HomeMy WebLinkAbout76190D - Burton�CAMA / ❑ DREDGE & FILL
3kNERAL PERMIT
New ❑Modification El Complete Reissue El Partial Reissue
No. 76190 A B
Previous permit #
Date previous permit issued
Ized by the State of North Carolina, Department of Environmental Quality 1
:oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC� 1 U
.��++� ❑ Rules attached.
e t Nam� � t �� t�G 'v"' \1,�i r1 Project Location: County r-") AS tr
2.6 G ,Q ^ Ce,� U \\r ' LV\ . Street Address/ State Road/ Lot #(s)
GIB, - --�'J State U� ZIP Z"} $?� �X� � � S h SA -
leis E-Mail UJ L,CW✓1C.ri. C urn Subdivision
ed Agent "A 6v , 0- City �4 zip
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❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
yes eio PNA yes /®
' Project/ Activity
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ng permit may be required by: ►n � k �� OL C f 1 ❑See note on back regarding River Basin r
Local Planning Jurisdiction) _ n , , ,
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner- Requesting Permit: �� t_L4 rt-(& 14. �u It--m ^I
Mailing Address:----
Phone Number: '7t `l — 02- --07 7-0 - ----
Email Address: W & 02! o6,V 'C r4C. � �.-_ ^A
I certify that I have authorizedGC F'Uc. ") d ,
Agent / Contractor
to act on my behalf, for the purpose of -applying for and obtaining all CAMA permits
necessary for the following proposed development: j2Focs3-ce%,tc_#n'`kPAyw
at my property located -at
in County.
I 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
Title -
CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: w i � 1 I Q m ��l �' u rN
�
Address of Property: Lw3 5 a, W,,3� 1 6V / 5qnsoy
(Lot or Street #, Street or Road, City & County} -
Agent's Name It�1St('uaiv�
Agent's phone #: ���� S�CI - q oq,5
Mailing Address:M 32Q&� DC- 3W
CW-o:1�5le �WW. Z't%q
I hereby certify that I own property ddjacent to the above referenced property. The individual applying for
this permit has described to me as shown on the attached Orawingte development they are proposing.
1 have objections to this proposal.
If you have objections to what is being proposed, you must notify the DIyI n of Coastal
Management (DCM) In writing within 10 days of receipt of this notice. Corr should be
mailed to 127 Cardinal Drive Ext., Wilmington, NC, 28405-3845. DCM represe also be
contacted at (910) 796-7215. No response Is considered the same as no object/on been
notified by Certified Mall.
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 wish to waive the 15' setback requirement.
CV1a_)9/,n n1a udah requirement.
(Property Owner Information)
1Signature
Print or Type Name
\vlZ 0 l�u�eh�c�eQ �►ti�u lad
Mailing Address
e Vo re,,1`lC 2`15�1-1`13�5
cityistate✓zip
Adjacent Property Infor on)
Signature
Print or Type Name
97-00
Mailing Address
-Jv 4 /kG 2,7017
City/state/Zi
.. - _, .- ,(1-N
ip
CERTIFIED MAID • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
w Name of Property Owner: �1I Q M T3u r'.V l-N
_ �
Address of Property: Lw� 5 a► W,00 1 6�-
(Lot or Street #, Street or
Agent's Name #:Grid. &x,*,,ji6,1
Agent's phone #: % c)` rJ�� - q
City & County}
Mailing Address:COtp t BXKN1
r)T6tQ �(" Nc Zmq
:ertify that I own property Adjacent to the above referenced property. The individual applying for
it has described to me as shown on the attached 4rawincgthe development they are proposing.
dive no objections to this proposal. I have objections to this proposal
ave objections to what Is being proposed, you must notify the Divi, n of Coastal
Mqjbonent (DCM) In writing within 10 days of receipt of this notice. Corr should be
marl o 127 Cardinal Drive Ext., Wilmington, NC, 28405-3845. DCM repressri also be
contacted atr10) 796-7215. No response Is considered the same as no objection been
no"by. ed Mall.
......r....
WAIVER SECTION
I u e land that a pier dock, mooring pilings, breakwater, boathouse, lift, or groin must be set back a
mi u distance of 1 rom my area of riparian access unless waived by me. (If you wish to waive the
set c you, u i iti the appropriate blank below.)
CI is to waive the 15' setback requirement.
1 o It
wi Ie 9
uirement.
(Property Owner Information)
1Signature
Print or Type Name \ j
`-IZ`o ti�u � . tt Q UV
Mailing Address
cityistateaip
(Adjacent Property Owner Infor on)
-CbeLC�t IL.'GLw-p�Sn� (1�GLp
Signature
Rem &,.,-�
Print or Type Name
Mailing Address c
�Cl
City/State/Zip
� iN ulr"a ice-\VVIA
`v) IL,; �T)N\�Vnq ���-4.s!xz nb,613-L
Jomplete items 1, 2, and 3.
d Print ,iur name and address on the reverse
8r Ate can return the card to you.
IL■ nis card to the back of the mailpiece,
me front if space permits.
,cle Add "R1. :
1ll
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A. 9tg UUre
B. Receivedbv-f
Name) I C.
D. Is delivery addressl different from item 17
If YES, enter delivery address below:
C1J�r'�
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El Adult Signature F-1 RegisterE
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2- Artirla Numher (Transfer from service label) 1-1Collect on Delivery Restricted Delivery ❑ Signature
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7017 0660 0000 7487 0559 Delivery t
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PS Form 3811, July 2015 PSN 7530-02-000-9053 Domestic Ri
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C3 COL IFti.3C 29205
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❑ Return Receipt (hardcoPY) $ 7�
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C3 ❑ Certified Mail Restricted Delivery $ $ l�f 10
C:3 ❑Adult Signature Required $ _$9_.00
CJ ❑ Adult signature Restricted DelNery $
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.n Total Postage and
CDOep: 95
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04/21 / 2021 l
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