HomeMy WebLinkAbout76863A_Harrell, Robert & Dorothy_20200825-= / --IDNEDGE & FILL
ENERAL - PERMIT Previous permit #
New )(Modification Complete Reissue Partial Reissue Date previous permit issued
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
� t s attached.
Applicant Name !� C { ! - Llrc> fly y qPE fl- Project Location: County
Address _ 12-94)- 1V,- Ni_ 13- - — — Street Address/ State Road/ Lot #(s)};
city_ZL-�_ _. Stace-AA:�-- ZIPaP-Z> -T-
Phone # (1s2)`}[(- Gol9 __ _ E-Mail $1►al�nJ�et G Kg • �S
Authorized Agent . _L.{,,� $�•.1�- -
Affected CW ?,EW '*M -ES PT5
AEC(s): -' OEA -_ HHF IH UBA N/A
_ Pws-
ORW: yes /on PHA yes no
Subdivision
city C.>;-,,--
Phone # (----) -------------- River Basi .Fos
Adj. Wtr. Body['r rd�faLk,-.%G4-_ ------(.nab 1mw_lunl n)
Closest Mal. Wtr. Body.C-Ut,"�1'rG_h- _
Type of Project/ Activity RegrlkxB&,�-f ;�—:lrkmco
(Scale: ) _ a j' 3
Pier (dock) length
Fixed Platform(s) _
Floating Platform(s)-
Finger pier(s)
Groin length
number
Bulkhead "pray length 9C),
avg distance offshore
max distance offshore
Basin, channel
cubic yards - _A --
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
1r —1
I
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r �
2
_1Z�VPlS i,. p
Shoreline Length _} R;il� - iGCj � �lcn
SAV: not sure yes
Moratorium: n� yeses no
Photos: (yet no fir lrB
iL
Waiver Attached: yes no POf
A building permit may be required by; -C-CAt. +t•C k. ,, N
( Note Local Planning jurisdiction)
Notes/ Special Conditions
r\ <(- JK
Agent or Applicant Printed Na
me
Signature * " Please read compliance statement on bacit of permit ss
Application Fee(s) Check*
��L
i For
See note on back regarding River Basin rules.
20± ieef _
--
Permit Officer's Printed NameSignature
--
Issuing Date Expiration Date _
SL D'*(> -- 3 Sic /( Jw
North Cantina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Emes Perdue, Gomm .lames H. Gregson, Director Dee Fremm, serxewy
Date (5 U.
Name of Property Owner Applying for Permit:
Mailing Address:
UPI,
I certify that I have authorize} (agent) t h :,,� ry-L- v 'i-I to act on my
behalf, for the purpose of applying for andobtainingall CAMA Permits necessary to
install or construct (activity)
at (my property located at) � �}{� tx �t t.� ntl
This certification he valid thru (date)
Property Owner Signature
400 Commerce Avenue, Momheati City, North Cwdma 2W
Phone: 252-8W2808 l FAX: 252-247-M t Internet www.rccoasWmanagementnet
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• Complete items -1,2 3.
• Print your name -and., Tess on the reverse
so that we can rt the card to you.
• Attach this card to the back of the mailpiece,
or on the front if space permits,
1. Article Addressed to:
�rf \P,lulu �o"��w�k�'� n�',
A. Bignat
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B. Received by (Printed Name)
r
13 Agent
El Addressee
C. Date of Delivery
D. Is delivery address different from item 1? 1:1 Yes
If YES, enter delivery address below: 0 No
3. Service Type 0 Priority Mail Express®
0 Adult Signature 0 Registered MailTM
0 Adult Signature Restricted Delivery 0 Registered Mail Restricted
0 Certified Mail® Delivery
9590 9402 5869 0038 1158 80 0 Certified Mail Restricted Delivery 0 Return Receipt for
0 Collect on Delivery Merchandise
2. Article Number (Transfer from service label) 0 Collect on Delivery Restricted Delivery Cl Signature ConfirmationTM
it 0 Signature Confirmation
7019 0160 0000 9887 3539 it Restricted Delivery Restricted Delivery
PS Form 3811, July 2015 PSN 7530-02-000-9053 Domestic Return Receipt
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DMSIOd OF COASTAL MANAGEMENT
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and f have no objec dons to ft dcveloptner# haJahe is proposing at that �tiart,
Pam•
DESCRIPTION AMDIOR DRAW NG OF PROPOSED DEVELOPMENT
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