMIT COMPUTER FORM APPLICANT NAIvE: W I(/ ADDITIONAL NAMES: AEC DESIG: p T Elk) DEVELOP AREA: .002 PROJ DESC: P - 12- (Will only take 6) ---- (Will only take 1) WORK: b L I o$ I ' - (Will only take 4) MATh11T: (Will only take 4) IMP: C) (A) (2a (will only take 6) ACTION EXPIRATION DREDGE&FILL REQUIRED: • 3 JJ 51 (0/30'119 CAMA MAJOR DEVEL REQUIRED: I _ t DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NQTIFICATIONLWAIVER FORM Name Of Individual Applying For Permit: 4//9r4 E R Q . GAL/.rc//k Address Of Property: 1/7 P yfJ-,1P,rT4c/7P /7t-,v�eR (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-nie 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. Jf you have ohjer,tions to what is being proposed, please write the Division of Coastal Management, 127 North Cardinal Drive, W' 11-mmvon, North Carolina, 2$405 or call 9l Q 395- '3900 within 10 days of receipt of this notice_ No response is considered the same as no objection if you have been notified by Certified Mail WAIVER SECTION I understand that a pier, dock, mooring pilings, breakwater, boat house, lift or sandbags must be set back a minimum distance of 15' from my area of riparian access unless waived by me. (If you wish to waive the setback, you must initial the appropriate blank below.) I do wish to waive the 15' setback requirement. X(, I do not wish to waive the 15' setback requirement. o .nrnr,(�) .grry 3-/9- I�' A1191111frA Signatur Date �� NSo� - Print Name 9/O —aTD - 32 L3 NCDENR Telephone Number With Area Code NORTH C.AROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES } DAPAw/// Of ,IOPd.r &_ Bann/Tr To ,�F , o«r, 0 _4r 9/7//(I61 t$ •PD___r- //4///lj ,2i ✓L t.- "Le,a.D DA/,/t40 fr'/9)/vc R Gte/s.v% ,et0/°O-rt p/t ///ir roR_ So gT_ �fT' ft 04771V6 To /29o/��c'rr L//V� * I ro .'dPoPF,�,- 4Wg7f,oz //1/4c //DTc 40.177AV6 /t:; F/,vp A,POPQS"fp 2'9r L/fr cKTEA/p L'ar T/y0,N G4//lory d� W9Tf/P �9Y .fCfIL�` • DIVISION OF COASTAL MANAGEMENT ` ADJACENT RIPARIAN PROPERTY OWNER NO WAIVER FORM Name Of Individual Applying For Permit: G✓fl rv' ,Q az iJx/i- Address Of Property: 4/7 //C&6,9Ef R.D. /{A/vSTff}B PEA/Ace (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 itie as shown on the attached drawing the development they are proposing. A description or drawing, with dimensions, should be provided with this letter. +r- I have no objections to this proposal. If you have objections to what is being proposed, Tease write time Division of Coastal Management 127 North Cardinal Drive, Wilmington, North Carolina_ 2E405 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. 7f/Cf-e -2-,2ce 3 - / -,- , N f c c g-A A . • . Signature R. gateet) �r i . Print Name _ '/6 ,7,//0(1%HO 7 �-, s3 NCDENR Telephone Number With Area Code NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES Ai49,9l///V Qf �i�Of�rCD Sadgr4/,T T4 _--lae474'4,---/417- 9/-7 4va66' ,P_D Pf vOr- Ca_uA/7:7 D�,/,+/t� rf/ftrivf R ZZ4/s-v%,- _.P_t.OPO-fZ"B •' f'/z/A/'i Fob_ S047 /z DO « i T" •oyor'fe rt J cg sU /A/r p TO ,'POP<,?�, 1 1 iA•f 41471;19Z ///F //aj,� ef/fT/,/6 ,Pi'f Lac' FI,vo p45/94(fp 157012 - t/jT c(TF.c/p it . L4ss rH09,✓ b/ivT,y A/9rfR ti/gY S��Lt- Or3121.37 bof 67-59dPY0' Oivy ,Y_7 '6V-9 " /s'/-If 7/ J10 / 7d'JJai/ii 01 ;W/7 P;- .7 d,>/d - z Y /Qbd of ' �11'ix3 .Y.20 p /Z/ 1 �r .1bO? -moo_- J'9/1'i c/a' i' 07:r40 Old' in-si7Tl a' 3N(H/14 d'?A'A7 71610667 Q-71:Pa/0f/ .10 9 NM i6V4t7 DR. SHIRLEY WAYNA. ULE R. ULISNIKISNIK NCDL 7125671 66-30/363 8351 417 HUGHES RD 910-270-9064 I IAMPSTEAD,NC 28443 Date 2/ 14' 9 Pay to to I $if A A Ordero �U ,74 vp • ctv Dollars Ei ,,,, FIRST CITIZENS 353 t 'BANK Wlleat oNBrtnJ Co '"' • Tor 1:053 i003001:003536636 i65ii' 0835 i (\ O(inrkef6rrerknn V�PC9\60 I 4) SEA'MEASURES WIR /