HomeMy WebLinkAbout77858D - Ardizzone CAMA,./ ❑DREDGE & FILL N° 77858 A B
IENERAL PERMIT Previous permit#
New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
-ized by the State of North Carolina,Department of Environmental Quality +a U v
:oastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC
❑Rules attached.
t Name 1/'a`C- A VA 1 Z Z-4)Y'1A- Project Location: County kJ�,w k-3/4c,vt 0v rr✓
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ng permit may be required by:F C11h(� E 1 ct�" 1516,4/VI Q 1 07,0.OV/�1'V ❑See note on back regarding River Basin r
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Aping A WN:minion Form-provnynvionNegrnoLcom-Gone
Name of Property Owner Requesting Permit: 7Tha .e. At-oit Z LoA;�
Mailing Address: 3 0 • dop e r.q opt 5
mc-to , ( - o8do9(o
Phone Number: 677 0 ct 4 6 8 - i ‘ 32
Email Address: a zone Car t r.C.c, r r•. c 1r)
I certifythat I have authorized
_"
�'� �,mot v,,.._1 ! � .n f- .
Agent/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA perm
necessary for the following proposed development: A N e 1 n/4!
at my property located at i S S m n Oki P01 n 4 6t) 'vi=nEl TJ 11 N
in 1k.) J4 .,.. erCOUrtty.
l furthermore certify that l am authorized to grant, and do in fact grant perm
Division of Coastal Management staff, the Local Permit Officer and their agent,
on the aforementioned lands in connection with evaluating information relate
permit application.
Property Owner Information:
Signature
rc Z Z.Cf:e.—
Print or Type Name
ADJACENIT REPTAZAikii PROFEEN Otcz:_cDPP ..A...17.1ERIERTIr
•
. •
•"
I hereby certify thafl own property adjacent to ir•it-clif 2 e et- ss
(REIMS- .7177-cpany°mar)
property located e 4-0 ; .
; Caddirew,Lot, Mod;
on , IA.3; , N.C.
eNaterbody) mei&Gcnity)
•lioant has described to me, a Sh01:1171 below,the dayeimment--.3r)posed at the above boa*
) I have no Objection to this proposal
( have objections to this proposal.
DESCROPTIOM MINOR OP,taliNGCP717 ".,:',•47-,VELOPIllalk97
(individual propv.sil.v deyel*prrierd twist reil ifrd - - site dratiiing
WAIVER
I understand that a' pier, dock, mooring pilings, famr-1_ _ or groin must be set b
minimum distance of 16 from my area of riparian by me. (If you tcliSh to
the Satre , you must 5nitia[l the appropriate blank
r
do wish to waive the 15 setback rsquireme:-
do not wish to waive the 15' vetoed(
(Propsew 73-mrstray 03,f:7r -
„---
ST a Siwre.s,77.-±,78
) (26
Print or Name , Prfrit or Type
• 3/4-L4
Art fan:ev elPhrge, e, Mailirin.ArifirAmm
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to • - J(.2,1 f }< r CJ( z z 's
nn (Na of Property Owner)
property located at . •
/ :' v ti v ;
(Address, ot, Block, Road, etc.)
on Y f <LI!i IS) �.QNG2 I , in )\I 4N , N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above locatior
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, breakwater, boathouse, lift, or groin must be set ba
minimum distance of 15' from my area of riparian access unless waived by me. (If you wish to w
the setback, you must initial the appropriate blank below.l
I do wish to waive the 15'setback requirement.
I do not wish to waive the 15' setback requirement.
(Prope Owner Information) • (Adjacent perty Owner Information)
,-2 /276—
Si v Signature
N ��i] r� �G�i S f A.;1)
Print or Type Name Print or Type NAme
Check
n(Name) Name of Permit Holder Vendor Check Number amount Permit Number/Comments Receipt or Refund/Reallocated
nn3 Column) Columns Column., Column? Column8 Column9
Bulkheads LLC Dale Ardizzone 'Wells Fargo 23505 $ 200.00 GP#77858D IKE rct.10790
Kelly and Tano Failla Charlotte Metro 1719 $ 200.00 GP#77853D I BB rct.11543
ine Construction LLC Linda Weber BB&T 5930 $ 200.00 GP#76597D I BB rot.11533
4C LLC Richard Reuhland BB&T 1117 $ 200.00 GP#76484D BB rct.11544
ist./Daniel Shirley Jordan Messick SunTrust 5365 $ 600.00 GP#765430 IPA rct.10267
ist./Daniel Shirley Melissa Hardin SunTrust 5366 $ 200.00 GP#76577D PA rct.10266
LLC Rebecca Taylor Wells Fargo 1025 $ 200.00 GP#77835D PA rct.10269 _
action,LLC Kevin Driscoll Navy Federal CU 1167 $ 200.00 GP#76587D PA rct.10264 __
pny Roger Hudson First Bank 1446 $ 200.00 GP#76544D PA rct.10268
ine Construction LLC Alison Marshal BB&T 5964,$ 200.00 GP#76487D BB rct.11549
same The Fidelity Bank 6413 $ 200.00 GP#76483D BB rct.11547
actors Inc. Webster Trask PNC Bank 8787 $ 200.00 GP#76477D KE rct.10792
rrvices,LLC Perry and Darlene Mansfield First Citizens Bank 3433 $ 200.00 GP#76432D Ben rct.10299
rrvices,LLC George and Karen Brake FCB 3432 $ 200.00 GP#77622D Ben rct.10300
1 IGary Godwin BB&T 2002 $ 200.00 GP#76448D Ben rct.10298
tors LLC :Chris and Nancy Sweeney ,FCB 9243 $ 200.00 GP#76436D Ben rd.10297
actors Inc. �Ppers Neck 29,LLC PNC Bank 8788 $ 200.00 GP#76478D KE rct.10791
ine Construction LLC Beverly and Patrick Wright Rev.TI BB&T 5951 $ 400.00 GP#76485D BB r t.11548