HomeMy WebLinkAbout76453D - MartinhCAMA / ❑ DREDGE & FILL N9 76453 A B
3"ENERAL PERMIT Previous permit#��
1CIew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
ized by the State of North Carolina, Department of Environmental Quality
:oastal Resources Commission in an area of environmental concern pursuant to I SA NCAC
❑ Rules attached.
t Name 9Q'YO(v 'r �O�h m,;,Y 1't0 Project Location: County PtyJ (;V
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E-Mail
ed AgentDO V)���
C CW EW COTA ❑ ES ❑ PTS
❑ OEA ❑ HHF ❑ IH ❑ USA ❑ N/A
❑ PWS:
yes / a PNA yes / ))O
ngth
nber
i/ Riprap length
distance offshc
x distance offslf
cannel /
)ic yards_
ip
seYBoatliH
Street Address/ State Road/ Lot #(s) sc yy�_L
Subdivision 1 N I f
City Sy w1 ('i ZIP L ��
Phone # ( 1r--- River Basin
Adj. Wtr. Body (V AA N� AA P, (tee C �
Closest Maj. Wtr. Body obi w'L sLo N (�
(Scale:
❑ See note on back regarding River Basin n
AGENT AUTHORIZATION FOR CAMA PERNIT APPUCATf ON
[Name of Property Owner Requesting Permit: kM59-r S%u'i —Wan l
Mailing Address: kTI444So►J pry
�SALE c,rna
Phone Number: 103—�5�-3�11
Email Address: k►Jeti —Lo'k
I certify that I have authorized thOiN . ��lu ,
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all. CAMA permits
necessary for the following proposed development:. n
at my property located at PVI ATW4 41 So
in County.
G
l 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.
Property Owner Information:
U' kgn`ature
. Print or Type Name
Title
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to r 's
A //,, �� (Name of Property Owner)
property located at I�3 1'jkitNS�O� KAiOD
(Address, Lot, Block, Road, etc.)
on WUL, , in LI , N.C.
(Waterbody) (City/T n and/or County)
The applicant has described to me, as shown below, the development proposed at the above location.
f� I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must rill in description below or attach a site drawing)
�t o5tlD
\'-�
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set back
minimum distance of 15' from my area of riparian access unless waived by me. (If you wish to wain
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)
ftiure %Q _
Print or Type Name
/4-7 .dM#Jf6iJ IGAn
Print or Type Name I -On dlJ �c ` CT
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to KJx 11' l na s
(Name of Property Owner)
property located at ��� A'fk la S er1 U DA a
(Address, Lot, Block, Road, etc.)
on , in N.C.
(Waterbody) (City/T wn and/or County)
The applicant has described to me, as shown below, the development proposed at the above location.
V/ I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must rill in description below or attach a site drawing)
VrJd'o N ►
Qb�
P
i
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set back
minimum distance of 15' from my area of riparian access unless waived by me. (If you wish to wain
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.
(Properly Owner Information)
Si r e nl rMp.n,J
ley 9= J
Information)
Print or Type Name
I" A?ki.JSwJ ko.
r (Name) _ _
Name o/WnNt Holder
Vendor
Chxk Numbw
pack
amount
Ps ft Numfwr/C—ft
R w RdundMoall—tod
m3
Colu-4
Columnb
Col.—O
Column7
column9
Column9
rvices. LLC Cape Fear Manne
Sean Winders
nstruction Robert Park
nstruction I Robert and John Martin
FCB
TrulieM
3313
$ 200.00
$ 400.00
. GP #71872D
GP #74819D _ _ _
GP 4#76456D __ _,
Ttnac rot. 10996 _
JD rot 10846
JD rct. 10782
WD rct. 10781
5548
_ _
Coastal Bank and Trust
3324
S 200.00
I Coastal Bank and Trust
1 3323
.00
GP #76453D