Linebeck, Eric 80015C

CAMA / ❑DREDGE & FILL NQ 80015 A B O D
G NERAL 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 ,q. -'7 P
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC _ V / +'ari
,KRules al
Chad.
Applicant Name (� e. Project Location: County G--h"L7�
Address p - G Street Address/ State Road/ Lot #(s)�y/�i•�u.
City-�y I2 State NCi ZIP �3q
Phone# -.E- ail Subdivision Authorized Agent r 11". City C✓ ZIP J
Affected `_OW ,,� " ❑ES ❑PTS Phone# ( ) River Basin I Oak
AEC(s): OEA ❑ HHF ❑ IH ❑ UBA ❑ W((��A Adj. Wtr. Body 170 C� l to n n unkn
PWS:
ORW: yes /(no PNA yes Closest Maj. Wtr. Body
Type of Project/ Activity QCOpo'C' If of
cubic yards -
Boat ramp
Boathous
Beach Buuill'''djjjozing
Other /�,[
Shoreline Length
SAM notsure yes 1
Moratorium: We yes no
Photos: yes no
Waiver Attached: yes no -- --_.
A building permit may be required by:
( Note Local Planning jurisdicti
Notes/ Special Conditions
.r
Please read'compliar/6e statamenton back
tYt
f VIP. / I '> h 6NP— -S . n See note on back revardino River Racin ndac.
Check #
Date

W/ ❑DREDGE & FILL , C/�/ N9 80015 A B 0D
IZPERMIT Previous permit #
❑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 I SA NCAC b �q. 7.4 + I�
Rules att ched.
Applicant Name ++�q��1 L� /11 IiQ (i Project Location: County �i(�
1P,
Address ' �D 1 N� �G` P p Street Address/ State Road/ Lot #(s) � tcq � L—OUAC
City 1"Men-iMe, State NCiZIP O3
Phone # (90)`
Authorized Agent
Affected eW N" � ❑ E5 ❑ PTS
AEC(s): 0 OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
ORW: yes /'not PNA
Type of Project/ Activity _
Pier (dock) length_
Fixed Platform(s)
Floating Platform(s)/�
Finger pier(s)_?c�w_
Groin length
number
Bulkhead/ Riprap length {-
avg distance offshore
max distance offshore.
Basin, channel _
cubic vards
i
Boat ramp
Boathous Boa !�
2� [ '
Beach Bulldozing ✓
Other ✓r t
r
Shoreline Length
SAM not sure yes
Moratorium: n/a yes no
Photos: yes no
Waiver Attached: yes no/
A building permit may be required bv:
( Note Local Planning furisdicti
Notes/ Special Conditions
Subdivision
City PK - ZIP 0 —0
Phone# (_) River Basin
Adj. Wtr. Body Sd P a n unkn
Closest Maj. Wtr. Body lap
fr r
(Scale:
f , fnp, L�> h ow-5 • ❑ See note on back regarding River Basin rules.
Si nature ** Please read compliance statement on backof rmit**
-9Ca V?7
pplication Fee(s) Check #
9/
i Date

I hereby certify that I own property adjacent to Cr(L eq' Gy _� S
property located at 1411 it (/ 4v"' -", — — w"'
(Address, Lot, B
on 5Brifq� , In
(Waterbody)
The app cant has described to me, as shown below,
10 O .
I have no objection to this proposal.
I have objections to this proposal.
N.C.
County)
the development proposed at the above
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(indlvklual proposingi development must lilt In description below orrattach a site drawing)
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 appropriate blank below.)
IN I do wish to waive the 15'setback roquiroment.
It I do n"sh to waive the 15'sotback requiron
L� riG
address
'Valid for one calendar year after signature'
Property
fd $ ,?d o
Print or Type NItr'ty—
Mading Address• /.J
(, (CSh.,�)7 A1L Z7QC,1
GYylstatsop O (1 y3 iJ p
I-
Tetephone Nurn erlem l address
Urrtn• RECEIVED
6®
(Revised Aug. 2014)
APR 14 2021
DCM-MHD CITY

ANENT AUTHORIZATION FOR LAMA PERMIT APPLICATION
Name of Property Owner Req
Mailing Address:
Phone Number:
Email Address
I certify that I have authorized
Agent/ Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: 4&1!�:
at my pro arty located at /
in %P County.
l 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.
Property Owner
L
o Name
f Title
I Z
Date
v
This certification is valid through � 1t�- 1
RECENE®
APR 14 2021
DCM-MHD CITY

I hereby certify that 1 own property adjacon!
property located at vZ it,W",-vr^ Nc �i 7zvlv,174
(Address, Lot, Blo p�zd�;c.}
on 7B in _ r'tQV✓��' 6 N.C.
(Waterbody) (Cityrrown andtor county)
The applicant has described to me, as shown below, the development proposed at the above
to IV o�
I have no objoction to this proposal.
I have objections to this proposal.
DESCRIPTION ANDIOR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing developmentmust fill la description belowarattach a site drawing)
aml Cat 14 (
WAIVER.S9CJION
I understand that a plor, 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 appropriate blank below.)
n I do wish to waive the 15' setback requirement.
do notypsh to waive the 15'setback
erg" ""LTr<G 0, 4r-4 lae4
address
'Valid for one celandar year after sgnature'
Property Owner Information)
al
(Revised Aug. 2014) RECEIVED
APR 14 2021
DDM_MWD CITY

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