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Home My WebLink AboutLineberry, Stephaine 78824C5AMA /-.- DREDGE & FILL 78824 A B � D GE ERAL PERMIT Previous permit# ew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued As authorized by the State of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC (�$ules attac d. Applicant Name r [ Y P Project Location: County Address\ �F'e'i�, q Q n' - Street Address/ State Road/ Lot #(s) City L �a State --ZIPt�a- 51 Phone # () E-Mail Subdivision Authorized Agent 1 0(j' � x i !r 41 L•5 City ZIP �q Affected ElCw "t `W �TA O ES ❑ PTS Phone # ( ) River Basin ❑OEA ❑HHF ❑IH ❑USA El N/A �V AEC(s): Adj. Wtr. Body [f 1I[-� i� a man Lunkn) ❑ PWS: ORW: yes no y PNA yes no J Closest Maj. Wtr. Body Type of Project/ Activity Pier (dock) length Fixed Platform(s) Floating Platform(s) r - Finger pier(s) Groin length --- - numbe -� - - - - - Bulkhe / Ripr/ap length _ - av 7 of nce offshore ��. max distance offshore Basin, channel cubic yards __ —... Boat ramp - Boathouse/ Boatlift p Beach Bulldozing Other �c r� n`f bLcl%ia I-v_:y (Scale: "U1 ia -;�: �CCCI Shoreline Length C)r,_ SAV: notsure yes no\t )- Moratorium: n/a yes no Photos: es no Waiver Attached: yes no _..- A building permit may be required by: -Lo (-tf)T [J See note on back regarding River Basin rules. t or Applicant Printed 19 me Si nature **Please read pliance statement on back of permit .� pplication Fee(s) Check # AMA /,416REDGE & FILL f Y N0 78824 A B a D "GENERAL PERMIT Previous permit# ew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued As authorized by the State of North Carolina, Department of Environmental Quality.1411 and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC o attac d. Applicant Name Project Location: County C Address Street Address/ State Road/ Lot #(s)� City State NCZIPI22516 Phone # (V)9q E-Mail Subdivision Authorized Agent --rm C�4 LLS City ZIP Affected Cw , OW �TA ❑ES ❑PTS Phone# (_) River Basin OEA ❑HHF ❑IH UBA N/A AEC(s): ❑❑❑Adj. Wtr. Body nrV Ccpe/mom) ❑ PWS: � J ORW: yes no PNA yes no Closest Maj. Wtr. Body iL(/lU 0 ' ✓'& Type of Project/ Activity D 1 Cam/ C E7 Pier (dock) length �. Fixed Platform(s) Floating Platform(s) r Finger pier(s) T — Groin length � I numb �--- - - Bulkhe / Popra ngth l-� — - av ' ance offshore r " S. max distance offshoreT� j Basin, channel o Boat ramp Boathouse/ Boatlik _ Beach Bulldozing� Other Shoreline Length too SAV: not sure yes rn Moratorium: n/a yes Photos: yes Waiver Attached: yes - r—i— -- A building permit may be required by: ( Note Local Planning Jurisdictiop), ,� (� Nntnc/ 4;... l Cnnditinnc ,j/�� lrry i t V 'A 0 J or (Scale: / ) [XSee note on back regarding River Basin rules. c/ Signature ** Please read compliance statement on back of permit** b'Yoo !W- /49 Check ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to &ZOO /}►N� z4AAW '& 's _ 1 .n n _ _ n (Name of Property Owner) property located at on�n r (Address, Lot, ck, Road, etc.) p�ggm— in , N.C. (Waterbody) (City/Town and/or County) The applicant has described to me, as shown below, the development proposed at the above lor..atn. _ I 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) �gEA) 5t rR G)f1 u-- WAIVER SECTION I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin 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 appropriat k below.) RECEIVED I do wish to waive the 15' setback requirement. ,J % 60 I do not wish to waive the 15' setback requiremen _ �k# IUQ JAN 07 2021 DCM-Ai HD C:(Ty (P�p"rtty,Owner Information) (Adjacent Property Owner Information) or fling FDk Me- 2,9-5-11P City/State/Zip � n ZS242S u �Sicl i n�iKl'!�(Q— I I A09j" Telephone. Number/email addres rimy 7 L hV- I Q yahoo-�, 60 'Valid for one calendar year after signature' (Revised Aug. 2014) ADJACENT RIPARIAN PROPERTY OWNER STATEMENT hereby certify that I own property adjacent to S�i/AAAl LIV c I �j (Name of Property Ownery property located at ZZ (ywtFOLDW (Address, Lo lock, Road, etc.) on is �L in t�N (Waterbody) (City/Town and/or County) The ap licant C. has described to me, as shown below, the development proposed at the above I have no objection to this proposal. I have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (individual proposing development must rill in description below or attach a site drawing) Pic C WAIVER SECTION S t� 0At I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin must be set back a minimum distance of 15' from my area of riparian access unless waived by Wme. (If p i h'to waive the setback, you 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 Information) Date (Adjacent Property Owner Information) ahlbw2a Date *Valid for one calendar year after signature' (Revised Aug. 2014) AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: G/tyE Mailing Address: Zzsa ( C ilk- 4 I"��F�4 AJC Phone Number: 25'2 425 2! z 4 Email Address: I certify that I have authorized -,(o�m 6clgr yt> J l-I 6A'Wz S jekymwz 4,0_51y •. 1$$j. Agent / Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: 5�'4 ,)Au at my property located at 2y Y in TCounty. / furthermore certify that / 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. Property Owner Information: / 6'gnature Print or Type Nar 6�—A^. Title ZC / Date This certification is valid through