HomeMy WebLinkAbout75892D - Gore'CAMA / ❑ DREDGE & FILL
;ENERAL PERMIT
�4ew ❑Modification ❑Complete Reissue El Partial Reissue
+.IT q
No. 75892 A B
Previous permit #
Date previous permit issued_
ized by the State of North Carolina, Department of Environmental Quality L
bastal Resources Commission in an area of environmental concern pursuant to 15A NCAC (I I . 12 w
❑ Rules attached.
: Name N A C%V (x S (' _ Project Location: County
1 1 Pei Street Address/ State Road/ Lot #+(s) 2
State�L ZIP TR(4 �s/S S R` '.A , h ST _
(rl /O) -SyU 2(A Y E-Mail
aclAgent Cj✓«,
❑ CW PrEW ?ZPTA ❑ ES ❑ PTS
❑ OEA ❑ HHF ❑ IH ❑ UIBA ❑ N/A
❑ PWS:
yes / PNA yes
Subdivision
Cityo I �c a c ZIP Z I
Phone #
River Basin L , , t
Adj. Wtr. Body e A ^ 4 ( (nat
Closest Maj. Wtr. Body Ac w
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ng permit may be equired by:
Local Planning Jurisdiction), r i
❑ See note on back regarding River Basin r
1 . .
,AMA / ,--j DREDGE & FILL N0. 75842 A B
EN ERAL PERMIT Previous permit #
kew Modification ❑Complete Reissue OPartial Reissue Date previous permit issued
ed by the State of North Carolina. Department of Environmental Quality a
astal Resources Commission in an area of environmental concern pursuant to 1 SA NCAC �� '
attached.
Vame C�,v�S Gp'. --- Project Location: County /f ►
Street Address/ State Road/ Lot f (s) ZS
�a �u State�ll C_ ZIP — —r--
q /D)-1 N U (rtE-Mail Subdivision
dAgent G,•�_Hord
City
Ei Cvb ?p PTA C ES PTS Phone # ( ) River Basin lv'�
OEA HHF i=1H C UBA ❑ N/A Adj. Wtr. Body nat
P%VS- Wtr. Body w
ye{ Closest Maj.
t'NA
Project/ Activity `•• `
0 (Scale: N
ck)lengd, Vo_ tY ? -
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y'YSf ,
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nnber '
rd/ Riprap bngt!'
g datance offshore
ax disome of{shore ' — .
jbic yards
Imp
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Bulldozing - I--� -- — - —
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fine Length 5 LO i3q) .ncot
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sure yesZ}S _.S Ott;`-�L_ •— - I i } - -1
torium: nla yes
_'
yes
er Aaached: no See note on back regarding Rrver Basi.
iWina penult rnaY required by: t ► a, - ►- A n.. i L, � l l
K
nm
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: C�IeS P&r-4,--2
Mailing Address: �� 2
Phone Number:
Email Address:
I certify that I have authorized
/'%le!�' S.07
41t, «i 1�4 Idt`'(11 ,
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: /25—
-k �� �-),- 0-
at my property located at /ems
in Aalo County.
1 furthermore certify that 1 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
R"Onw-j
Title
,i
n� OfIndivicual Applying For Peanir: Cif/�lii lCs , ✓�
dress of ��-
or :9 car Rai
f - AC
(City and County)
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!� i ! t•i .mart.{ f,it:t ttt� t' t t kti�
UWA IM days sfreeefgt �# a�avmw- NO r e is - thesame as no obj
m bae bemSECUONI
w
breaUxubm
et a"Aa sbeat er bastes
I in warm of Amm - anjss moved b
► �ie�et�ees 74mot bd" t1he Orpaurrmun bbmk be%w)
..�� - I coo Irish ors wave# l 5` sefbac3c
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CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/1�,1 IAIVER FORM
Name of Property Owner v a� _
Address of Property: 43 /� c / C z-Z,
(Lot or Street #, eet or Road, City & County)
Agent's Name #: 41t° p 411&
Mailing Address: I 50 2 �tjr
Agent's phone #: 61W .S"q t) / (�
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 whatis being proposed, you must notify the Division of Coastal Management (DCM) in
writing ►+1thin 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive Ext,
Wilmington, NC, 28405-3845. DCM representatives can also be contacted at (910) 796-7215. No response is
^onsidsred the same as no objection if you have been nodf/ed by Certified Maid
WAIVER SECTION
I understand that a pier, dock, mooring
pilings,
must
back a minimum distance of 15' from my area of riparian access unless Iwa �edroin by me. (if be
ouet
wish to waive the setback, you must initial the appropriate blank below.) y
_ I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
Pr?perty/Ow,apr 1 nformation)
1ignature
V1 I _
'nnt or Type Nam
Bailin Address
��7 A .% il A
(Adjacent Property Owner Information)
Signature
Print or Type Name
Mailing Address
Ss of A& cry A �- ems, e
or
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WC 28405 or can
e�raeyrteseamhis �s #g as aao obi
bre bftta uggftd by CmMfied M.-L
�ie�ai� ��! ft�e�area �#�u access - s waaved �
Ado.
duo.
1Y setback