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Home My WebLink About74823D - Smith 'GAMA / -DREDGE & FILL No. 74823 A B C D GENERAL PERMIT Previous permit# )G pt9w ' ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued As authorized by the State of North Carolina,Department of Environmental Quality 1^(`i.4 ,ZOC and the Coastal Resources Corn issio ' an area bf environmental concern pursuant to I 5A NCAC �J I les attached. Applicant Name 1- l:„. ---( roject Location: County r 401 _ - (Z 1 k Street Address/State Road/Lot# s) City State J ZIP U n I (0 � Phone# )Z 14,-313 E-Mail 37 qE5' Subdivisldgnl (Jl, Authorized Agent A-1U 'r City ! ( l ZIP �l'f \ Affected ❑CW ETA ❑ES ❑PTS Phone# ( ) Ri er Basin ❑OEA HHF al IH ❑UBA ❑WA AEC(s): Adj.Wtr. Body 4itn i). U Sc (nat /man /unki ❑ PWS: /� - `, ORW: yes ( riot PNA yes no Closest Maj.Wtr. Body c+�' n r SO1I/C---- Type of Project/Activity IA5'f1 f s' /6( ffit- � I (Scale: ►f Pier(dock)length l� 1 1 f �'��" f, Fixed Platform(s) . ±7' " a /Y 2U( i Floatin• Platform(s) I0 • , Finger.'er(s) Groin len. h 4r""� 1 numb r i Bulkhead/Ri. .. length avg distan a offshore ✓ ' ' max distan -offshore Basin,channel - . . 1� . , cubic yards Boat ramp ( - - - iii 0,- . P- Boathouse/Boatlift 2.0 . Beach Bulldozing Other 1 ='-� I I !1 ' '' + --- HI ♦ I . . 1_- - Shoreline Length 5`-. A1, .6) /fiL Fri, h 0,@ -- SAY: not sure yes c� �� V /`• 9-- jF 'SP+ Moratorium: n/a yes I Photos: yes lip � _ i -_ . Waiver Attached: es .V 1 1 I •-•-•-'5. Vi A building permit may be required by: . I I See note on back regarding River Basin rules. (Note Local Planning Jurisdiction) Notes/Special Conditions • .'dn •.. . t PrintedN0 ? - Agtor I Sign re Please read compliance ifill. ent on back of per t*'" Sign ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to `e( 51.v fli s (Name of Property Owner) property located at G O"] 1 Io`f j f-- (Address, Lot, Block, Rpad, 9tc.) on C> ra I , in r 15/�h✓ , N.C. 1 (WaterbOdy) (CityfTown and/or County) T - - •► - t has described to me, as shown below, the development proposed at the above location. AI have no objection to this proposal. I have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (Individual proposing development must fill in description below or attach a site drawing) ‘.., z ', -A 7- .2A / ICoverBQ ,, ,5,- s 4, I 1, 1 _________ WAIVER SECTION I understa • at a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set back a min..- J' d . - ce of 15' from my area of riparian access unless waived by me. (If you wish to waive t►- --tb- ' •u must initial the appropriate blank below.) __ _ do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement " > — ) (Property Owner I)-.rmation) (A "acent Pro rty er Inform 'on) /1 svEci) -<_-_.A; _---- Si tura i e L , DGl Ai. �r,.,-T e� fr. __c yvt --A-- Print or Ty/pye Name Ppt orType Nam , / /a 7 // A,�f r 1 4)6 , T 4i, f7 Mailing Addre§s MailingAddress / 23, 1^30r14•&si A) c93 City/ te/Zip C fat /Zi (I/0 ,19 3.33( /z,),5?_ -/a te Telephone Number T e eph ne Nu ben Date S t ' .Poa--) ,5/� /,2 I Date (Revised 6/18/2012) A C N ' s adjacent to �'` a Property Owner) l hereby certify that I own property fi {Name of Y � property located at / (Address, Lot, Bio�k, R etc-) N.0 �� / , e / . in { C fr and/or County) on___i___�(Wa rbodY) The applicant has described to me, as shown below, the development proposed at the above location Ut(03 I have no objection to this proposal. I have objections to this proposal. --- DESCRIPTION AND/OR DRAWING OF PROPOSED R iDVELOE NT (Individual proposing develo•ment must fill Ibelowon or attacha site drawing) — A -Sir rpe .19 ---- : ' ----, I l g('Th 02 ,•-- a'Zi,. *--'.' ' 1 T 3 y WAIVER SECTION that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set b I understandy If you wish to minimum distance of 15' from my area of riparian access unless waived b me. ( the setback, you must initial the appropriate blank below.) iii_ 22__ I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Prhi: rty Owner Informa , on) (Adjacent Property Owner information) L. 4autukii4,121.,) 1. 'I /7 .. , Signature 1 S`� e e e l iV • . 1 Y1rlajow Anrie cczh ne n or T e Name Print or Tye Name Print A ,f- 1 OS Pri me .i4.p Ma' "ng Address Mailing Address mv% ytl NC 2. "7k• e Cif)r/StatelZrp t q i(9 d' .9'. 3.9.7 -2-52 - -75 - g----) 51 Telephone Nu ber Telephone Number A. _ki , 1 '1I 1 / ni,. ZAPS. 7n ?_ i_ AGENT AUTHO ZATION FOR CA ,';A PE'1 flT APPLICATION Name of Property Owner Requesting Permit: Q a 1 3//7 ,'/I‘ Mailing Address: Sc.r C'lly /VC a g Vgg Phone Number: 9 /0 ac& 333k Email Address: J 92 IC p i c /na; , CD . I certify that I have authorized di eJ i�1 '-0 LIS< 4/1GL�✓i -t Agent/Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development:. II at my property located at Cp0 in e9 ti` County. I furthermore certify that I am authorized to grant, and do in fact grant permission to Division of Coastal Management staff, the Local Permit Officer and their agents to enter on the aforementioned lands in connection with evaluating information related to this permit application. Propert ner Information: Sign ure Do/ N. .S�► 7� Print or Type Name Title 6 / 03 l ada-f Date This certification is valid through I I Check Dab Received Clete Deposited Check From(Name) Name of Permit Holder Vendor Check number amount Permit Number/Comments Receipt or Refund/Reallocated Golan) Column2 Column3 Column) Column3 Column[ Columnr I Column! Columno 7/1/2021 Richard Brackin Jr. same 'BB&T 2256 $200.00 GP#79989D TP rct 14877 7/1/2021, Lighthouse Marine Const. Joel Smith Coastal Bank and Trust 3816 $200.00 GP#74823D JD rct 14081