HomeMy WebLinkAbout89242A - Molton, Amber0(ourk +,-CAMA DREDGE & FILL N9 89242 A B C D
GENERAL PERMIT Previous permit
Date previous permit issued
a-ZNew ❑ Modification ❑ Complete Reissue ❑ Partial Reissue
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 ' ) !1 I 10 u ❑ Rules attached. 9 General Permit Rules available at the following link: www.d .nc. v CAMAruI
es
Applicant Names b N r- /'l
Authorized Agent
Address i l 3
Ig r O o� r L .. v4
Project Location (County):
City
11, 1 i S State ZIP L
)! 61,
Street Address/State Road/Lot #(s)
Phone#(=L)
3 ry 5_ OG 6 7
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Email [I
`I % u (rJ 9 F • C u
Subdivision ^ ')
City ZIP
Affected ❑ CW
DEW ❑✓ PTA ❑✓ ES
OPTS
Adj. Wtr. Body (nat/mar unk)
AEC(s): ❑OEA
❑IHA ❑UW ❑SPIMA
❑PWS
nn
Closest Mal. Wtr. Body
ORW: yes/no
PNA: yes/no
Type of Project/ Activity
Shoreline Length
(Scale: �,V 'I S )
1:1
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Floating Platform(s)
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111
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Finger pler(s)
�1
1
1
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Total Platform area
■■■L�....■5�.�.■..■Inl.■1:1
1
Groin length/#
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Bulkhead) Riprap length
Avg distance offshore L
1
,
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Max distance/ length
inn■■■■■■■
lasin, channel
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n
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Cubic yards
'oat ramp■
oil�
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A building permit/zoning permit may be required by: j.) rt ( i
Permit Conditions
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT (Please Initial)
Agent or Applicant PRINTED Name
Signature "'Please read compliance statement on back
Permit Officer's PRINTED Name
Signature
Application Feels) Check q/Money Order
Issuing Date
Expiration Date
Do &v gn Em bp* ID: A7D13503.78CB4D13-9DA340183A3ESF95
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Name or Propery a
N.C• OIYISION OF COASTAL MANAGEMENT
RIPARIAN PROPERTY OWNER NOTIFICATU)NOWANER FORM
(TOP PortlOn to be o0nVhited by owner or their agent)
w►S. �
l t4r*k39 0er%810 t Mn Property 41000Mto the above termenCetl pmpmty. The In "hAl applying for this
W" has desamed t0 fK as shown an the amdww &%wNp, the eerroprw ft they aft propogrp. 8
ordrawate wah dwne�n. n.w ��Ar: m ft falter.
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TYPOW""M MWWofARPO: Roy A. Hayes
WliftAd*r o/ARPO: 118 Mallard Lane, Grandy, NC 2 014'AS-
Anpqy tt: rahayesconstruction@gmail.com g04-892-2908 I 1
ARPO's Ph~
Ddw. 1W for uP b WO yea►rrom ARPO's eignm W
■ Comploto items 1, 2, and 3,
■ Print your oeme and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailploce,
or on the front If soaco darmlln
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9590 9402 8645 3244 4411 73 0
9589 0710 5070 0017 4058 71
Is delivery address dYforent from hem 17—CI Yes
It YES, enter dNrvery address below: ❑ No
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ReaVCIN Dofvery
1 PS Form 3811, July 2020 PSN 7530.02-000.9053
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