HomeMy WebLinkAbout71879D - Schiller ]CAMA/ ❑DREDGE & FILL N°
_ / I8 /9 A B
3ENERAL PERMIT Previous permit#
}New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
rued by the State of North Carolina,Department of Environmental Quality
:oastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC ;�? / . (/v 0
1kt o41r / ,„O Rules attached.
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Project Location: County ,5./ c',-GO V 2 f4 f! t/a".....it Olk , Street Address/State Road/Lot# s)
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0 CW f�,?TA yES ❑PTSV Phone# ( )-------~ River Basin 1/✓ r
0 OEA 0 HHF 0 IH 0 UBA ❑N/A Adj.Wtr. Body ._u C.-1 • l fit^ a (n
❑PWS:
' Closest Maj.Wtr. Body tJ//L1/a Sea Ai L
yes / no.% PNA yes /�
r Project/Activity r I A-(./--- a^r( &pi /+��4_124""`
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uc distance offshore ( I
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not sure yes V
-cum: n/a yes
yes
Attached: yes -
ng permit may be required by: V/-f n See note on back regarding River Basin r
I neat Plannina hiricrlirtinnl /
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to keZ. cc,4,)//e
'S
(Name of Property Owner)
property located at akAiii.>I- -r"
an PArs, 0.I (Address, Lot, Block, Road,Atc).,
, in (-- , N.C.
(Waterbody) (City/Town and/or County)
The appli nt 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)
IvcAA-) '6olae/N.)
65'
oi
WAIVER SECTION
I understand that a pier, dock, mooring pilings. breakwater, boat'nouse, 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 wa;
the setback, you must initial the appropriate blank below.)
I do wish to wa've the 15. setback requirement.
do C-7 wir waive the 15' setback requirement
(Properti9 Owner Information) (Adjacent Property Owner nformation)
11 ( / ----
/ 16- I/
Signature, Lacure
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A cx..4(1,1/e::
Prj'ntor Type A.I' 77e A Print or Tye Name
; '14%,
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: rk< G�, ikr
Mailing Address: /0 3Z-7
cC J- C/A k,
hone Number: 400 Z- Z`�5'- 6714 7 _
nail Address: fy1ici at) . , c; ,'/ler 9r»o rl . co-
ertifv that I have authorized
Agent/Contractor
act on my behalf, for the purpose of applying for and obtaining all CAMA permits
.essary for the following proposed development:
ry property located at q'UZ O S(jr C,4,7 ( }
r)S County.
`hermore certify that 1 am authorized to grant, and do in fact grant permission to
ion of Coastal Management staff the Local Permit Officer and their agents to enter
e aforementioned lands in connection with evaluating information related to this
it application.
y Owner information:
,/11'T Lii:V
Sign all
j/, . , if; \,•At'
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to /72
�A/ �� � (N� party Owner)
property located at 9U'y+� �a a C!
on 1,
f -) (Address, Lot, Block, Road, etc.)
in Le rV t1=j , N.C.
(Wa X) (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)
N -FaoIKt
55'
WAIVER SECTION
understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set back a
ninimum distance of 15' from my area of riparian access unless waived by me. (If you wish to waive
he 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.
'roperty Owner Information) (Adjacent Property Owner Information)
v •turf Zrzatze
A-e 6. rr / ; 1.15e-
m tt�or Type Name Print or T Name
i` Z'7 9a, '"T 2 IN _P 1l L) i/
Check
n MMame) Name of P4rtnit Holder Vander Check Number amount PamNt Number/Comments Receipt or Rdund.aYDw4O
rm.? Column( Columns Column. Cohnnn7 Column! Column!?
uction,Inc. Tommy Herrin Bank of America 1096 $ 200.00 OP#735940 ;JD rct.11650
instruction Mike Schuler Coastal Bank and Trust 3414 S 400.00 GP#71879D_ !JD rct.11655
Buffy 8351 E 200.00 GP#77880D check 1 of 2 KE rct.10797
odors,Inc. Steve and Anderson Branch Banking and Trust I
actors,Inc. Steve and Buffy Anderson Branch Banking and Trust 1 8350 $ 400.00 GP#77880D check 2 of 2 KE rct.10798
Bud Norton Wells Fargo 293 $ 400.00 GP#77884D PA rct.11551