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Home My WebLink About21009_STAATS, PHILLIP_19981110O 1S7V.. c_W? __I±a-wj„ ►. "W ac. : - T CAMA AND DREDGE AND FILL Q� GENERAL PERMIT + Nlukco as authorized by the State of North Carolina Department of Environment, Health, and Natural Resources and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC (. fV- 1 Applicant Name Phone Number 257 2��1 ZY�55 Address A ., 2 - r -\ r _ City ' : " i State r -C. Zip � C> Project Location (County, State Road, Water Body, etc.) ' 0 r 1 'U '" C &'t✓ Type of Project Activity L/ _%r (� F t . vi /�. '- _ N t I,�i �!� ;�i v\.' &L V PROJECT DESCRIPTION SKETCH faJG -- i 'r A Pier (dock) -length G-roin length number Bulkhead length max. distance offshore r: - Basin,channei-dimensions VFW YU cuhic yards Boat ramp-difensions r �_— iT. �' /OU7l ALtt,N1✓rl(i (:�! �111!JE <` W thll. �IG�' C�. � �v .' r\ l � r� gyp•-/ � �\ `i ofiec4;1vA rLr4.TU io -- lniczcrlt vhi?ti yit K� This permit is subject to compliance with this application, site drawing and attached general and specific conditions. Any violation of these terms may subject the permittee to a fine, imprisonment or civil action; and may cause the permit to be- come null and void. This permit must be on the project site and accessible to the permit officer when the project is inspected for compliance. The applicant certifies by signing this permit that 1) this pro- ject is consistent with the local land use plan and all local ordinances, and 2) a written statement has been obtained from adjacent riparian landowners certifying that they have no objections to the proposed work. N�.1 ll t; taeA o (SCALE: C,.�f<-,-r applicant's signature Ct+A - ICtiw permit officer's signature issuing date attachments expiration date In issuing this permit the State of North Carolina certifies that I HDpjc�`' this project is consistent with the North Carolina Coastal application fee.iS� O c7 Z 0�e237U Management Program. UNITED S1MES 1'OSTAI. 3101NEAY ( I ER .� ��Ace:. 41v! 000 �,�,,,�\�\ ,,u��m��70 *100*00 �� 6863361,8591 \\\\" SERIAL NUMBER YEAR, MONTH, DAY_p�,,,.,,, •, POST OFFICE U. S. DOLLARS AND CENTS PAY TO �� "� , TER ,,. k�� Dui a �I) �i � EA � $�U Ion ».gyp �iWr COD NO.Q USED FOR ( J / s &P=Waltb�j 4601� NEGOTIABLE ONLY Ui1`HE U:S. AND POSSESSIONS 0000130021: 685336 1859 Lill —..................,.......,. .... k ii: O O CO M P 405 193 532 Receipt for Certified Mail No Insurance Coverage Provided DINTEDS—ES Do not use for International Mail �TAI SEfNILE (See Reverse) Se to AA iri Str 7 t and No 0 q ST , YlyS P. ., tfe ana ZIP Code dhJ Postage r Certified Fee Special Delivery Fee Restricted Delivery Fee Return Receipt Showing to Whom & Date Delivered ' D t Return Rece Date, an r hom, TOTA age & Fe s t Postmark -Datel 5.1998 STICK POSTAGE STAMPS TO ARTICLE TO COVER FIRST CLASS POSTAGE, CERTIFIED MAIL FEE, AND CHARGES FOR ANY SELECTED OPTIONAL SERVICES (see front). 1. If you want this receipt postmarked, stick the gummed stub to the right of the return address leaving the receipt attached and present the article at a post office service window or hand it to your rural carrier (no extra charge). 2. If you do not want this receipt postmarked, stick the gummed stub to the right of the return address of the article, date, detach and retain the receipt, and mail the article. 3. If you want a return receipt, write the certified mail number and your name and address on a return receipt card, Form 3811, and attach it to the front of the article by means of the gummed ends if space permits. Otherwise, affix to back of article. Endorse front of article RETURN RECEIPT REQUESTED adjacent to the number. 4. If you want delivery restricted to the addressee, or to an authorized agent of the addressee, endorse RESTRICTED DELIVERY on the front of the article. 5. Enter fees for the services requested in the appropriate spaces on the front of this receipt. If return receipt is requested, check the applicable blocks in item 1 of Form 3811. 6. Save this receipt and present it if you make inquiry. 105603-92-13-0226 ■Complete items 1 and/or 2 for additional services. ■Complete items 3, 4a, and 4b. ■ Print your name and address on the reverse of this form so that we card to you. -Attach this form to the front of the mailpiece, or on the back if spat 3. Article Addressed to: Ka A y AAC Con Ac,! I .3 5o4 ST, Mary Rd` 41 I is borou5 h NO, a' ) N.1 6. Signatu: Addressee or Agent) e permit. ■ Write'Retum Receipt Requested' on the mailpiece below the article ■The Return Receipt will show to whom the article was delivered an delivered. 3. Article Addressed to: Ka A y AAC Con Ac,! I .3 5o4 ST, Mary Rd` 41 I is borou5 h NO, a' ) N.1 6. Signatu: Addressee or Agent) I also wish to receive the following services (for an can return this extra fee): ai does not 1. ❑ Addressee's Address 5 number. 2. ❑ Restricted Delivery to d the date Consult postmaster for fee. c. 4a. Article Number a° 1-' Lf 115 9 q �3�� 4b. Service Type ❑ Registered ertified +a! ❑ Express Mail ❑ Insured ❑ Retum Receipt for Merchandise ❑ COD 7. Date of Delivery 8. Addressee's Address (Only if regfjsted and fee is paid) r PS Form 3811, December 1994 Domestic Return PS Form 3811, December 1994 Domestic Return j n r First -Class Mail UNITED STATES POSTAL SERV Postage & Fees Paid USPS Permit No. G-10 • Print your name, address, and ZIP Code in this box • pt� G po /�3 ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIERIMOORING PILINGS/BOATLIFT/BOATHOUSE) I hereby certify that I own property adjacent to A,/I/c c /,p 5' j �g� i S is (Name of Property Owner) property located at y c - xr7 Al, -5 �/L 4 t" z-.,v `✓ (Lot, Block, Road, etc.) on s c /{Fi k , in �� h'� le�.9r� L cz , N. C. (Waterbody) (Town and/or County) He has described to me, as shown below, the development he is proposing at that location, and, I have no objections to his proposal. I understand that a pier/mooring pilings/boadift[boathouse must be set back a minimum distance of fifteen feet (15') from my area of riparian access unless waived by me. l� I do not wish to waive the setback requirement. I do wish to waive that setback requirement. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: (To be filled in by individual proposing development) i ,;1� /I i 1/ 0Lp 4'L/e Ncr�n tjr '6'J'1c jf(j,4,0 N ;r fire ignature kwi--- Print or Tylpe Name Of -73-Z - Telephone Number S� Date: / 0 i 0 WX at FaTM0 WIN: 12 r ki B EIRDIFU r DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM Name of Individual applying for Permit: ��/ 1-4 / � S i s Address of Property: (Lot or Street #, Street or Road, City & County) I hereby certify that I own property adjacent to the above referenced property. The individual applying for this permit has described to me as shown on the attached drawing the development they are proposing. A description or drawing, with dimensions, should be provided with this letter. I have no objections to this proposal. If you have objections to what is being proposed, please write the Division of Coastal Management, Hestron Plaza II, 151-B, Hwy. 24, Morehead City, NC, 28557 or call (252) 808- 2808 within 10 days of receipt of this notice. No response is considered the same as no objection if you have been notified by Certified Mail. WAIVER SECTION I understand that a pier, dock, mooring pilings, breakwater, boat house, lift or sandbags 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. Sig ture Date .�, ? Mceov„ie'(1 _ Print Name qtq -73'1-M51 Telephone Number With Area Code ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIER/MOORING PILINGS/BOAyllFl/BOATHOUSE) I hereby certify that I own property adjacent to //xv //- 's (Name of Property Owner) property located at o '� -"":� /') G <) '/ (Lot, Block, Road, etc.) on , in �iT.l'`'i9�/�� , N.C. (Waterbody) (Town and/or County) He has described to me, as shown below, the development he is proposing at that location, and, I have no objections to his proposal. I understand that a pier/mooring pilings/boatlirt/boathouse must be set back a minimum distance of fifteen feet (15') from my area of riparian access unless waived by me. I do not wish to waive the setback requirement. I do wish to waive that setback requirement. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: (To be filled in by individual proposing development) 4 K� � J J i qc S 1 4-nae Pant or Type Name �yly1 ZV-y-6--c>zo Telephone Number Date:�t/