Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
77402_Cody Woolard_20200930
�' C DREDGE & FILL .AMA/ El ��� GENERAL PERMIT • 77402 A Previous permit# OM ® D ew ❑Modification ❑Complete Reissue CI Partial Reissue Date �� previous permit issued q/ As authorized by the State of North Carolina,Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC 714, i zoo Applicant Name "p y w�L.1/�Q� CRITules attached. Project Location: County Sew,, ' Addresss' , -_ inny�n S �n� Street Address/State Road/Lot#(s) W City 4511)i1940II StateIvC. ZIP_alf5851 SO4 jin;arDSC. 6)1 re R� Phone#(Z$ -)96/ - 51c>E-Mail Subdivision�` IAyy)p,,,,.p, S�pres Authorized Agent'T 5'S U 1 1-t ro Ns sT. City Wp1,$k j 49.61 ZIP P 3'5$4 Affected a cw ISEW PTA ❑ES ❑PTS Phone# (152)yob • y(o$b River Basin AEC(s): 0 OSA 0 HHF 0 IH 0 USA ❑N/A 0 PWS: Adj.Wtr. Body I CD �. t V)V na mks /unkn) ORW: yes ,e, PNA yes / no Closest Maj.Wtr. Body? b1�C•D Q•1u&i .. Type of Project/Activity EX .YIt) PxIsq-1, �7I C! Wi j1'li Cokf SIYW 1- 0-4 dC « � ...�E, t'x5a.' pige �,A /Z 1 X)�� a4�'o,%, Pler(dock)length 3 Z r A 61 — (Scale: �� ! T Fixed Platform(s) /L >< (�O 7 ' i -i_.._ -1_f ' . f ( + j-_— ,--r Floating Platform(s) 1 I - i -! Yt Fingera 1_.. ._... -� _ ! O Pier{) "�17 -- ----_- 1-1- { i Groin length I. .. . i V �- T �� s ,_i I. -01 1._. , \-'7 !-- number t1 r s Bulkhead/Riprap length I -M- I_ i , f avg distance offshore - i ' j s f.i- 1 max distance offshore -- - '�� w F Basin,channel 1 - 1 ' i', * i t4 r-1 {� i i. i i l cubic yards__ -- l-;--i•-I -; • . IVIctio, , , ,-, -: - ; f-f H.- ---1--I --I-! - 1.---f--- t `i- r + -1. Boat ramp - a i -i -1 i- -t o '1 /�j _; _ _ i� A� —Gt — Boathouse/Boatlift i ,....pi; . - 1 i ; jor. -`t, - I ; 1 i j - _ _- • Beach Bulldozing 1,- ' - I,j�, t I i - _' -�--- I Other 1 L, + {- i .t.--+ Y 1- : r 1-- ' - i Shoreline Length t it., i 1 - _� _ _ + i -.-- ) j _i..4-._.. - ._ -. -..._ SAY: not arse yes ► f' i s — 1 i I. Moratorium: , ' i : n/a yes ® - + wi; • :� � Y ._ t Photos: yes � - �: , 1 . pit. WO°14kR° 1 ; P ; • 4Png - -- Waiver Attached: ?COT ; -1— v •'��' A building permit may be required by: i Le 4,T Coc sry / (Note Local Planning Jurisdiction) Le note on back regarding River Basin rules. INotes/Special Conditions 7 )S /77 ;,,, 1v7e f4 yy? �;4 G 11 D_w 7�,ee(• pp1 trn4 will b uus;" 79 s' . 4--1 of T1►Cir C./A,WetJ 6art.c4 2- or# it 7,-, pli t rimed N e ��l U f' ___ Perm' (ricer's Printed Name Signatu **Please read compliance statement on back of permit's'* -Sign ii7e-e—r----6y--- otorXam'c lit—44'20°`—'� /396 a Application Fee(s) S '7-0 ) O �74-r_j'24 2 Check# Issuing Date Expiration Date al CAMA / -- DREDGE & FILL N° 77402 4Ji C D G NERAL PERMIT Previouspermit# } � 'New !❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued W/I As authorized by the State of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC 7)4, 2-6 . .1 ferules attached. Applicant Name C LOCO CO LA4Z-N) Project Location: County '5e L c r-k Address /00 6 j1ry- of S &a t Street Address/State Road/Lot#(s) 11 City w40#194/41 State NIC ZIP 0�4S SOLI it);rrnv56• 611.(CS Zc� Phone# (Z6V)q13- 54p E-Mail Subdivision' Am Ys DSo+ Sho � Authorized Agent'-3'S n1AR-'�� Cots ST, _ City WDIShi49 4Dri ZIP t7t Affected ❑CW ®EW Ci TA ❑ES ❑PTS Phone# (157.- b)(leap - y495b River Basin AEC(s): El ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body 0517,11 �-1 Lt v Q/❑ PWS. �(' c!,/man man /unkn) ORW: yes / PNA yes / no Closest Maj.Wtr. Body 7a 1l tt 9-Tut-V. Type of Project/Activity e_dickr1C) Pxisho pier MI/7i GoLjS LAdi ac a ,h--..,,, to")('f Z.' pee W/7 I Z'Y l ' p/dt.fo/ry, (Scale: ;. - ) Pier(dock)length 5 2' A(9' _ Fixed Platform(s) Z 14, I -.4*'— ' G Floating Platform(s) ► 4' , ?kW/U.-4 j Finger pier(s) j T..... f I� f y_ Groin length v t'?j �r f�N _ } _ ,,,y al- number 1 Bulkhead/Riprap length `- "--I--" `I T- �sty� `P �} 4a`,y�1D rjthi eD� max distance offshore �C-&- F .• G (IA� ' 1 Basin,channel `5v �1�J G S 1 1 1 t •r ✓ cubic yards q ' J Boat ram 61f ,�f _ Boathouse/Boatlift Beach Bulldozing ......... �__ ILL Other i C4'44 kilrs-,� i ( f I ' licit i i Shoreline Length ID f SAV: not sure yes n� i___ -Q _Ili ;..- �_.._. —__._._---- Moratorium: n/a yes P g r ` � Photos: yes ® �_... - t, r�!C)Q1— i Waiver Attached: (a no ' i i Writ. � ,� A building permit may be required by: eta 4- Low,i, . to Kee note on back regarding River Basin rules. (Note Local Planning Jurisdiction) I , 1 ), n' Notes/Special Conditions � ' S ina/' J )1J.v /l�Gt.47 14/T'7 G / W /'t r. /ipp)?Las + w/l/ 4e us;" 7-V / ..1-7.- of cir- cslloi,-'e g04Dc4-1-Y L 1.)-c-N Agent or Applicant Printed Name Perm' fficer's Printed Name Signature Please read compliance statement on back of permit** Signatu - yGa'c ht___1120O /396 4- 3o SeQ z-oZu SO Yc--1-zo-2- 1 Application Fee(s) Check# Issuing Date Expiration Date I Statement of Compliance and Consistency This permit is subject to compliance with this application, site drawing and attached general and specific conditions. Any violation of these terms may subject the permittee to a fine or criminal or civil action; and may cause the permit to become null and void. This permit must be on the project site and accessible to the permit officer when the project is inspected for compliance. The applicant certifies by signing this permit that I)prior to undertaking any activities authorized by this permit,the applicant will confer with appropriate local authorities to confirm that this project is consistent with the local land use plan and all local ordinances, and 2) a written statement or certified mail return receipt has been obtained from the adjacent riparian landowner(s). The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available information and belief,certify that this project is consistent with the North Carolina Coastal Management Program. River Basin Rules Applicable To Your Project: /Tar-Pamlico River Basin Buffer Rules Other: Neuse River Basin Buffer Rules If indicated on front of permit,your project is subject to the Environmental Management Commission's Buffer Rules for the River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the NC Division of Water Resources. Contact the Division of Water Resources at the Washington Regional Office (252-946-648 I) or the Wilmington Regional Office(910-796-7215)for more information on how to comply with these buffer rules. Division of Coastal Management Offices Morehead City Headquarters Washington District 400 Commerce Ave 943 Washington Square Mall Morehead City, NC 28557 Washington, NC 27889 252-808-2808/ I-888-4RCOAST 252-946-6481 Fax: 252-247-3330 Fax: 252-948-0478 (Serves:Carteret,Craven,Onslow- (Serves: Beaufort, Bertie, Hertford, Hyde, North of New River Inlet-and Pamlico Tyrrell and Washington Counties) Counties) Elizabeth City District Wilmington District 401 S. Griffin St. 127 Cardinal Drive Ext. Ste. 300 Wilmington, NC 28405-3845 Elizabeth City, NC 27909 910-796-7215 252-264-3901 Fax: 9 I 0-395-3964 Fax: 252-264-3723 (Serves: Brunswick, New Hanover, (Serves:Camden,Chowan,Currituck, Onslow-South of New River Inlet- Dare,Gates, Pasquotank and Perquimans and Pender Counties) Counties) http://portal.ncdenr.org/web/cm/dcm-home Revised 7/06/17 41 � ��++/ BCAMA / DREDGE & FILL N9 77402 A © C D GENERAL PERMIT Previous permit# ►J7 �� _New Modification III Complete Reissue ❑Partial Reissue Date previous permit issued N/A As authorized by the State of North Carolina,Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC 7)-1 i izoo . ` [mules attached. Applicant Name Lot)y We t LA - Project Location: County '�ec.L.....gv irk Address ►7 /OD. lj► .ynoyi S c+LY/'_ Street Address/State Road/Lot#(s) City ,) 3 194oYl State NIC ZIP ',q s8`t ` I t-1 /71/n'1•U %. ,h,i e s g� Phone#(2-51-) :'/5 -75lc E-Mail Subdivision' Mi ry7� S SCA . hcxeS Authorized Agent 1 3 S it1X� C o tJ ST. City wG,5J,109 4V/ ZIP 3a Affected ❑CW JEW V TA ❑ES ❑PTS Phone# (.75 Z ) Nob t)• 9( River Basin AEC(s): E OEA ❑HHF E IH ❑UBA ❑N/A Adj.Wtr. Body lPGYY1))(D t1'JtNC' na man /unkn) ❑ PWS: �U& ORW: yes /moo; PNA yes / no Closest Maj.Wtr. Body I)Co Type of Project/Activity !xle r0 t-'/ X I S 4-;//7 71f/ w'r 4 C°a c/y w L(t o-•' of < ,�^ / LD y pi . -ce" ' 'i " /Z 'y 43,11p tale: 1' _ 4/0' ) Pier(dock)length 'j 2' i dv' I1.X 1b 'Fixed Platform(s) _ j ' Floating Platform(s) I �� I � Finger pier(s) if j — I ib -- i ; il4 Groin length I` . Y 1 p/P f l►r� ;� 7 i number _.-- -----._......j.._...__._._.. I I --- f r i t e L. I Bulkhead/Riprap length \ j.....____ Z'.._ t avg distance offshore , !" P ' \� y I $ max distance offshore I` 47 + ; �O R SL (' _I Basin,channel ,� f ,`S>'v u e- -, ' ; Mgt �p 1 cubic yards L 1 1 h5 ....*r, ,� j J r I Y 1�)" Boat ramp -i ( '�f l(1: [ is {��t\� f ; Boathouse/Boatlift r ... Pr. b _2( - LNG.. ff -- — - Beach Bulldozing �Z /� - j Other ; tit . 7 x 3 I - C"f-a''4 it/ - Shoreline Length 4-. �t70 f ' ; I ! SAV: not sure yes n® _ I O'" — — t� Moratorium: n/a yes G i w {.t1j , �,• fin .,, 1 .0Q. N_4 Photos: Yes ® __? _ __—.p I �� Waiver Attached: �e no ' ' L-AR / A building permit may be required by: UU 4 Cowl . 114 ee note on back regarding River Basin rules. (Note Local Planning Jurisdiction) JJ � ` '/ n Notes/Special Conditions I b ' s m,c' �TIMpip c3 /a. u/f� a �'w 4PeevC i—e7.--I es.") ►1.) -N. Agent or Applicant Printed Name PermitOfficer's Printed Name Signature **Please read compliance statement on back of permit's* Signatu 312't 'IL d'zad / 39-'6 3(.7 ' - 2-02-L) :=5C-1-t--) 2- l Application Fee(s) Check# Issuing Date Expiration Date Statement of Compliance and Consistency This permit is subject to compliance with this application, site drawing and attached general and specific conditions. Any violation of these terms may subject the permittee to a fine or criminal or civil action; and may cause the permit to become null and void. This permit must be on the project site and accessible to the permit officer when the project is inspected for compliance. The applicant certifies by signing this permit that I)prior to undertaking any activities authorized by this permit,the applicant will confer with appropriate local authorities to confirm that this project is consistent with the local land use plan and all local ordinances, and 2) a written statement or certified mail return receipt has been obtained from the adjacent riparian landowner(s). The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available information and belief,certify that this project is consistent with the North Carolina Coastal Management Program. River Basin Rules Applicable To Your Project: Tar-Pamlico River Basin Buffer Rules Other: Neuse River Basin Buffer Rules If indicated on front of permit,your project is subject to the Environmental Management Commission's Buffer Rules for the River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the NC Division of Water Resources. Contact the Division of Water Resources at the Washington Regional Office (252-946-6481) or the Wilmington Regional Office(9 I 0-796-72 1 5)for more information on how to comply with these buffer rules. Division of Coastal Management Offices Morehead City Headquarters Washington District 400 Commerce Ave 943 Washington Square Mall Morehead City, NC 28557 Washington, NC 27889 252-808-2808/ I-888-4RCOAST 252-946-648 I Fax: 252-247-3330 Fax: 252-948-0478 (Serves:Carteret,Craven,Onslow- (Serves: Beaufort, Bertie, Hertford, Hyde, North of New River Inlet-and Pamlico Tyrrell and Washington Counties) Counties) Elizabeth City District Wilmington District 401 S. Griffin St. 127 Cardinal Drive Ext. Ste. 300 Wilmington, NC 28405-3845 Elizabeth City, NC 27909 910-796-7215 252-264-3901 Fax: 910-395-3964 Fax: 252-264-3723 (Serves: Brunswick, New Hanover, (Serves:Camden,Chowan,Currituck, Onslow-South of New River Inlet- Dare,Gates, Pasquotank and Perquimans and Pender Counties) Counties) http://portal.ncdenr.org/web/cm/dcm-home Revised 7/06/17 —- , 0 AAMA/ I"DREDGE & FILL N°. 77402 A 0 C D GENERAL PERMIT Previous permit# ki A )------"---:- Aew Modification EComplete Reissue El Partial Reissue Date previous permit issued AllA As authorized by the State of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC 7/4„ /260 ISKules attached. Applicant Name !• (;)1")y WO)‘,..A a-7) Project Location: County 172--,--- ,, ,..k-i!., oak; Address /00. t ry,ynoei c L 0 yie Street Address/State Road/Lot#(s) City ,d 6491)k 1 00r) State rsiC ZIP -:!:4 S89 --,14 9 h i 1 riii).::,cA ,--;1),r c Phone#(.761.-) 'V'> - i`,ic E-Mail Subdivision ,ffli a7C• .":,!6• .Si .! •{4± .5 Authorized Agent-1----S rl 440-1--oc.---- (.2,4-> I City iit.-)a_Sh 109 MI ZIP 3c so Affected 0 CW 0 EW /PTA 0 ES E PTS Phone# ('cL ) ti 7.t., - 94.,St) River Basin 0°EA E HHF 0 IH 0 UBA 0 N/A ...n AEC(s): Adj.Wtr. Body !!",•:.+Yr 1)( 2- -1Qt‘e ( it./man /unkn) 141 PWS:ORW: yes / no PNA yes n ."7_ „.1 ..,„ Closest Maj.Wtr. Body ixff f) (- /2-"tut-r-, / o 1 Type of Project/Activity x iShvie4 )--1,f tA. • - .... 4- ,.., „ t -.Lr Z Y Vi p4-fi-4:C),4.. Ngc..Niale: ' _ Pier(dock)length 5 7 ALP 1 1 I Fixed Platform(s) /2 78' Up 1 ! , , i 1 _• I Floating Platform(s) 4r----,- i 0 I I ; , i rk feta. t b 1 ! 1 • V .. .._ Finger pier(s) i l're4- , i /k, 1 + { 1 ,--- rt1 vein.:1-- • 1 - 1 1 Groin length i —t t 1 ! ! 1 --)10., r,e ili . number 1 ' i ,- - • , 1 : ! , Bulkhead/Riprap length '4111 ___ _ L avg distance offshore .141.1 1 141-4---07(i/ " 1 , * „ max distance offshore -I i At' ! ' ,AS4',14 fl! 1 ! i 1 i .cot2 8*tv 47 Basin,channel 1 ,r l I I i I 'NS GI' i 1 1 cubic yards E \561 -4.4 1-e , 1 I 4.-1-4. 4 10 4 Li 1 1 • i . ! Boat ramp . iv ' 4- 11/. ° •Boathouse/Boatlift i III___EiQ, •,Li-_.s. / 1 Beach Bulldozing Other I I!:i:,• I!.!, - • I i , , Shoreline Length i I I! I . . ! , SAV: not sure yes (no ! 1 11 ' ______I_L ! i --Vi‘b __ i miniiii." .,1 X7Ai i Moratorium: n/a yes (no r tot A _ 1 -1---i- 1 I ! 1 .".. .ts_. c,k4 1 i el** 1440 , i T.,.- ,.. 4. ! Photos: yes Cno 41 _ _ , I ! 1 t— • 7 ce ___, ! ! Waiver Attached: i: no !! I ! 1 - r....*V- A building permit may be required by: 70.6i/A 4."4 (-,-*-7 17 • RIe note on back regarding River Basin rules. (Note Local Planning Jurisdiction) i ..). Notes/Special Conditions e•• ' '-iits 1,7,- '',,- 44.1..., 1.4 / 4 4_, 4 " iv?e'r 7 4 y 4 .4 2 4- -i-ii,.-1 r ._.,I 1':..,Pa.'e 5M.(.4 1. Agent or Applicant Printed Name Permit Officer's Printed Name / , __Le.. 6 Signature ••Please read compliance statement on back of permit** Signature ) •' •-,--‘ ;-' • I) -•-1-4.-) , :„) Application Fee(s) Check# Issuing Date Expiration Date Statement of Compliance and Consistency This permit is subject to compliance with this application, site drawing and attached general and specific conditions. Any violation of these terms may subject the permittee to a fine or criminal or civil action; and may cause the permit to become null and void. This permit must be on the project site and accessible to the permit officer when the project is inspected for compliance. The applicant certifies by signing this permit that I)prior to undertaking any activities authorized by this permit,the applicant will confer with appropriate local authorities to confirm that this project is consistent with the local land use plan and all local ordinances, and 2) a written statement or certified mail return receipt has been obtained from the adjacent riparian landowner(s). The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available information and belief,certify that this project is consistent with the North Carolina Coastal Management Program. River Basin Rule pplicable To Your Project: ar-Pamlico River Basin Buffer Rules Other: Neuse River Basin Buffer Rules If indicated on front of permit,your project is subject to the Environmental Management Commission's Buffer Rules for the River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the NC Division of Water Resources. Contact the Division of Water Resources at the Washington Regional Office (252-946-648 I) or the Wilmington Regional Office(910-796-7215)for more information on how to comply with these buffer rules. Division of Coastal Management Offices Morehead City Headquarters Washington District 400 Commerce Ave 943 Washington Square Mall Morehead City, NC 28557 Washington, NC 27889 252-808-2808/ I-888-4RCOAST 252-946-648 I Fax: 252-247-3330 Fax: 252-948-0478 (Serves:Carteret,Craven,Onslow- (Serves: Beaufort, Bertie, Hertford, Hyde, North of New River Inlet-and Pamlico Tyrrell and Washington Counties) Counties) Elizabeth City District Wilmington District 401 S. Griffin St. 127 Cardinal Drive Ext. Ste. 300 Wilmington, NC 28405-3845 Elizabeth City, NC 27909 910-796-7215 252-264-3901 Fax: 910-395-3964 Fax: 252-264-3723 (Serves: Brunswick, New Hanover, (Serves: Camden,Chowan,Currituck, Onslow-South of New River Inlet- Dare,Gates, Pasquotank and Perquimans and Pender Counties) Counties) http://portal.ncdenr.org/web/cm/dcm-home Revised 7/06/17 ROY COOPER Governor MICHAEL S. REGAN Secretary Coastal Management BRAXTON DAVIS ENVIRONMENTAL QUALITY Director BUFFER AUTHORIZATION CERTIFICATE FOR PIER AND DOCKING FACILITIES ACCESS WAY A riparian buffer authorization is required for pier and docking facilities access ways through the Tar-Pamlico & Neuse River Riparian buffer per Division of Water Resources (DWR) regulations 15A NCAC 026.0233 & .0259. The Division of Coastal Management (DCM), through a Memorandum of Understanding with the Division of Water Resources (DWR) has reviewed your project proposal and has determined that the project as proposed complies with the aforementioned regulations. Those activities covered by your Coastal Area Management Act (CAMA) permit have received Buffer Authorization provided the project is constructed in a manner that continues to meet all of the conditions listed below. Failure to comply with this Buffer Authorization may subject the property owner and the party (contractor) performing the construction and/or land clearing to a civil penalty by DWR of up to $25,000 per day per violation. 1. Crossing is Perpendicular: Pier and docking facility access way must cross the 50 ft. riparian buffer perpendicularly (which is defined as between 75 and 105 degrees) unless otherwise approved by DCM. The alignment shall minimize the removal of woody vegetation to the greatest extent practicable. z. Pervious Materials: All reasonable measures shall be taken to ensure the access way is made of pervious materials like open-slatted wood or composite, mulch, or grass to meet the intent of the rules to the maximum extent practicable. 3. Access Width:The width of the pier or docking facility access way shall be limited to six (6) feet. 4. Project Drawing: The drawing on the CAMA General Permit is considered the project drawing of your property indicating the relative location of the pier or docking facility and any requested access way. This drawing will be used to aid in compliance and monitoring efforts. • Pre-project site conditions: t* ;S in ) he,e) /4 wW wi -'ew /C(r. By your signature below you agree to be held responsible for meeting all of the conditions listed above and verify that all information provided is complete and accurate. Agent or Applicant Printed Name Permit Officer's Signature 9 - 30 -z Agent or Applicant Signature Issue Date CAMA GENERAL PERMIT#: 90 Z J3 State of North Carolina (Environmental Quality I Coastal Management Washington Office 1943 Washington Square Mall Washington,NC 27889 1252-946-6481 Wilmington Office 1 127 Cardinal Drive Ext.Wilmington,NC 28405-3845 1910-796-7215 Morehead City Office 1400 Commerce Avenue Morehead City.NC 28557 1252-808-2808 ADJACENT RIPARIAN PROPERTY OWNER STATEMENT. I hereby certify that I own property adjacent to CO ( ; 644 oh id 's C A /� (Name Q party Owner) �� property i cated at C24 y J u�,i >11)S& A/) e r...� ��'GC Address, Lot, Bock, in ot. q6, oeld, etc,4)`r� � J on xalnkeo evc, (Waterbody) (City/T g and/or County) -- - The applicant has described to me, as shown below, the development proposed at the above location. .ri^carZ X I have no objection to this proposal. Frogert owner 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) &,c_ A i I-I-6 di ed G-D74 a 17,--- -- WAIVER SECTION 's ja`a" I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin Pros. ;; r•anal must be set back a minimum distance of 15' from my area of riparian access unless waived by dt7.15'[ me. (If you wish to waive the setback, you must initial the appropriate blank below.) wiitw 14(N_I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Pr pe y Owner I rmation) (Adjacent Propertyer Owner Information) 412t.t.. �/r sir».4 1. a fe Zalur e /yr tP if P ype e f ,, P t olrTyp eme -J. 4 a 61.5 /vtit�C e / /y 1 , S '. ,.t ry /, rG Ad 'ass it gAd rags �}43 , f jegy i ca my3 7i70 c / tte/Zip.7/i 7_ 66,0 _ T phon Number email address Tele one Number!email address Date Date* (Revised Aug. 2014) *Valid for one calendar year after signature* (RRuiepri Lit tr 9 1A+ ADJACENT RIPARIAN PROPERTY OWNER STATE/MENT. I hereby certify that I own property adjacent to li f uJa/)/: V2 l 's (Name o perty Owner) �� property I cated at g--0 y (t i`� )5c> /i.() ei c.5� i�-- ` ,f/��, Address,Lot, [3 ock, o4d,etc) on ca 4C'6 ✓UDC, , in � //l; t fe .C. (Waterbody) (City/Tdwn and/o County) - -- The applicant has described to me, as shown below, the development proposed at the above location. A'jacarfi x I have no objection to this proposal. Property Samar I have objections to this proposal. Cheek on:- DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (individual proposing development must fill in description below or attach a site drawing) • Ls, At....t6.die4 ,D74' WAIVER SECTION `'`ia'nt I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin Presperty must be set back a minimum distance of 15' from my area of riparian access unless waived by .b'ttsc me. (If you wish to waive the setback, you ynust initial the appropriate blank below.) hAst tZly:i---41 I do wish to waive the 15'setback requirement. 1 do not wish to waive the 15'setback requirement. (Property Owner I formation) (Adjacent Property 0 er Info ation) OJAI 'Lt. "1/(M4g161 ep AW 41 k,vtfr_) • 11A,�tlt 6 G�P ype 'e Pr" or Typ ame S � ,.5 Q „&A Ls r im4) /lic02/U C f+pQl 75 C / p 7 LC -Li 31t T phon Number email address Tep)his Nur►b r/email address „.47,1 Date Date* (Revised Aug. 2014) *Valid for one calendar year after signature* MC Division of Coastal Mgt. Habitat Impact Computer Sheet Applicant: Ct) 'dart) Date: -/l 1)/ZD General Permit* 31.40Z B Describe below the HABITAT disturbances for the application. All values should match he lame,and units of measurement found in your Habitat code sheet I j TOTAL Sq. Ft FINAL Sq.Ft. TOTAL Feet FINAL Feet . I. (Applied for. i (Anticipatedfirtal ! (Applied for. ;Anticipated anal DISTURB TYPE Disturbance total disturbance Disturbance disturbance. Habitat Naive Choose One ndudes any Excludes ry total includes Excludes any ! I anticipated :estoraria any anticipated istoration and/or restoration or and/or Imo restoration or temp impact -temp impacts) impact amount) temp impacts) amount) )[ ) j Dredge❑ `!II] Both ❑ Other E i � I Dredge❑ Fill!E Both ❑ Other ❑ I ! Dredge D Fill Both ❑ Other Dredge 0 Fill Both i i Other j Dredge 0 Fill:D Both !� Other ❑• I j l Dredge!7, Fill. Both ❑ Other ❑ j i I i I ! Dredge J ! !II In Both El Other Dredge -ill Both ❑ Other ❑ i 9 � Dredge!i ;ill!CI Both ❑ Other !.E_, i i ! • Dredge❑ Fill❑ Both '] Other I i • Dredge❑ F ill❑ Both El Other ❑ • Dredge El Fiil.❑ Both El Other l • Dredge❑ Fill J Both ❑ Other ❑ ! • • • Dredge 0 F!ll 7 Both ❑ Other ❑ i , Y Untitled Map • -'r • Legend !r Write a description for your map. #�; • • .r • At'ft 4* a ' 1 • l2 • 1 A IN oogle Earth • N