HomeMy WebLinkAboutDoyle, John�] .�CAMA / ❑ DREDGE & FILL N9
78481 A B c' D
GENERAL PERMIT Previous permit#
i,RNew ❑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 I SA NCAC , ?/L
L 1
M Rules attached.
Applicant Name " 1 ; ! f1 / l( Project Location: County �3
r:
Address � (-< /' � f�� � Bn `, Street Address) State Road/ Lot #(s)
City ����"� (,{� Statethr ZIP
Phone # E-Mail
Subdivision
Authorized Agent ff
Affected ibCW —OEW �UPTA AES ❑PTS
AEC(s): ❑OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
ORW: yes / no PNA yes / no)
Type of Project/ Activity f '\ �
Pier (dock) length (c r
Fixed Platform(s) �f
Floating Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Nprap length_
avg distance offshore_
max distance offshore
Basin, channel
Shoreline Length 1
SAV: not sure
Moratorium:
Photos:
Waiver Attached:
no . `. A building permit may be required by: i jj( t i Q ( '/ ? 1 ® See note on back regarding River Basin rules.
( Note Local Planning Jurisdiction)
Notes/ Special Conditions
City ZIP
Phone # O River Basin
Adj. Wtr. Body I q / J : I �' 1 (� (nat /man /unkn
Closest Maj. Wtr. Body , /: -,.
(Scale:
yes .
yes/
ye5l
i
40
Agent orApplic, i Prjnted Name
Sign t rfe,+ ** Please read compliance statement on backofp it*
71,57 �
Application Fee(s) Check #
Issuing Date
HAND DELIVER
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(TOR A PIER/MOORING PILINGSIBOATLIFTIBOATHOUSE)
I hereby certify that I own property adjacent to' -QV —
property located at
S 3)
EVA
(Lot, Block, Road, etc.)
I
on �/ll/SC / J UC / _ in_�Uel6Cl� N.C.
(Waterbody) (Town and/or County)
Applicant's phone #: ZS 1--12L'/S�-?Mailing Address:
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 / boatlift / boathouse
must be set back a minimum distance of fifteen feet (15') from my area of riparian access unless
waived by e. (If you wish to waive the setback, you must initial the appropriate blank
below.) 7
V I do not wish to waive
I do wish to waive that setback requirement.
----------------------------
DESCRIPTION AND/OR DRAWING OF PROPOS)CD DL:VttOPNtt NT:
(To be filled in by individual proposing development)
(Information for Property Owner Applying
for Permit)
SIA (23.
Mailing Address
N
1- xkrt.N06-, C aSS3a
City/St ate
aS;.-UA9-IS�o3
Telepho e Number
ignature Date
(Riparian Property Owner Information)
�ignature
Zk�ilCrC. G �YIA"/
Print 4r Type Name
J y Telephone Number
Date
SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
i ■ Complete it(rns 1, 2, and 3. A. Signature ,f
■ Print your name and address on the reverse X ❑ Agent
so that we can return the card to you. Addressee
■ Attach this card to the back of the mallpiece, B. Received by (Panted me) C. �tepf Dive
or on the front if space oermlts. p .�C/5//,.7 13 ry
1. Article Addressed to;
Yt •i �,S�jOfOJt,� ylU,5, O8ii UL1
D. Is delivery address different from Rem 17 ❑ Yel
If YES, enter delivery address below; Q No
III'lllll
IIII
l'IIIIIIIII
IIII
IIII
IIIIIII�III
III
3. Type
0 Priority Mail lRestrited
O Adult8gnturee Restricted Delivery
❑ Certified Malle
❑ Reggistred Maice
Delivery
9590 9402 5803 9274 5281 91
❑ Certified Mail Retricted Delivery
❑ Return Receipt for
❑ Collect on Delivery
Merchandise
2. Article Number (Transfer from Service Mhr,n
^ ^-"--' _ ' 'ivery Restricted Delivery ❑ Signature Conflnnation^
7019 0140 0001 0230
1696
'astacted Delivery
❑ Restricted Confirmation
Signature Delivery
_
over 5001
PS Form 3811, July 2015 PSN 7530-02-ODO-9053
Domestic Return Receipt