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Home My WebLink About19866D - Blanchard - 4 CAMA AND DREDGE AND FILL GENERAL N1 019866 —b PERMIT as authorized by the State of North Carolina 10 Department of Environment, Health,and Natural Resources and the C st I Res Commission in an area of environmental concern pursuant to 15A NCAC 1�. / cL)/ A0k 5)/4 K(,iaY�8 90'4 5i79' Applicant Name � Phone Numbe Address n � �° c , / v c —M(�' ( w4k�I ^ / City ` .��+' / o t'fi( State ' v Zip a U �j� Proje t L catio (Coynty, State Ro , Water Body,etc.) / es/ I ct 1 1/ t 0 r't .re 4 A J/t3�I-+ I eu C ` P ei JQ(0 ,-r eon C>IA AiivW 1 A 7/stLl4 5 14d/ L >� r' , 1 on r,.cT /00 l/ifv. — �T 6'-'44A cf T i 41°#Crward o Type of Project Activity S� / 9 J/ 49r-�%Sid( pi /i^` S o.� •C l rr� re11 ciCAt [ AI/ CoA r-is o-F' q tf4�kcd 7f'��.� 5,3 /I a pp/ . IJtl1k Aekd sA parQlff1 �4 ewe--'iS/eIC pi/i if W kit/PROJECT DESCRIPTION SKETCH l , "r w (SCALE: �o S�Q� ) Pier(dock) length T Ire p� r �'Mgr � �''� �-- r Groin length 1 t J i r- C T Al- I aY d 9' ' ET A number f I B Ikh ad length— VVVI"' V( ,A) ' 1 i ` i max.distance offshore 9 1 17 CSC c.k,( _._-_;_ i I Basin,channel dimensions /a I Se(61 C 4 L cubic yards Boat ramp dimensions U Other • t '-/ ii is This permit is subject to compliance with this application, site r„, drawing and attached general and specific conditions. Any ) /P/ . /27 .," violation of these terms may subject the permittee to a fine, / applicant's signatun imprisonment or civil action; and may cause the permit to be- come null and void. Ct- a' This permit must be on the project site and accessible to the permit officer'ssignatur( permit officer when the project is inspected for compliance. 7:A;(4/k f . i9 The applicant certifies by signing this permit that 1) this pro- ject /2 is consistent with the local land use plan and all local iss ing date expiration dab ordinances, and 2) a written statement has been obtained from 1, `� �J �"1 adjacent riparian landowners certifying that they have no •f ( objections to the proposed work. attachments r D GENERAL PERMIT COMPUTER FORM APPLICANT NAME: landykrci , Chap.'ES ADDITIONAL NAMES:�j ,� AEC DESIG: EA Par DEVELOP AREA: _.Qj PROJ DESC: p - (Will only take 6) (Will only take 1) OD WORK: % 1 W • (Will only take 4) ri.kr\k)Q1''j MAINT: (Will only take 4) I/vIP: OUS 100 (will only take 6) ACTION EXPIRATION i`� DREDGE&FILL REQUIRED: 6&E- h CAMA MAJOR DEVEL REQUIRED: ci SENDER: I also wish to receive the G •Complete items 1 and/or 2 for additional services. following services(for an rn ■Complete items 3.4a.and 4b. a) ■Print your name and address on the reverse of this form so that we can return this extra fee): card to you. al i •Attach this form to the front of the mailpiece,or on the back if space does not 1.❑ Addressee's Address v ■Wri el t"Return Receipt Requested"on the mailpiece below the article number. 2.❑ Restricted Delivery 6 2 ■The Return Receipt will show to whom the article was delivered and the date Consultpostmaster for fee. delivered. i 0 3.Article Addressed to: 4a.Article Number ) a !t/1✓'. T/I_ _-• Zj`2U9," f74/' Type1 4b.Service ' E // C f � ❑ Registered R-CTrtified � f 4 r9� C t� �� [�fo"�.5� 9 ❑ Express Mail ❑ Insured y I, 9l F .fx ❑ Return Receipt for Merchandise ❑ COD •, 7. Date of Delive ct 77/ 7 ''-� '5. Received By: (Print Name) 8. Addressee's AddresstnlY if requested r and fee is paid) ' J 6.,Si lure: (Addressee or Agent) • N PS Form 3811,December 1994 102595-98-B-0229 Domestic Return Receipt 1 SENDER: I also wish to receive the n •Complete items 1 and/or 2 for additional services. following services(for an w •Complete items 3,4a,and 4b. n ■Print your name and address on the reverse of this form so that we can return this extra fee): card to you. > •Attach this form to the front of the mailpiece,or on the back if space does not 1.CI Addressee's Address `' ■Wri e rml t"Return Receipt Requested"on the mailpiece below the article number. 2.❑ Restricted Delivery d •The Return Receipt will showsto whom the article was delivered and the date delivered. Consult postmaster for fee. 0 3.Article A dddresssed to: 4a.Article Number `/ 3� 7&� /��" ` IJ, 4 Type B —PA U CI Registered I�Certified n ( ❑ Express Mail ❑ Insured n El Return Receipt for Merchandise CI COD ' n [ < /�u2 �� v ( . Date of Delive/ --642_ . / i 5. Received By: (Print Name) ... . , * ' 8.Addressee's Address (Only if requested ' D • and fee is paid) W F cc 6.Sign t red Ad ressee or Agent) >. 'y ' r -1'14 e--eg I 2 PS Form 3811, December 1994 102595-98-B-0229 Domestic Return Receipt • DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER- FORM Name Of Individual Applying For Permit• CA.,t`/'e5 ,`!• 73/4'fr1 Clice Address ' Of Property: / l/ S2cL5/d€_ 14/0i,gy �P c7t City & County) ( / ?7)(Lot or Street #, Streeor Road 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. 6p- -4y . I have no objections to this proposal. If you have objections to what is being proposed . please write the Division 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 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.)) • ate • I do wish to waive the 15 'setback requirement. I do not wish to waive the 15 'setback requirement. Signature Date ` • • ' Pint Name ~7 ki �--�-� ......fir .�� ele one Number With Area Code I 4469 , — 2132 _ ._ .— 66 30/69f 09/76 018l Charles M. Blanchard �� Linda F. Blanchard ( �` 4107Nal His 733590 Hers 549-89 DATE- _ ar S tt,NCere Way Ph 549 8512 .....�� Charlotte, 28269 $ �C d� C _ -1 PAY TO 711E4 - �— ORD OF --- ,c901 _ _ __----- 57 ��RRR Cl"ut � _ 1 V v _= present,do not cash k for Micro Print signNurc 1 gray type ork.Flrst Citlzcns Bank logo on back.If not P alest nt,do loo u �� CITIZENS tl,B �y(�� 0,�� '[j PbstLitizens Bank 6 Trust Company C4A)6 -N,.�/f%' (jG{-(/�Ir1i-Charlotte,N.C.26208 .11��////!!��// FF/.. FOR----- — .._. _ � 053L00300�:OOOi36737570°' 02L __-_.. •