HomeMy WebLinkAbout77616D - Andrews CAMA/ ❑DREDGE & FILL N9 77616 A B
3ENERAL PERMIT Previous permit# /
'New —Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued /
rized by the State of North Carolina,Department of Environmental Quality jf I
:oastal Resources Commissi n in aea of environmental concern pursuant to I 5A NCAC 7+t' 1 4D C)
4nIr&tn ,�Tt Name t slgoAg a ryU Project Location: County g riAn j w I ck
()A hll...- Street Address/State Road/Lot#(s)
/ State ZIP - ` l 3 •33 h tr(o� c7L,
`( �/ E-Mail �b o't a r6 Subdivisioonn /-
tt. 1 /%_._ QMaj��Col ty MN & L
:ed Agent Ci Ph a ZIP
❑CW VEW /*TA ❑ES ❑PTS Phone# ( ----r--- River Basin Lt.m
❑OEA ❑HHF ❑IH ❑UBA El N/A Adj.Wtr. Body `a / (nat /
❑ PWS:
yes no PNA yes / no
Closest Maj.Wtr. Body AZW�f Project/Activity Rtel(&r 7aSi n dock avl d r a r- p 9 (Scale: 1
!ck)length atform(s) 7"/Platform(s) �X�(piier(s) H - i\"\ At-
, , ,
! PH
-7 i 1
tuber __._. — —..._... }j
d/Riprap length
g distance offshore •I �p
ix distance offsho I. ''1'��`��
Flanneli X`S a. ' 46((�
bic yards ( i
j r�
lipI "'`
.
ue/Boathft —*P —• t- —T
lulldozing „.•••"".° i!( ,_V,e i 1 1 5c1
Ili
ie Length 50 I ft
not sure yes no Q.A\tly N `' ` CPI
S� : -
Attached: /1_f7',10e,•
If l./^
rium: n/a yes n ;40110 no &, : I
Z.. Q � - l
ing permit may be required by: /70/2IeS1 [ f a(,4� See note on back regarding River Basin i
I nral Plannino Inriarlirtinnl I r' I . i 1
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: ,C,\(\a ci 4,1\c:4e-t-t-)
Mailing Address: 1 3 3 -\ 4,
' \ .L, o
Phone Number:
Email Address:
I certify that I have authorized
g t Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: W.e aic_e_ 47/4/ -0/Ks
(R(,, A.AAta SA-0 c w-
at my property located at /33 CAYr �5 if 7 ! 1?
in, (1)Y6 County.
l 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.
Pro Owner Information:
A 4/ell
T/��� ,,,�^^ Signatu e
/4442.A.;
Print or Type Name
i.(1P1'
Title
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to l�t;'�t`%�JN �, 4 ZC/t/s' 's
/L (Name of Property Owner)
property located at 1 33 21cI%TT'. - 4i4, >th' L AC(,0�8402
/
!/ (Address, Lot, Block, Road etc.)
on 4-6/din �JOQr',� f` ail9* J/ , in /,/u/c&.n a7O.C'Ji A/C , N.C.
(Waterbody) (City/Town 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 you wish to waive the setback, you must initial the appropriate blank below.)
7r? I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Informa ion) (Adjacent Property Owner Information)
wipwahig. 4 1
x tit-t-re
i•nature Signat�ur *
$n z/ii , 4i,dirr/s I O fry 14AI
Print or T pehlame Print or Type Name
/?i. ('At•.,v/A, o 3 �., , c i /_.'ir
•
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to /e :2af2t �� h / ✓S 's
(Name Property O�wn"ewrg�) �� 'io
property located at /3 3 C/,Q.�vi J`j r��G `` f 7 / ert /�e
on /4// a� ���� (Address, Lot, Block, Road�.etc.) /
/4/L / idt. 1v 1.2t)✓ , in /. zit vae/ , N.C.
(Waterbody) Coca/s. (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
Cation.
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.)
tikL I do wish to waive the 15' setback requirement.
I do not wish to waive the 15'setback requirement.
( roperty Owner Info mati (Adiaeent Property Owner Infoorr at(on)
/
Si nature Signaltrre (
ge,a/_5- k7/7-4 z t
Pnn o T e e i Prin r Type ame
Mailing g Address MOOR Addressf/v _ !ek /17G M ? r%�-11s ter //G o77 /D
City/Stata2lp9 6/1 , City/StateQlptr,— hr 447 el
,Q/;WS Dx—k---1 s)--- 2-1-140
CERTIFIED MAIL—RETURN RECEIPT REQUES TED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
Name of Property Owner: 4cirec.e).5:
Address of Property: 13,3 Ckotr1 0 T Q S f
(Lot or Street#, Street or Road, City & County)
Applicant's phone#: Mailing Address: f 3 3 Ow ic
,z,a460,_ 2eael, ay(6, -
I hereby certify that I own property adjacent to the above referenced property. The individual applying f
has described to me as shown on the attached drawing the development they are proposing. A descriptio
with dimensions,must be provided with this letter.
I have no objections to this proposal. I have objections to this prof
If you have objections to what is being proposed,you must notify the Division of Coastal Managen
in writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardin
Wilmington,NC 28405-3845. DC14I representatives can also be contacted at(910) 796-7215. No ri
considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION.
I understand that a pier,dock,mooring pilings,breakwater,boathouse,or lift must be set back a minimu
15' from my area of riparian access unless waived by me. (If you wish to waive the setback,you must i
appropriate blank below.)
T`i I do wish to waive the 15' set back requirement.
I do not wish to waive the 15' set back requirement.
pe2wn7rmation)y ( .iparianPrope, ty Owner Infornn
ra
('(--)
Signature Signature
?.-Z)(40\1 ' -5 pc.,+rck reifyy,
Print or Type Name Print or Type Nafne
133 C hct l �4, 7/5- c t s .� d ,
Mailing/ Address�/ Mailing Address
i /i r
i In • 2, _. / --. ,f . A ,
"F. /2-7D0 /4 - Dt.k C21":-.)
CERI IFI ,D MAIL—RETURN RECEIPT REQUES FED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
Name of Property Owner: A c�
Address of Property: } 33 C c, I ,L
(Lot or Street#,Street or Road,City& County)
Applicant's phone#: Mailing Address: 1 3 C 110 lOA'S-�
Tom/ ?iebe , aT-rL
I hereby certify that I own property adjacent to the above referenced property. The individual applying for this
has described to me as shown on the attached drawing the development they are proposing. A description of dra
with dimensions, must be provided with this letter.
I have no objections to this proposal. I have objections to this proposal.
If you have objections to what is being proposed,you must notify the Division of Coastal Management (D
in writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Driv
Wilmington,NC 28405-3845. DCM representatives can also be contacted at(910) 796-7215. No response
considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION.
I understand that a pier, dock,mooring pilings, breakwater, boathouse,or lift must be set back a minimum dista
15' from my area of riparian access unless waived by me. (If you wish to waive the setback,you must initial tl
appro.riate blank below.)
41111211
I do wish to waive the 15' set back requirement
411,
I do not wish to waive the 15' set back requirement.
roperty Owner Information) (Riparian Property Owner Information)
g ignature
Print or Type Name allr)e. e
Print or Type Name
( - 3ori
Mailing Address Mailing Address
t_
R„
yu5
CD 0x-1-it �odC
ose.A. F 00,4(
I 1.3 `-I,-R-
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gib ' -�
fy
Check
n(Name) Name of Permit Holder Vendor Check Number amount Permit Number/Comments Receipt or R.M1xM/R.d/oceted"
nn3 Coiumn4 Column6 Column6 Column? Column6 Column!) _
same BB&T 4480 $200.00 GP#77616D Ben rct.10295
Calvin LaFrance Coastal Bank and Trust 3284 $200.00 GP#77827D JD rct.11632
Ryan Mattox BB&T j 7896 $200.00 GP#77826D ;JD rct.11631