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Home My WebLink AboutHicks, Scott 80002C®AA /DREDGE & FILL Nl? 8000, A B Q D E L PERMIT Previous permit# New ❑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+A area of environmental concern pursuant to I SA NCAC O %� . /�bo '— Rules attach d. Applicant Name r5cc# / 1 C,K 5 Project Location: County AX-r'''P- Address 7 Street Address/ State Road/ Lot #(s) Clry tate fyV ZIP -�--FT Phone # t)�E-Mail % Subdivision_ Authorized Agent q✓ CityZIP Affected �CW !` EW A DES 0P7s Phone# (_) River Basin AEC(s): DOEA ❑HHF Bf ❑UBA ❑WA Adj.Wtr,BodyMIS C ❑ PWS. nat a tun ORW: yes no PNA y/ no Closest Maj. Wtr. Body— .■ ■■ ... ....�... .. Oa:. :■:■■ : ■■:■■ ■ . . . :'�...: :■ �; ► Ali! ' iiI■ ■■ M IPA ■r��►.� r �ii��ii��i■� Hill RIM NUNN JgA MINE :.:::::■::::.'R�n` I �y ®KiCAMA / QQDREDGE & FILL Pi , N9 80002 A B Q D ENE L PERMIT Previous permit# New ❑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 07�• /� CO _ /� Rules attach d. Applicant Name >� C o t G�S Project Location: County Address iieStreet Address/ State Road/ Lot #(s)�%/� City tateAJC ZIP Phone # (T)/010 E-Mail / Subdivision Authorized Agent ✓ City Z ZIP Affected ❑CW XE—W ypr�A ❑ES ❑PTS Phone# O RiverBasin AEC(s): ❑ OEA ❑ HHF `rIH ❑ UBA ❑ N/A Adj. Wtr. Body T C nat a unkn ❑ PWS: ORW: yes no PNA y / no Closest Maj. Wtr. Body Type of Project/ Activity ,p o(' AAa jr\+P_neaA7Ce` _ e t IrAI ! Pier (dock) length r- Fixed Platform(s) \@\� Floating Platform(s) Finger pier(s) Groin length number Bulkhead/ Poprap length i avg distance offshore_ cubic yards Boat ramp � Boathouse/ BoatliR f Beach Bulldozing - Other a/ Shoreline Length 5": not sJyes Moratorium: Photos: Waiver Attached: A building permit may be re( ( Note Local Planning jurisdi Notes/ Special Conditions t r it nL tit SC oy� Agent o<�l , Printed Name 'Sig�` ure •�'Please r d compliance statement on back of permit ax ��_M.04� &$ _ 301$ A�plication Fee(s) Check # yr� r (Scale:' � ) ❑ See note on back regarding River Basin rules. I 1 , I I I 1 _ — —1-, " Sco4 t✓�t�a r �1, 3-R-ao�> �v` 4, ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to Is to'N 147 LILS s ii (N me of Property Owner) property located at _ho /�I h�'rt/t `hCLe �Y (Address, Lot, �gJlock, Jtoadt etc.) on pn� 4d(I' S�t6rC,tVey2� in Yi Ll o(( �ker-PG N.C. (Waterbody) (City/Town and/or County) The applicant has described to me, as shown below, the development proposed at the above locatio 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) 7fir-.ed3 Kta.v- bt"'A Lead WAIVER SECTION I understand that a pier, dock, mooring pilings, 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 appropriate blank below.) I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. City/S./y tate/Zi-lPp_ ly-AF7 Telephone Number // ar—ck 8 ,)0'�-- I Date ,!,AAJ,rpn Propert ner Information) Si at Print T or Type Name //r✓r 4-,-t -r M �'J'ng Ad ess !'l A P P €toll skor'-s City/State2ip Date RECEIVED -I C� �Co (Revised611812012) CY �7 MAR IS 2021 DCM-MHD CITY ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to '3ft7r MC-kS 's / (�1ame of Property Owner) property located at_ / / o & bov-V4� Ar �I' (�� //y �-- (Address, Lot, on rt z /uto t�� , in _ (Waterbody) N.C. The applicant has described to me, as shown below, the development proposed at the above location. 1 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) rLL"zl- b1'JlL- 1k" Ott-r proe rly' WAIVER SECTION I understand that a pier, dock, mooring pilings, 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 appropriate blank below.) ware I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Adjacent Proper�tyy Owner Information) Sig alure t i Ji11 %I1r/VK .S Print or Type Name JD$ X12elr✓i it br: MalJ1�g Add(e�ss YinP Ki1O/I 5h6:t'S cuyt5 2p2�f2 136 Tele,pphone Number Xeir6k , ofd3/ NOW (Revised 611812012) MAR 22 20 1 DCM-MHD C Nw J M Y J cs� RECEIVED MAR 22 2021 DCM-MHD CITY