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HomeMy WebLinkAboutBrookins, ElizabethLiCAMA / ❑ DREDGE & FILL N . 9 78927 A B �" C ' --b GENERAL PERMIT Previous permit# New ❑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 15A NCAC %% ! K r ' attached. Applicant Name �I %<\V%� 1"i .'�;Y i , i I 'l Project Location: County / f� ., Address .c. 1—�Gi 'F 1 /-!Y�]f' Street Address/ State Road/ Lot #(s) City "1 / State' ZIP': Phone # Authorized Agent 1, Ot11 ,,A 114, �(li l � N� IQ i f iE lP�% Affected AEC(s): ORW: yes /rtio I ❑CW ❑EW El PTA '�VES ❑PTS ❑OEA ❑HHF ❑IH ❑UBA ❑N/A ❑ PWS: yes K no PNA Subdivision fCa%) 0/1 -61 1,04T City ZIP Phone # ( )%� r River Basin'1''/A tit! 00, Adj. Wtr. Body l6 C ,, �r C W nat man. unkn Closest Maj. Wr. Body /%G,t , jr .. ye , A■■■■ ■■■ ■ ■■■■■■■ ■■■■■■■■■■■ S■■OEM .JIMMEjos . M■■�I , 0 MENNIONSI�mmooll NEWS MEMO MEN MESSINESS! M ■ ■■■E■■H a.■■■■■.■■�■..■■.�►�.® iiMENNEN ■■�■■■■■■■■ momommmom�� M. ®iMOMMEMi Miiiiiiiu®■i iiii■i ■ =1 ■■■■■Ea ■ME■■ �■■■■�C :... a■■■■■ ■ ■■■■�®.■■■■■� ■■■■■■■■■■■■■■SEES • ■MI/Illill!■■ NEMESES ■/1'�i6�i�31M.�!11lI�EEAe��IM�911�11�5_►.�rINEEENI��L��_:,- S: rr�a�fl. MEME �MM■El�r N�f�/IiM�ii■��'flElrilfiv�WN I■�r� iN M■■■■■ IMEM ■ISMIN VEIN MISS ►.L.... ES.I..R, .... .� �■ .. MM■MII EJ ME■MEME���ME IMEM :�■■iiiiu IN Ag nt or Applicant Print d Nam€ Ali Signature -** le se read comp Ian esx t ment on back of permit'" Application Fee(s) Check # r PermitOffcer's Printed Name r Signature Issuing Date Expiration Date AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: /= /, 4= L /h -8 (-D, kL s Mailing Address: Phone Number: Email Address: 55 113lec.0 4�"A / C- aRsi G 54 73,-z — �,/G 3 ,CCJ r I certify that I have authorized DENNIS & SONS MARINE CONST. 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 `i D at my property located at in CARTERET ,�?5"5 County. 1 furthermore certify that l am authorized Division of Coastal Management staff, the on the aforementioned lands in connecti( permit application. Property Owner Information: signature Print or Type Name Title eg Date a S=)/ to to grant, and do in fact grant permission to Local Permit Officer and their agents to enter in with evaluating information related to this This certification is valid through" '2-- / -3-1-"' I IZ� �3� a� CERTIFIED MAIL • RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONNVAIVER FORM Name of Property Owner. --Orcr-'IC�V-vS Address of Property: (Lot or Street #, Agent's Name* WILLIAM DENNIS or Road, City & County) Mailing Address: 109 SEAHORSE DRIVE Agent's phone #: 252-241-6962 BEAUFORT, NC 28516 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 must be provided with this letter. I have no objections to this proposal. I have objections to this proposal. If you have objections to what is being proposed, you must notify the Division of Coastal Management (DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is available athttp://www.nccoastalmanagement.neUweb/cm/staff-listing orby calling 1-888-4RCOAST. No resnonse 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, boat ramp, breakwater, boathouse, or lift 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) Signature y' zC V-x,- n �GCO 1y-)s Print or Type Name �5 <-- rC J2�. bane - Mailing Address City/state/Zip a--(3a- coI(�a3 Telephone Number/Email Address Date (R' arian Property O ner Information) u�-- Signature IU1Q.r,C") (i Print or Type Name I50-I, Mailing Address 1,4E ✓S '� 3 c) I City/state/Zip , q-r K`,L� Telephone Number/Email Address Date (Revised Aug. 2014) ADJACENT RIPARIAN PROPERTY OWNER STATEMENT hereby certify that I own property adjacent to �/ &G- eft n S s (Name of Property Owner) / property located at uZ SS a-[L1 L ,-tne, 81Tu� -fo It /V. C. Q 85'/6 (Lof (Address, Lot, Block, Rora+d, etc.) on Core C(eek in J3eauT0 N.C. (Waterbody) (City/Town and/or County) The applicant has described to me, as shown below, the development proposed at the above location. _ X 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) He,'PjA1ce gram le- Coo-/<�'S "bare, Sjft'tS 0N 4Ac,- 7Ja ,k o Pr0/ er-'3 . r Ae �ar SPo i 5 wl,Pre- }he /ruc 1S save w/ashe ct vb��/ /have eeT/iv�A!'ef lAl //h"nD -/-Ae ]J qn%e / *)-) i S .O f— Y'L / l S /u i- j-e p t C e J (JC Q C i'n ; SSr " � I k J ,f, I^c ck �al fiP( �oN shorel6'he o t/ e exi S� J Core CreeY- 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.) K C.— I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Property Owner formation) (Adjace tt Pr perry Owner Information) ilure Sign ture 0/- aN6e-kb S. My ok; � S e i/in e e Print or Type Name Print or Type Name �.S �a:�seq Lane �Ra9 L;11/e Creek ClNrcl. R�- Mailing Addres Mailing Address u or-f C o? Chxy/oa/, NC- • aysao City/s ate/Zi City/sta e/Zip / Telephone //�(�,mber/email ddress �m�;/,cu, Telephone Ali mber/err it adder //oZado Date Date* (Revised Aug. 2014) *Valid for one calendar year after signature*