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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 ❑ CW Fd EW - ❑ PTA $J ES ❑ PTS ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A ❑ PWS: yes eio PNA yes /® ' Project/ Activity L Phone # ( ) River Basin v Adj. Wtr. Body Closest Maj. Wtr. Body �AAA �n (Scale: �J 7 Platform s) ■!� ■•'■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■I ■1►'■■r■■■■■■■■■■■■■■■■■■■■■■■■■■■■■1 ngth distance offshore �x distance offshore iannel iric yards -1P :se/ Boatlift Mill ■��a■i■■■■■■�■■i■■■■���■■■i ulldozing■■■■�H■■■■■■■■�■��■■■■■■■■■■�■■■1 �■■■■■■■■not e Length sure ■■■■■■■■■■11■ ■■■ ■■ ��1 ��11■■ ■■■�IR�'�'.■�w',■!� ►fir_'"t!P17■■11■ ■■■ ■ kIM" Ti = J■H■■ ■■■■■N■■!!1 yes T ■it'1���1ii�3i■Ylli■■i�ii■�li��i■ilk■ii■■■■rii■■1 yes 1�ttachecl: Yes ,T ■■■i■■■■■■1■■■■�IrF■L!�Ll�!:�■■■■■■■■■■1 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 9DO3 P \,, bzt� C, i 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'� 111111111 III III II I II I I II I I II I I I I I I I 3. Service Type El Priority tv El Adult Signature F-1 RegisterE ❑ dulfSSign ire Restricted Delivery ❑ Delivery e 9590 9402 2219 6193 1040 59 ❑ Certified Mal Restricted DeliveryRet�lrn R El Collect on Delivery Merchan� 2- Artirla Numher (Transfer from service label) 1-1Collect on Delivery Restricted Delivery ❑ Signature Il ❑Signature 7017 0660 0000 7487 0559 Delivery t it Restricted Delive Restricte PS Form 3811, July 2015 PSN 7530-02-000-9053 Domestic Ri r`R.T.W17PREWT M. C3 COL IFti.3C 29205 Certified Mail Fee rc $N.er tr j $ c r'lExtra Services & Fees (check box, add hae�ppgp{ ate) ❑ Return Receipt (hardcoPY) $ 7� O ❑ Return Receipt (electronic) $ $0 . (III C3 ❑ Certified Mail Restricted Delivery $ $ l�f 10 C:3 ❑Adult Signature Required $ _$9_.00 CJ ❑ Adult signature Restricted DelNery $ 0 Postage r .n Total Postage and CDOep: 95 Sent en) --------------- p S idAat. No., r? Bo o. -------------------- SC ppccy, $$fate, ZlQQ+4 ® ^1 q 2- ,U S — lA�il,,,,btU L 77 0459 ;,Il kkk Postmark Here 04/21 / 2021 l 1 ■ Q" Domestic Mail Only ul u1 O N Certified Mail Fee t. CO $ $2.85 r'— Extra Services & Fees (check box, add lee a te) ❑ Return Receipt (hardcopy) $ ! i '