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Home My WebLink AboutBlue Holding Co.AMA / ❑ DREDGE & FILL N9 78961 A B 6 D ERAL PERMIT Previous permit # ❑New ❑Modification ❑Complete Reissue ❑{>artlal Reissue Date previous permit issued As authorized by the State of North Carolina, Department of Environmental Quality /h f t J and the Coastal Resourc ommisslo In an of environmental concern pursuant to 15A NCAC� tJV C-� �fy�� + � J'%'a� t ❑Rul attached. Applicant Name_i, d/ l c [ �� ' t �S u Project Location: County Address U� �Y h Street Addre ss / State(Road[/ Lot #(s)� City---N e Lf (I W � State IV( ZIPP U ' r7C J I� + r`1 /6)U C ` Phone # (may 2j /V gip( Lf/aE-Mail Subdivisio Bc-rr• t� J l% Authorized Agent 9 ll City ZIP Affected OCW .J .0111M OES ❑PTS Phone# (_) f n� AEC(s): ❑HHF ❑IH ❑UBA 17 NlA Adj. Wtr. Body_' /((U�verBasin "u�/( t an unkn ❑ PW El PWS: ORW: r/�o PNA yes /r / Closest Mal. Wtr. Body Type of Project/ Activity J5 dtkJA4-L4t X U t j r d /1 (Scale: ) Pier Fiz Float. Fing Grol Bulk) Bmir Boat Boat Beac Othr Sher SAv Mon Phot Waiv on ME M ■■�■ _mum ■■■■■■■M■■mmMEMO , ■■'� ■/t►7 msmmmmm■RMEMENEII■m■m ■■■ ■ ■ �iimMMON ME■= �mE� M� MEmE rampim■■.'%-�r� MmM■E■M■■■.■■ Em:�m ■■■MEN M ME MIN M. 01111M■ M I■m�Il■�.■■ MEMO Is �'mmmmmmmm:m mm�MM11N mom /■dim' No MEN mmm:E NINON ►immmmm::::'� notsure Yes li.m■o ■ '1r ■M■■�■�,�.ai■■■■■�■i■■i�■■iiN ■■M■aL�J■■■■■M■v mmmr� ,w.H.Pmmmmm■mzmm ■■■■ ■M ■■■ m \-e A building permit may be required by: ( Note Local Planning jurisdiction) Notes/ Special Conditions j C CY 1 er-1- "O M compliance statement on ❑ See note on back rellarding River Basin rules. Ai7j OL,4 AQ11,1e.1 Name Fee(s) Date S AMA / ❑ DREDGE & FILL N9 7896I A B 6/ D GENERAL PERMIT Previous permit# ❑New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued As authorized by the State df North Carolina, Department of Environmental Quality /+ir / and the Coastal Resourc ommissio in n ea of environmental concern pursuant to 15A NCAC 00 (..� f t ❑RuuT attached. Applicant Name 1. I ��S u Project Location: County c` B�1 Address IOF 1-Y Y 7/t-t Street !Address/ State(Roadd// Lot #(s) City/AJ Q %., W) State I '✓/� r ZIP U 1 �� l e/`J / Ji - f Phone # Subdivisio c.,_ Authorized Agent llc-rv, V s/ rr^ City X � ZIP ❑ CW 'PFM eftA ❑ ES ❑ PTS Phone # ( ) River Basin f n L Affected ❑OBA ❑HHF ❑IH ❑UBA ❑N/A /(ftiy� AEC(s): Adj. Wtr. Body / t an unkn ❑ PWS: ORW: es /-�o PNA yes //no Closest Maj. Wr,. Body Mi_ 't wA Type of Project/ Activity Pier (dock) length Fixed Platform(s) Floating Platform(s)1� Finger pier(s) Groin length number Bulkhead/ Riprap length avg distance offshor max distance offshor Basin, channel Boat ramp. Boathouse/ Beach Bulldozing Other Shoreline Length SAV: not sure yes ono Moratorium: n/a yes 6. Photos: w Waiver Attached: yes no ---- A building permit may be required by: ( Note Local Planning jurisdiction) Notes/ Special Conditions Agent or Applicant Printed Name Y (fCV 4 rfl, Si re.�'r•Please read compliance statement on back off2ermit*• r— Application Fee(s) Check # (Scale: , fr ) ❑ See note on back regarding River Basin rules. ermitOffce / i to Name ignatu e ,di,t Da �Piraqlcin Date d . AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: (r ge/!Gs -r-&• "t /Blwe % .� �" `zG Mailing Address: �' ✓�%� S �i�, c1< 2v/y A Phone Number: 02 Email Address: G'eofc its (uC�xpress�� ry�c�cu •� 1 certify that I have authorized c rry ! 7ir�mO gen Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: pockl'net_I at my property located at in (.urtzrei County. I furthermore certify that I 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:a,-, / �' �/ Signature I1T S `Y � iz Print or Type Name Title /Y 1 Loz0 Date This certification is valid through 11 1 31 1 20"6 ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to CAi Cc N j t,-k5 Q.a � . LLC. I ti property located at__ z . aO flj re, y beck L), (Name of Property Owner) on ma ,,0-,,J , in Hcv-kw:; islwd N.C. (Waterbody) (CltylTown and/or County) The applicant has described to me, as shown below, the development proposed at the above location._, I have no objection to this proposal. I have objections to this proposal. 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 riparian access unless waived by me. (If u wish to waive the setback, you must initial the appropriate blank below.) 014 1 do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. Telephone N��ber/email address IIjig12c2v Date Information) Mat in AddrreeslS pr .LTIrn� iUC. ��,�aJ 1 City/State2ip TelephgnelNumber/email address z z4 z�zu Date*' (Revised Aug. 2014) *Valid for one calendar year after signature* ADJACENT RIPARIAN PROPERTY OWNER STATEjMEN/T� . I hereby certify that I own property adjacent to 2'ro 1 apto uol� nc l u j �.t L_ 's z \ II pp ( a�me of Proper Owner property located at Joy r Dock Ted. 5 3s, Lot, Bloc , Road a c.) in uor ers- T� r N.C. (City/Town and/or County) The applicant has described to me, as shown below, the development proposed at the above locatiop. I have no objection to this proposal. I have objections to this proposal. 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 riparian access unless waived by me. (If you wish to waive the setback, you must initial the appropriate blank below.) _ v 1 do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. Teleph ne Number/email address �3 Lc2d Date 'Valid for one calendar year after signature* Property Owner Information) c, S Print or Type Name / PO Ba•c 2. Ma' in�rfj Addres''s (( �^ City/stateaip Telephone Number/email address Date* (Revised Aug. 2014) d 0 20 \ &C cn CryJrd KI2 400)'^SC—PCn,(jLLC �,—b^2 -� � ,nv C -3,5' 3.5 _o 33'3.5'J0 I CA 3. 6' G � I F,x« Crj7ku 6��Z rta�C ,`C CcmPMII,L ry III fif A n C N N ++ cm _Q C U � U m co U O UU 0 C •0 O Z N m �> U 0 U Z Nu L U E o N m Z LL O U O ZCL y D D ¢ � ¢ 0 U ° U o CL ¢ a u U) U)