Loading...
HomeMy WebLinkAboutRoyer, Jack 78803C�kbAMA / ffiDREDGE & FILL N( %fiii�) �r �G,ENERAL PERMIT Previous permit# A B C ° 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 I SA NCAC_�� l Rules attar ed. Applicant Name t ! Project Location: County v Address_ I%2�J (�r iy� Street Address/ State Road/ Lot #(s)�. City-- (� -- State ZIP Phone # "y' 93E-Mail Subdivision__ �.�- � �, Authorized Agent _ ( G-C t J I n t city—.----- ZIP Affected UCW _L�LW 'ETA .bES ❑PTS Phone # (_)_ River Basin AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body an unkn ORW: yes /(6o) PNA yes Closest Mal. Wtr. Body 0GtC3 Type of Project/ Activity Pier (dock) length_ (Scale: i I F I ) (''4 Fixed Platfonn(s) __. Floating Platform(s) _ - Fingerpier(s) Groin length �,uber• Ipvlkhj Riprap length fl -,.. ag distance offshore max distance offshore_ _ -I j Basin, channel _ _ Y I --' -f=. cubic yards Boat ramp —L Boathouse/ Boatlift..-- i J Beach Bulldozing_ Other,___ s.. {t I ri:-1.;.<:�--,.--:-�I- � r _L�ts: !_ l I . � ..t•GS i, C�1' n., C.` � f�- ._ ; I Shoreline Length $AV: not sure yes no �t Moratorium: n/a yes no -- --- - Photos. yes no Waiver Attached: yes no A building permit may be required by: ( Note Local Planning Jurisdiction) Notes/Special Conditions PccnPft' A'l C 1f�t4 t or Apph nted Name — —" CSignature I readcompi cestatement onback ofpermit** Application Fee(s) Check # t' tt.fy F\ig({{ . ❑ See note on back regarding River Basin rules. AGENT AUTHORIZATION FORM FOR PERMIT APPLICATIONS Name of Property Owner Applying for Permit: S� tarn -Li 41��'TH �Q` G-2 Mailing address: SJ(� K)C 2ZV)o Telephone Number: Q3`1 - 5 �3 - CAS 3 1 I certify that I have authorized C q-W06- (agent/contractor), to act on my behalf, for the purpose of applying and obtaining all CAMA permits necessary for the proposed development of INy 1 w � t k 2ol ) at my property located at S pu SLA- C8T'6- This certification is valid through Owner Information) �T err Print or Type Name (DU(N 62 S Title, co. owner or trustee for property ( / I `i / 1-0 Dates G3")-� 33-CAS 31 Telephone Number (date). I hereby certify that I own property adjacent to :TN('1C -t- C a-Z4&i N 'RQ4, ? s (Name of Property Owner) property located at 5 to 564- (;' �- DQI' 1 r':7- (Address, Lot, Block, Road, etc.) on TCL-) in wrt '27%7 ILL (Waterbody) (City/Town and/or County) N.C. 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) t WOPp5c o P'Wzo,< ► z0, -:5 (-\C Y'- WAIVER SECTION I understand that a pier, dock, mooring pilings, 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.) I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. Owner 0\ 5 Print or Type Name td? SGA anrrr fi2�1lG /M�a�iling Address f 1 \/�jL�t71irL\ l� City/State2ip rl 4. (Z—rl O Type Namer Mailing Address S�il� Pori cJ .L . City/State2ip ') -Z) Telephone Number Telephone Number Information) I hereby certify that I own property adjacent to \Nor. + rLT7A L,ctN 1�2J`:GQ 's (Name of Property Owner) property located at S 06 _S6a e- n-r4- 7R. d (Address, Lot, Block, Road, etc.) on TCW in__N %)=,ya2T tit N.C. (Waterbody) (CltyiTown and/or County) The applicant has described to me, as shown below, the development proposed at the above location. _L,If� 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) �1�JPG5(.n t,J 4.11, ppvaw WAIVER SECTION understand that a pier, dock, mooring pilings, 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.) I do wish to waive the 15'setback requirement. M67 1 do not wish to waive the 15' setback requirement. Owner f/ Name ' Print or Information) Marling Address Malting Address _ �t J?o2T rJL �(w>ctr s�c—lo Iftat iip Cdy/Stateop -ISS' / O l`T<''r'l U Tele hone Number Telephone Number--�— _ I IAIWO-u 12 04 VI., A