HomeMy WebLinkAbout76582D - Sutton1CAMA / ❑ DREDGE & FILL No 76582 A B
'3ENERAL PERMIT Previous permit#
7New ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
rized by the State of North Carolina, Department of Environmental Quality
.oastal Resources Commission in area of environmental concern pursuant to 15A NCAC !J ry V
Ax(�
t NamProject Location: CountyO r•✓ Street Address/ State Road/ Lot #(s)
State �� ZIP Z
41 t y E-Mail Subdivision r
:ed Agent N 1/U�J+�/ City �V ZIP y'
❑ CW IEW )&TA X1 ES ❑ PTS Phone# ( j—"—'� River Basin❑ OEA HHF ❑ IH �7❑ USA ❑ MIA Adj. Wtr. BodyLIAM e If G na i
❑ PWS: IV
yes / � PNA yes / no
Closest Maj. Wtr. Body
f Project/ Activity
ck) length
atform(s)
Platform(s) i
L ,ier(s) Q 7 /f G(/
d/ Rip length
g distance'Wshc
w distance oN
cannel
bic yards
np
is tli 7 Z
not sure yes
•ium: n/a yes
yes
4ttached: A.11-
ng permit may be required by: ��i�r• ❑ See note on back regarding River Basin r
Local Planning lurisdiction)
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: t Y { Cl l' V� ti t l
Mailing Address:
Phone Number: Arl 01- 19uzq - 1 U y q
Email Address:
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: A 31 x 4A'I -�_n e-.1"
Ci e-r5 l n d Q k &1+ �4t
at my property located at
in U n , a County.
I furthermore certify that I am authorized to grant, and do in fact grant permission
Division of Coastal Management staff, the Local Permit Officer and their agents to er
on the aforementioned (ands in connection with evaluating information related to I
permit application.
Property Owner Infomnition:
VC1,111V "i"'s
Signature
Print or Type Name
f I 1 0 1 ill ,c I/-
� i. i.nsL:�i�:��Sd�: r �_►i�_
I hereby certify that I own property adjacent to
property located at
on �'1C� , in
(Waterbody)
of property Owner)
etc.)
and/or County)
Is
N.C.
The applicant has described to me, as shown below, the development proposed at the above
location.
Tw 1 have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION ANDIOR DRAWING OF PROPOSED DEVELOPMENT
(Ind`Wduaf propasingr development must-ftlf In descr pfiotfbeiow�or-a#fich a she-d'rawfng)
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin
must be set back a minimum distance of 16 from my area of riparian across unless waived by
me. (If you wish to waive ve the setback, you must Initial the appropriate blank below.)
Tw I do wish to waive the 1 5' setback requirement.
I do not wish to waive the 15' setback requirement.
(Pro"rty owner In H (Adjacent Property Owner Informa"o
-97? -�- '64� �0 in)
S1 re Signature* Todd woodard
! ple
Brookside Dr. 6it)l
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to nry i n 5 L i =. n s
j- �N me of roperty Owner)
property located at (id
II� (Address, Lot lock, Roa , etc,)
on l C1) in �LIf K G N.C.
(Waterbody) (City/To n and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location
4`L I have no objection to this proposal
t-�1Cit
I have objections to this proposal,
t1 t
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin
must be set back a minimum distance of 15' from my area of npanan access unless waived by
me. (If you wish to waive the setback, you must Initial the appropriate blank below.)
.(' 16/ 1 do wish to waive the 15' setback requirement.
Yet �C`
l do not wish to waive the 15' setback requirement.
Owner I
a
Pn*nlof T e ame
I)T2)-MtY'�5�
Marling Address
Cdy/St9Jg11P
Ta/nnhnnn
(Adjacent Property Owner Information)
OF
Chxk
n11 M
tl D Bi44ers _ BUT 13936 $ 200 00 GP #76568D BB rC.
__ _
y Whitaker _ 6&T. _ 13942 $ 20000 GP#76571D __. BB rd.
.ankin 688T 13943 $ 200.06 GP#76572D - BB rct.
Jurnev BB&T 13940 $ 200.00 GP #76570D _ BB rct.
Noble IV BBBT _ _ 13937 $ 600.00 GP #765690 _ BB rct.
i Burton BB&T 13937 $ 400.00 GP #76190D BB rct.