HomeMy WebLinkAbout76251D - Brodeur)eCAMA / ❑ DREDG & FILL
GENERAL PERMIT
XNew ❑Modification ❑Complete Reissue ❑Partial Reissue
No. 76251 A B C
Previous permit #
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 (�) r% (.1 . 2 O O O
❑ Rules attached.
Applicant Name -DA L e- R o DE Lk 9— Project Location: County Nr ,,j (4 A A) oy c�
Address 97 3 2 0 BA L,o F_ AGt_s L n/ Street Address/ State Road/ Lot #(s)
City W I L M 1 NC,-ro A! StateAI%C _ ZIP 2 R'411 S A ME-
Phone # (11l 10)3(a7- "1I 37 E-Mail U( ks.(,Aubdivision
Authorized Agent j la tp p tpp W
City
ZIP
am
Affected ❑ CW XEW IXPTA ❑ ES ❑ PTS Ac-%1: nl-r Phone # ( G 10 ) 411 -.2 034 River Basin W t4% , c CAA K
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ USA ❑ N/A Adj. Wtr. Body —Al W W nat an /unkn)
❑ PWS:
no PNA yes no Closest Maj. Wtr. Body
ORW: (E
Type of Project/ Activity %A A I ni T r_ AlAA/ C r- /X RC ?A JR Tn F—,e m 7 w(-, -Da c r - w n FA c u- ny
i-) SAME r-DOT PI-Zt,4T wITH /VC-,.J T:A/`ARciEy R.»F
,W-' Zr ) leporh 15F95 " X /n 4'
fixed Platfor
oating Platfc
Finger pier(s)_
Groin length
number
Bulkhead/ Rip
avg dista
max dist
Basin, channel
cubic yai
Boat ramp __
Boathouse/ B(
Beach Bulldog
her G
CA
Shoreline Len
SAV: n
Moratorium:
Photos:
Waiver Attacl
(Scale: fJT S
A building permit may be required by: /J.r ,,J PA VuVr 1Z Cou-Al Ty ❑ See note on back regarding River Basin rules.
( Note Local Planning jurisdiction)
Notes/ Special Conditions "1) S i P Ar- T,.Rr—S SNAu. AoT F X c r- VD Fr D1= RAr_ c 14AWA/F L -Sr TnACK
7r-' 2) S'I tiftxitr-3 SMALL A/o-f V nlcR-oAt-w IN ,n 15 121?A 1? lAn! r"oRR1 C>oR Sif t aAct6r
Agent or Appli rinted
Signature PI se read comp) nce statement on back of per 7
C1��
Application Fee(s) Check #
Permit Officer's PrinteddNNa.me--,
Signature
3Ap bC, '1XP12-0
Issuing Date Expiration Date
N.C. DMSiON OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date 1
Name of Property Owww Applying for Permit:
ot
2�
'.1laSting Address:
i eertify that i have authortted (agent) -_ j PL �J � n to act on any
behaii, for the purpose of applying for and obtaining all CA IA Permits uccusary to
install or construct (activity) -^
at (my property located at) W � � � � �� iT' 4\ . LAnrf
This eerttiiratiou is valid tttru idate) 4/,Ij 40.,
0
Property Owner Signature I' pate
ADJACENT RIPARIAN PROPERTY n%AIKI STATEMENT
I hereby certify that I own property adjacent told pj �dl may,
s
property located at �3ZD �C (Name of Property Owner)
on --,ejej W+ (Addre s, Lot, B oc , Road, et ,.) in N.C.
(Waterbody) (City/T wn and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
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)
Al*we, xloeio,
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.)
I do wish to waive the 15' setback requirement.
i do not wish to waive the 15' setback requirement.
(P operty Owner Information) (Adjace6t Property owner formation)
l.'
St nQtztr signw
Print or Type Name � "7 4 f �.
$3 z 0 Print or Tye me r-
Marhng Address ic mox,gg Address
vEG-n.,--—`—__g�
City/State, ? City t t ip f
CIS , Cam► -
Telephone Number mail address TelephonefNumberl mad a dyes
Date Date,.v
'Valid for one calendar year after signature' (Revised Aug, 2014)
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent top�,,,
's
property located at 83,E (Name of Property Owner)
(Addre, s, Lot Bloc , Road, etc
on .)
(Waterbody) N C
(City/T n and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location
! 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)
e ex-x-iKli e 1� f 5 fl�6
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.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
(Adjacent Property Owner Information)
r
Si mature
"-) e L- -
a��► y rnr�p �� J�
Signature *
G. K-,-t
Print or Type Name
= 6 l a �
Print or Type Napge
S2/4, ;It E
3 (.dress -Z e t
i
Mailinq Address
1"✓ t L / t) t N � —IC tv Li/
Citylstate/Zio
-�I�e bcad����rcc��i��;ty�a,p 7 ZS, y34 j&
Telephone Number / email address
ZO
Telephan Numb r 1 email address
Z 27
Dat --- __
Dale * --� G 2-�'
*Valid for one calendar year after signature` (Revised Aug. 2014)
Elm
�Ell
Mond
■
a�
��
Date Received
Onfe ad
Cheek Flom
Name &Pemdt Noldr
V d-
Check Number
Chock
amount
Permit Numbe lC—mfa
Reed f -Re/ dRteallocafed
Columnt
Cdumn2
Cok—I
Cobmn!
Column5
Column6
Cob-7
Column8
Cobmn9
3/10/2020
3/10/2020
B & J Construction of NC LLC
Cam Delores Snel rove
BBBT
2170
$ 400.00
GP i76274D
BB rct. 10906
TMc rct. 9771
- - - - - - - —
TMc rct. 10382
3/10/2020
3/10/2020
Pippin Marine Construction LLC
Dale Brodeur Jr.
Wells Fargo
6402
$ 200.00
GP #76251 D _--
--
3/10/2020
--
3/10/2020
Pi in Marine Construction LLC
Ral h & Jackie Pennin on
Wells Fa o
5389
S 200.00
GP f76259D