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Home My WebLink About17575D - Melvin • CAMA AND DREDGE AND FILL GENERAL �� 75-i -1� PERMIT as authorized by the State of North Carolina Department of Environment, Health, and Natural resources and the CoastalResources Commission in an area of environmental concern pursuant to 15A NCAC -// • /1V� Applicant Name rti 4e/tYi' % 44 A.-/ co4VR'G-/-7OA- Phone Number(9/g Art/..)- 754/6 Address /.)`! (AA Awe 5' City /4 kibv• gemsµ State /14C Zip A yba Project Location (County, State Road, Water Body,etc.) / A'/O AP Sf ' f-b1 6a4 I{ ` ,'9CAcA,7 M l4/v-4N4-cLt cA,v4I , 4Rk?i Sa%cg eek,A71t,/ Type of Project Activity (OA r U t r•A- d •QU!'riff c4 t e407r/) O� /f7S/l b ,N/A 1) of/f c401,0 fnitt I ot" 7,�{ .•/UV sr4lil 41FPiy PROJECT DESCRIPTION SKETCH (SCALE: //' jot Pier(dock)length Groin length il,/�i — 444 cA 4/A / number l�`� Bulkhead length max.distance offshore 07 A ,f46e Basin,channel dimensions etAl cubic yards &Se Boat ramp dimensions _ — _ �� , 5 " Other r SD / Lol I I This permit is subject to compliance with this application, site drawing and attached general and specific conditions. Any / )714 violation of these terms may subject the permittee to a fine, imprisonment or civil action; and may cause the permit to be applicant's signature come null and void. �/ CD 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- hi 7//s/yir_— 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 �,/ r�/no objections to the proposed work. attachments ff • 'GENERAL PERMIT COMPUTER FORM APPLICANT NAME: Ed flute%, N ADDITIONAL NAMES: rvl vv� /V I t 44 2 AEC DESIG: CS , 9 Ee' DEVELOP AREA: f2..c2I PROJ DESC: P - 1 I (Will only take 6) (Will only take 1) WORK: (j 1-) 5--C) (Will only take 4) MAINT: (Will only take 4) IMP: s e ; �v (will only take 6) ACTION EXPIRATION DREDGE&FILL REQUIRED: /(s/?6 /r/ d CAMA MAJOR DEVEL REQUIRED: `1//ilfi 7//$id)d DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM IdGIJZZA Name Of Individual Applying For Permit: AJAAZ • Address ..Of Property: tad' • A - F � n (Lot or Street #, Str et 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 me as shown on the attached drawing the development they are proposing. A description or drawings -with dimensions, should be provided with this letter. I have no objections to this proposal. • i= You have objections to what is beinc proposed . please write the Division of Coastal Manacenen t . 127 Cardinal Drive Extension , W lmincton . North Carolina . 22405 or call 910 395-3900 within 10 days of receipt of this notice . No response is considered the same as no obiecticn if You have bCen notified by Certified Mail WiAIii S ECTTON I understand that a pier, dock, =coring 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 recuirement. • I do not wish to waive the 15 'setback recuirement.;4:4 Signature Date • 1 • // �.- �' Print Name �� ,/ - 7 9 rf) I-INF-=I Telephone Number With Area Code DIVISION OF COASTAL KANAGEMENT • ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM T4 l J 1f Name Of Individual Applying For Permit: C-,.C! . Address ..Of Property: / 0�- . (�.�' . (i2:64/,,, A) J C . (Lot or Street #, Strut or Road, City & County) . I hereby certify that I our. 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 drawing7 -with dimensions, should be provided with this letter. a5I have no objections to this proposal. • i= you have ob?ections to what is beinc proposed . please write the Division of Coastal Manacement . 127 Cardinal Drive Extension , Wi lminctcn . North Carolina . 2E405 or call 910 395-3900 within 10 days Of receipt of this notice . No response is considered the same as no ob1 ecticn if You have been notified by Certified Mail iiLiv 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 r_cuirement. I do not wish to waive the 15 'setback requirement. k 7foj? e A . .A /??•q-RVR i R, D�ua--I-r / '� Print Name .g( 2_ - 25 q !] I---1 NJ R Telephone Number With Area Code • • 0. 79,3 8 + ON WHITE PAPER 2402010 9 T HAS A COLORED BACKGROUND T • THE FACE OF THIS DOCUMEN U.S. �Q1_tARs MONEY ORDER ORED PERSONAL NOT VALID OVER FIVE HUN. ORDER COMPANY y; PRESS MONER OOMPANY 8863 � � MERCHANTS MONEY ORD 17001' 4.. J �� , { i `r MEMp HILL.PA NIA FOOD fir' � ` •� ��..i�'�-% ME g863'COMPENNSYLYIAIIONV- y ,..� N� PO.BOX SUBSIDIARIES gSSOC st5� r r1 r �.r� SUBSIMEACHA OFS ENNSY 0 '�' I,, e�,i`��"•' 7 pERs ti' 0 �" ''R �oll.a�s vv , , 19` a FIFZY :h.;t,ao c SYCIR�'1 r uI 'I." • pGENj-A2�9 -C�C�UC�U2AU2p1U *t��*�*��*�pRR 1� ,T-., * ► # ** THE�R' 'SER'S .S SET FORTH ON � �IP ' � � ' AND SERVICE CH•-GE ' � GTY/STA / E TERMS AND CONS ,INNS �� TO THE / — .;�By PAY R S To: - ADrESS N 55949 A ` '. C — Bank Lenesb0ro.M OF c ` OFiD BY SIGNING.• R National J PA'.IHFOUGH.Goodhue County • /I',. 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