HomeMy WebLinkAbout76429D - GurkinCAMA / ❑ DREDGE & FILL M 76429 A B I
iENERAL PERMIT Previous permit #
Vew ,[]Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
zed by the State of North Carolina, Department of Environmental Quality / 0, 12 b Q
3astal Resources Commission in an area of environmental concern pursuant to I SA NCAC ❑ Rules attached.
r U rV6>n Project Location: County �_ P tJ iTuv'U�/er
Name
VAD.D� �L Street Address/ State Road/ Lot #(s)
J'/ M t►1A ri State NLZI P� 9a
I 2
(") (P 3 7 53 KE-Mail 10 k r 61 �)hegu ivis on
W AgentS`:+ 1n S
City IJV i f ►r�4 ✓-� ZIP a� 1
❑ CWy (EWy P(pTA ❑ ES ❑ PTS Phone # ( River Basin
❑ &A ❑ HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body W w
❑ PWS:� W
� Closest Maj. Wtr. Body
Project/ Activity
atform(s) d{�U
Platform(s)+%� 2
3ulldozing
xium: Na yes no
yes no
ell
r Attached: yes no
ding permit may be required by:
❑ See note on back regarding River Basin
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit:z'rt
Mailing Address: �� `i
W t LKI N(,To�-
Phone Number: ql9 - (q-3A - 5'M
Email Address:
tomtit n-e g�
I certify that I have authorized Agent /Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: rG 43 �'�^-
at my property ert located at
in _N &, ounty.
1 furthermore certify that 1 am authorized to grant, and do in fact grant permission to
Division of Coastal Management coaff, the ncal Permit nection evaluaCfficer and tinge"nformateonir agents to enter
related to this
on the aforementioned lands in
permit application.
Property Owner Information:
I�
Signature
(�2'(yT V V4K 1C
Print or Type Name
6" tjAx
TiAn
, Benjamin
Mike Linville <mklinville@theamericansignshop.com>
Monday, June 29, 2020 10:33 AM
Brink, Benjamin
A: [External] Brett Gurkin dock @1344 Hill Valley Walk
eWbr open atiMents unless
Mike Linville, owner of 1340 Hill Valley Walk. I have no objection to the docking facility at 1344 Hill Valley Wa
I by Brett Gurkin.
ee to contact me with any questions or concerns.
;s,
_inville
can Sign Shop
94-8807
rille(a-)-theamericansignshop.com
CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner:C�✓nKi,✓ -
Address of Property: brio W, �"�" �O'� Nc-
(Lot or Street #, Street or oad, City & County) 1ti„ H "Oki
Agent's Name #: Mailing Address: "
Agent's phone #:
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.
ilI have no objections to this proposal. I 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. 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
considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, 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)
1 kkkr �"o�
Signature
�t T- � 4 AX I n/
Print or Type Name
1 Oyu IkI L L, U NV-N WAL11-
(Ad' Pro Owner Information)
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Signature n
Print or Type Name
/3oG 9, // 1 *,4-<v U rc
Mailinq Address
Mailing Address
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