HomeMy WebLinkAbout76988A_Schmieler, Albert_20200730{ Y' CAMA / R DREDGE h FILL 4 ��ggg
GENERAL PERMIT ® 8 C D
Previous permit #
ANew nModification OComplete Reissue OPartlal Reissue Date previous permit issued
As authorized by the Sate of North Carolina, Department of Environmental Quality
artd the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC
,7 ® Rules attaChed.
Applicant Name Q lb? r�- c , �r (� Project Location: County ilto,r
Address_ _ ?!1 E . ( ,�- S e Street Address/ State Road/ Lot #(s) Lai it I (o
CiState NC ZIP _ a 3 $ �' av Ede i �nu se 14d,
Phone # CULq 321 ' * 1 ri E-Mail dlu X �@q,'I Aivision�(ci('�C.
Authorized Agent_ (xettn d ��t ee�CS j3, frt� l( » City ZIP 27 a 577
Affected D CW R Ew IN PTA 8 ES tR PTS Phone # (=) River Basin CKC w*j 1
AEC(S): OOEA O HHF ❑ IH ❑ UBA El WA
❑ Pws: Adj,Wtr. Body CkUA.).n ��vf'✓ /man lunlar)
ORW: yes ! no PNA yes ! Closest Maj. Wtr. Bodz iiKn 1Z i W,
t�- - - s '�
Floating Platform(s)
Finger piers)
Groin length .,
number r
Ikhea Nprap length 7.'30
an timunce offshore V
mart distance offsh, Z �
Hasin, channel
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Agent or Applicant Printed Name U
S+ re Please ompliance statement on back of permits+►
Application Fee(s) Check #
6 . i~;re
Permit &'s Printed Name
e
Signatu
1/ 3 d /Zoe -_ _ ............_.
Issuing Date Expiration Date
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: I ' C-- S`�M' Q_
Mailing Address: 4V E�� n- N I�ovs�- �
Phone Number. Z4
Email Address: Gh��1c..•`��-�^ e. tom.
I certify that I have authorizedCrravL!¢�j�
Agent /Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
2- -3 o /"O� pe Zzgv,"t
at my property located at
in ?),Il& County.
l furthermore certify that i am authorized to grant, and do in fact grant permission to
Division of Coastal Management staff, the Local Permit Officer and their agents to enter
on the aforementioned lands in connection with evaluating information related to this
permit application.
Property Owner Information:
Signature
Print or Type Name
Title
4� 12 ��- 12a2y
Date
This certification is valid through ) 0 1 a 0 1
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to A IQ i C 's
N me of Prope O rngr 21
Property located at ® C-rf�fr�%Eav 0. I� 1 g�ji
(Address, L� Block, Road, etc.)
onj41 in !F—(L- � % /r, Nt N.C.
(Wate body) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
to 'on.
1 have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must rill In description below or attach a site drawing)
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, 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.)
XI do wish to waive the 15' setback requirement.
1 do not wish to waive the 15' setback requirement.
4 (Property
ign 11
�ture �C� � iin—
Print or TypeG'V N In
ailing Adc�r�sfr
tit j� ll v
ci /star r
T,olephone Number/email address
Date
"Valid for one calendar year after signature'
(Adjacent Property Owner Information)
Sr ature * ?
J � r�Cj � 'de, lJ�
Print or Type Na" Q
74Z 6--V
Marling Addre$
t � t ` Nc ,Z� a1c�7-1
M'z,►z�L
��;�r-"a-2•�3go�
hone
Tel pne um er/email address
- --2-a2-Q
Date*
(Revised Aug. 2014)
y
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
nn
I hereby certify that I own property adjacent to t ullo tt C , sd A) s
(Name of Pronertv Owner) ---
property located at
a
yy /} (Address, L Block, Road
on t IOW , in Oc:. _, N.C.
(Waterbody) (city/Town ao4or County)
The applicant has described to me, as shown below, the development proposed at the above
loca_t(on.
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
a 3o LF t b0010k
WAIVER SECTI
1 understand that a pier, dock, mooring pilings, boat ramp, 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.)
XI do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner I formatio) (Adjacent Property Owne71nf�qrfnat* n)
Sr afore S gnature*
Li #- C. Schrn;eler Mll-1Ui�-L 1))t D�9/h'S
Print or Type Name Print or Type Name
a39 EAgn Fz 0 U c--ttv ems. n
Mailing Ad ss M it ng Address
(1 x1 C o`A5-1 AX ZZll •y ,C�t/ LL
C ty/S te2,�p „ —� CityaG 2 -7
felephone Number / email address Telephone Number / email address
2.S 2r i 2-- -4V 7 2---
Date ""} -�� _ Date • '—T ' ZU
(Revised Aug. 2014)
'Valid for one calendar year after signature"
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