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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