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HomeMy WebLinkAbout76557D - LoiacononCAMA / ❑ DREDGE & FILL N9 76557 A B 3"ENERAL PERMIT Previous permit# ],New 1Modification ❑Complete Reissue El Partial Reissue Date previous permit issued rized by the State of North Carolina, Department of Environmental Quality I Zoastal Resources Commission in an area of environmental concern pursuant to 15A NCAC r z U ' El Rules attached. it Name (�,6 d D_(�LI A CDAc Project Location: County impel_ ' N ( V C Street Address/ State Road/ Lot #(s) State Nc. ZIP 7UA -S 1,p� fir (�C � ly' ✓C �i� -Mail Subdivision :ed Agent N / 61" CityZIP �r ❑ CW 17IW VTTA ElES ElPTS [IOEA ❑ HHF t IH ❑ UBA ❑ N/A ❑ PWS: yes /rrri5 j PNA yes 7 F Project/ Activity length �ngth amber �d/ Riprap If g distance ax distance hannel bic yards np not sure yes Ium: n/a yes yes Attached: yes ©4 Phone # ( 7-­_� River Basin CA) Adj. Wtr. Body & / A N ffi3D/ Closest Maj. Wtr. Body % �r� IL SU o/ (Scale: ing permit may be required by: 1. (A (Yj(/L ��[ j El See note on back regarding River Basin r Local Planning lurisdiction) -44 -- ------ 0' A(* t 1 / 1 j -4 Pal51 c i ' I + DCA LO qs RECEIVE JUN 2 5 21 DCM WILMINGT( AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: __i_�Lb' ra l-OIUC,L,'Y1 Mailing Address: '4 N, Kj,&-WCc�ev- Or. - 4 VV"0 kad f >Q c_ a N d 3 Phone Number: 910-uSu - 5 S 1 ^7 Email Address: i (tCA-30-c4)i, 01 W0. tDrn certify that I have authorized Mar I At, Agent / Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: k iU boo,i k i t4 .+t at my property located at oA - I at Qo i x� S"'c", n in t'C.nJCA'*'- County. I 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, r Property: ner formation: I ` ' q Signature (� Print or Type Name o u) 11 Title Date CERTIFIED MAIL • RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM Name of Property Owner: 641� I Ia LA.-lY\ t) Address of Property: Lo - 'IS OW 9DIr"A , 5xCAi +:m (Lot or Street #, Street or , City & County) Agent's Name #: Mailing Address: Agent's phone #: c! 10-2961 --?9Q 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. t 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 15from 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. ter Information) R(dit~ Prope Owner Information) gre Print or Type Name An, vejey�f lWarimg Address Crty/3ta /Zip Print or Type Name r' Marlrng Address aA-4`-c 14 j,--> C- City/state/Zip CERTIFIED MAIL - RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM Name of Property Owner: (�" ak Loto t,,,c;-n to Address of Property; �-i + S (��C Q�Ir A , SRU�) y\ (Lot or Street #, Street or City & County) Agent's Name* C-) t1�61 v Mailing Address: Agent's phone #: IC - ,� 9 C1- 79 Ot '] 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 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 Waif, WAIVER SECTION I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set back a minimum distance of 16 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. TI do not wish to waive the 15' setback requirement. er information) (Ad' ent roperty OwnerJnformation) ignalure Print or Type Name L11$ Dr Mailing Address �LIKOW L a CitylSta lZt� ipp �a4m CAV Al Print or Type 16me Mailing Address 40-vwfl �r� - C- City/Statelz ISM 1�