HomeMy WebLinkAboutOgden, TimXCAMA / ❑ DREDGE & FILL
GENERAL PERMIT
NNew ❑Modification ❑Complete Reissue ❑Partial Reissue
N9 78935 A
Previous permit #
Date previous permit issued
B -t D
As authorized by the State of North Carolina, Department of Environmental Quality jj/ _- / /
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC '
[7es attached.
Applicant Name i i) Project Location: County G'1.i
Address
City . '� State N ( ZIP
Phone # E-Mail
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Authorized Agent
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Street Address/ State Road/ Lot #(s)
Subdivision
City ZIP
Phone # O River Basin
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Agent or Applicant Printed Name
Sigtur e e"Please read compliance statement on back of permit"
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Application Fee(s) Check #
Permit Officer's Printed Name /t
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Signal Yre /
issuing Date Expiration Date
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: I rn 04&11
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Mailing Address: _J ' Imf'1yi (AA) Dme,
Phone Number:
Email Address:
I certify that I have authorized
to act on my behalf, for the purpose of applying for and obtaining all CA�MA permits
I
necessary for the following proposed development: u 116 V zoJrLpLx men,f-
at my property located at gqq ri Ili.( ICE ylo'k)
in OrADW County.
l furthermore certify that l am authorized to grant, and do in fact grant permission to
Division of Coastal Management staff, the Local Permit Officer and their agents to enter
on the aforementioned lands in connection with evaluating information related to this
permit application.
Property Owner Information:
Signature
Print or Type Name
Tiittl�le//-,�
Date
This certification is valid through
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Tracking Number: 70190700000234672295
Your item was delivered to an individual at the address at
3:21 pin on February 27, 2020 in SNEADS FERRY, NC
28460.
Text & Email Updates
Tracking History
Status
OV Delivered
February 27, 2020 at 3:21 pm
Delivered, Left with Individual
SNEADS FERRY, NC 28460
Get Updates \/
February 27, 2020, 3.21 pm
Delivered, Left with Individual
SNEADS FERRY, NC 28460
Your item was delivered to an individual at the address at 3:21 pm on February 27, 2020 in SNEADS FERRY, NC 28460.
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Postmark
Here
02/25/2020
Tracking Number: 70190700000234671021
Status
Your item was delivered at 4:12 pm on March 9, 2020 in OV Delivered
JACKSONVILLE, NC 28540. March 9.2020 at 4:12 prn
Delivered
JACKSONVILLE, NC 28540
Get Updates
Text & Email Updates
Tracking History
March 9, 2020, 4:12 pm
Delivered
JACKSONVILLE, NC 28540
Your item was delivered at 4:12 pm on March 9. 2020 in JACKSONVILLE, NC 28540.
February 27, 2020, 9:42 am
Available for Pickup
JACKSONVILLE, INC 28541
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to
CERTIFIED RECEIPT
Domestic
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all fleslndetl DelNery $ trl_hrl
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RequlreJ $ $000
❑ Adult$19aals. Reatrlcao Delivery $
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$02/25/2020
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RECEIVED
CERTIFIED MAIL • RETURN RECEIPT REQUESTED MAR 18 2020
DIVISION OF COASTAL MANAGEMENT DCM-MHD CITY
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner:
-Address of Property: I I 11�� �i� \Xy �� (� �> ��� � '� l_ � \� Y)5J
(Lot or Street #, Street or Road, City & County)
Agent's Name #: Vb � bec Mailing Address: (,'?`7 V a Y 11 o (,xbi
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Agent's phone #: � (J) — 755dt2 r`' H�� au �`t�d_ro
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 drawino with dimensions must be provided with this letter.
4— 1 have no objections to this proposal. 1 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 at httn•//www.nccoastaimanagement.net/web/cm/staff-listing or by calling 1-888.4RCOAST.
No response 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.)
14. 1 do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Informati�)
Signature
1 R n-) 0�xl ,,n
Print or Type Name
2911 LnM \i I Pew DY
Mailing Address t
City/State2ip
Telephone Number/Email Address
Date
(Riparian Property Owner Information)
b 1YX/AAhI'Y� �dt,
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Print or Type Name
MIX q 1
Mailing Address
30&w lu W M41, oo��
City/State/Zip
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Telephone Number/E/nail Addrdss
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Dat
(Revised Aug. 2014)