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HomeMy WebLinkAboutPruitt, Bland4AEM*—M DREDGE & FILL N9 78465 A B C ,JENERAL PERMIT Previous permit# New ❑Modification []Complete Reissue ❑Partial Reissue Date previous permit issued ` As au horized by the State of North Carolina, Department of Environmental Quality / j/6? ' and the Coastal Resources mmission i n-, rea of nvironmental concern pursuant to I SA NCAC / !!//�� vlJ OR 'les attached. Applicant Name l !, l+'t "/ ��' Project Location: County Address - I V 3 111�oK u e l i City f State/VC ZIP Phone # ((Jj %a�f' / /od E-Mail Authorized Agent �r / / r "t/ 5 E�_& 0EW L}P'TA Li ES ❑PTS Affected ❑ OEA DHHF ❑ IH ❑ UBA ❑ WA AEC(s): ❑ PWS: ORW: yes Kno ; i PNA yeso Street Addres / State Road/ Lot #(s) Subdivision City Y � ,f. %��'° � ZIP �) si Phone# O/ verBasin/ `ii Adj. Wtr. Body j Jr,�.(( ' ✓4�r�r n3f"man unkn Closest Maj. Wtr. Body r7 Type of Project/ Activity ■■■■OMOME M■■■■....E MEN ■■�►■■wr��i�'■',,r�irz�■n�■/r■���,�,r��r ��■■■�■�up■ �EME .■.■ MWO�GII 'i1111 ■■■��.■�..�� ■tl!■■ii.�■.CIS■W■I■■■■ .■� MEMO. ■■■ ■.■ .. M® MEMO _ PMEMEMEME ME ■■■E M■�/ ■ERIPWOMw EM �i _... iMEr i.:!� M■KWJIFA ■■■■ O■■■ ■■�Ellir�"lillr ■MIMMM■M ■EI,.■.. ■■■� M■■ �� ONE Em � MEMO MEMO M. MEN■�..■.. WR _- SEEN him ■ii NEW No 0 momE0MMEWHOMMM= MEN 0 i M■■M■11�®NoSM�■�■■■■O .■ M.■1� ■M■5..�.SEE.■. ® �.■ .■ ■L�■■■ ...■. M■■E■EMEME `iL.■.Ir010Iml �■■MS■SM■■SE .■...,..E.� NEON ■IM■■■ ..�■MEMO■.E■ No ■.■�..SENSE ■■■ ■■OW SENSE ■!■■E■■■■d■■O■..■O■N.OH■O■. SEEN MME ■■■■■�.® MEN ME 11111M No �i■C...w .IEEE■®■�ME MEN PT r : e %�i Agent or Applicant Printed Name Signature *' Please read compliance statement onback ofpermit •• Application Fee(s) Check# ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to E IA ;✓ 'I' 6 J —j!. ,s y�.. (Name of Property Owner) property located at �n ! f w E // 3-11- (Address, 1-61t, Block, Road, etc.) on �.{- N r� l in 11,4 r A; r f N.C. (Waterbody) (City/Town and/or County) The applicant . as described to me, as shown below, the development proposed at the above location. I have no objection to this proposal. _-----�Lav�objectLon�t9this_pr_npcs-aL-------..__.___----- --- --- DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (Individual proposing develop rent must fill in description below or uattach a site drawing) RECEIVED I JAN. 2 4 2020 DCM-MHD CITY 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. (Property Owner Information) Signa� g1- / f L/ 01 r v; % Print'or ype Name Mailing Address City/State/Zip Telephone Number Date (Adjacent Property Owner Information) Signature Print or Type Name * �5i Mailing Addre7ss )r . AL. City/State/Zip AX--- (:A SM 3 I Telephone Number q)o 9'zL1 X-174 Dare �J la, �,0. � (Revised 6/18/2012) I hereby certify that I own property adjacent to property located at /n3 /Y%xwE (Name of Property Owner) ress, Lot, 92 ck, Road, etc. on in 41,4r kris s- N.C. (Waterbody) (City/Town and/or County) I The applicant has described to me, as shown below, the development proposed at the above location 1/ I have no objection to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (Individual proposing development must fill in description below or attach a site drawing) 1 S I iA° MrN µin �j t {�r_ m err 0=4� RECEIVED JAN 2 4 2020 DCM-MHD CITY yyMly Gf\JLV eevev _.--.—.—_. I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin back a minimum distance of 15' from my area of riparian access unless waived by 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) Signature or Type Name Mailing Address City/State/Zip !alq y96/ 97,?y Telephone Number must be set me. (If you (Adjacent ProperpA Owner Information) Sign at re T. 10,4"- �z Print or Type Name //1::L Mailing City/S(t�a_t5/� Telephone Numbe%/ :iZ n;,ra (Revised 611812012) Eric Ellis Marine Construction DOCKS*SEAWALLS*BOAT LIFTS DECKS & REPAIRS Telephone : 252.726.6775 205 Nottingham Lane Morehead City, NC 28557 OEM ME _ /A �� WEEMM SIMEMSE �� '. molEM! M■ C ; 1M■MSE ME MIEMMI MEMEMIMIM Capps Prirviing, Morehead City