The URL can be used to link to this page

Home My WebLink AboutNelson, Cliff 76400C-rCAMA / ❑ DREDGE & FILL GENERAL PERMIT ,<New ❑Modification ❑Complete Reissue No. 76400 � A B l / D Previous permit # ❑Partial Reissue Date previous permit issued As authorized by the State of North Carolina, Department of Environmental Quality 0-71 / and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC cgm o � •Wules attach d. Applicant Name �i J(J Project Location: County Address I (ve Street Address/ State Road/ Lot #(s) City State NGZIP Phone # (3&), 7� E-Mail Subdivision Se-0 Authorized Agent j�� f V � 1 n/ 2�111l- City ZIP Affected El CW �W ETA ❑ ES ❑ PTS Phone # ( ) River(BBaasinWe_DG� Affecte El OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body l� � a unkn ❑ PWS: ?-O ORW: yes / no PNA yes Closest Maj. Wtr. Body 1 `7EME • ..■■■1�■■■■■■■■■■�■■■■■■■■■■■■■■■■ ■■■■■■■■■■■ '0• • E ■■■■■■MEN ■■■■■■■■■■■■■■■■■■ ■ ■ OEM ■■■■■■■■■■■■■■■■■■■®■ ' . • ... . .. . :.. ' .. • . ■■■■■■■OEM■ ONE ■M MEN E!1■■■■!■■■■E■■■■■■ ■■■■■■■■■E NONE E/■It111WARN Ml1■■■■■■■■ ■■■■■�EEYrw ■■■ ■■ ■■■ ■ 0�■■■E■E■�■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■ MEN ■■■®■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■!\■■■■■■■�■ ■■■■■■■■■■■■■■E■E■Ml:1_!1■�w■ �M■�■ MEN■■■�■■■■■��::� ■��■ ■.■■■.■■■■.■.■.■■■■■01F ■EEE�■ ■ ...■■ .■■■.■ ■■..■■. ■. ... ■■■■®�.MEMaO_■■I■_■■.■■E ■■■■.■ ®■■■ .■ ■■... .ME ■M■ IN■■■ ■.■.EE� ■EO�■ ■ ■■■.� ■■■■ ■EE■■E■■II 11M E ■ Err MM1 ME�Mmlmm'J■■■■■EEOEM■ ® ■ E■E■ ONE EMOEM MINEEE■■■MMM■■■■ E■E■■Min■EEi�■■M�■i■��■MM�■iE��■ ...�-� s affi®■■■■■iN.IJI ■■E■■■■■■■� ■ ■■, ONO EME■■■EEEOMEN i ■■ti►rtEeIN■■■■■■■■■■ r T- S Agent or Applicant Printed ame Stpature ** Please read compliance statement on backof permit" pplication Fee(s) Check # - 2 (-aj (�n Permit Officer's r' ted Nam Signa re Iss ng Da xpirati Date AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: Mailing Address: C'`A._�� Phone Number: Email Address: I certify that I have authorized DENNIS & SONS MARINE CONSTRUCTION, LLC Agent / Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: c'o c'_� at my property located at Q' i tZ County. I furthermore certify that l 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: _ZZ zzt - Signature Title Date This certification is valid through 12 / 31 / 2020 RECEIVED APR 2 8 2020 DCNI-MHD CITY ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to "-' r� C, i.I*Kr iir�L�C)fJ Cep (Name of Property Owner) property located at AJFiVP-'URj' LC (Address, Lot, Block, Road, etc.) on i c, i.t l in �'AR i ��R�°i' /-"/y2vi Y , N.C. (Waterbody) (City/Town and/or County) 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) E X 1 6 `i 1 /J (71 L- 0 C P i 1 U Q 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.) I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Property Owner Information) *Valid for one calendar year after signature* (Adjacent Property Owner Information) Signature * ,l)i)RL Print or Type Name Mailing Address ;V' O,'� City/State/Zip Telephone Number/email addr1ECEIVED Date * APR 2 8 2020 'Revised Aug. 2014) CM-MHD CITY ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that property located at adjacent to t >= (_ J 0 lc "C �J 's (Name of Property Owner) on 1 C, 'V� (Address, Lot, Block, Road, etc.) in C' f(1(Li (-". P-L, `C C 0(),QT y, N.C. (Waterbody) (City/Town and/or County) The applicant has described to me, as shown below, the development proposed at the above location. 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) 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.) I do wish to waive the 15' setback requirement. `/ I do not wish to waive the 15' setback requirement. (Property Owner Information) (Adjacent Property Owner Information) w70 S�P�Vte,j P Signature Pnr�f or pe Na P " or Type Narqe ing Addre s Mailing Address C. NC a-135-1 i Sfa�t 2ip City/State zi RECEIVED /G 5/�- Cr��iSov�l`6 a�C,CiLC�in 3310- -6$a- Telephone Number/email address Telephone Number/email address '41 t51 ad APR 2 8 2020 Date Date* (Revisequg H CITY *Valid for one calendar year after signature*