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HomeMy WebLinkAboutAnnie M Piner Family Limited Partners 76693CCAMA / ❑DREDGE & FILL N9 76693 A B C D ENERA� PERMIT Previous permit# New ❑Modification ❑Complete Reissue ' [-]Partial Reissue Da a 'ous permit issued As Al auth rued by the State of North Carolina, Department of Environmental Quality pp�, and the Coastal Res rces Commission in an area of environmental Concern pursJ}�fant to�) I56 NCAC P/ C,/ ❑ ues atta ed. Applicant Name TD(IJ1 Proj✓eTct'Location: County Address Street drf sfi/^State Road/ Lot #(s) 1 Phone # E-Mail Subdivisio Authorized Agent City ZIP Affected ElCw �EW PTA ❑ES ❑PTS Phone# fiver Basin ` AEC(s): [IOEA HHF IFH ❑UBA ❑N/A Adj. Wtr. Bod rat a nkn ❑ PWS: ORW: yes / PNA yes / Closest Mal. Wtr. Body i Type of Project/ Activity 4zdak (Scale: �—.CC ) ) Pier (dock) length _ - 7 Fixed Platform(s) Floating Platform( Finger piers) Groin length ------- number Bulkhead/ Riprap length avg distance offshore max distance offshore Bain, channel cubic yards Boat ramp _ - /, Boathouse/Boatlift IV` / - Beach BpWozing V - '—I Other LUk Shoreline Length _ i T_. SAM not sure no es Y Moratorium: n/a yes o - i Photos: yes o Fvf ' q�.i Waiver Attached: yes o ---- — - �/ ----- -- A building permit may be required by: ❑ See note on back regard/�r�},�Rivee Basin rules. ( Note Local Planning Jurisdiction) / 1 (, 4O _\ Il /'V read compliance statement on back p�perqj�:* Fee(s) �e of V-10porety Owwr Ro uesting Pamilt; me Num ol...'e. +S eth 'o;itrictw -Ar_ w g �ohdt. for the purpose of applying for and obtaining all CANIA permits .{�i`1i13ia7iUsed " iiD�}'�"i"?1i4`� s .;,, 9`:}T#=pel y lr)x t d at furthonnom t"Iettity that t am authorized to grant, sand do in fact grant ,orris' i to ivvgo t t)l t°;e: w1al M n ementstaff, the Local Permit Officer and their agents to ont rr (jm Me jr0aar rriontionod lands in connatWfl, writ, evaluattic.7 irafomi atian rotated to t/ais taom ii l�li A ali ra certify that I own property adjacent to 606iL NO r�� xGrYff%� � Ad 's � Name of Property Owner) Iom:ated at �_. �^ (Address, Lot, Bloc , ad etc.) /gVJV�`— —__-- N.C. (Waterbody) (City/ own and/or County) )pticant has described to me, as shown below, the development proposed at the above n� 1 have no objection to this proposal. e-Qbjections.to ttus_pcapci:sa .___ DESCRIPTION AND(OR DRAWING OF PROPOSED DEVELOPMENT victual proposing development must fill in description l�cU ption below or attach a site drawing) 1�1't 1 C kIt } o Q WAIVER SECTION i understand that a pier, dank, 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. (property owner information) Si�naltire Naino f. ikyl ;tt�icallq> fra' _ t ...,.. tJ:nrMatx3fi (Adjacent Property Owner Information) ADJACENT RIPARIAN PROPERTY OWNER STATEMENT eby cetfity that I own property adjacent to erty located at (Name of . . PGf wkd 's (Address, Lot, Block, d etc.) _ C f4y�-�_ � �--� , in _ _ , N. C. (Waterbody) (City own and/or County) applicant has described to me, as shown below, the development proposed at the above ation. I have no objection to this proposal. DESGRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT nclividuaf proposing development must fill In description below or attach a site drawing) � Qalcs`� FIN Fly Ntw os _ WAIVER N SECTIO 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. roperny owner 1111umva—lit 1,r 3 t} '.l �s!d'!: roty vlat i f ave authorized r%art ti un'=�a�t��r E" ()r, n,iy Behalf, for the pur se of applying for and oW ning .all C��NIA p�rrrtl#s � Fe eery fsir Iihe following proposed development_ at v y Imated at �. 3 N rr" ' y that i am authotized to grant, and do in fact 9tant ,permission to Division Ot st t Manegenwt stall,, dw Local Pit Ofter and their agents to entor on the at mmentioned land$ in cwWO0 0n raftir a+atuaft7l inibi r tion Mated to this k it y� MAO d _p[oposa ctlogs._to,JhjsL _ .---- --- .____..__ ____.-____ _ - DESCRIPTION ANDIOR DRAWING OF PROPOSED DEVELOPMENT viduat proposing development must filliesc description below or attach a site drawing) r o a ML.✓ r�dos Q, CA-G% 1/2 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 wisr, 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. (property r Infonnation) Vx: TcakaptrUne Numbor (Adjacent Property Owner Information) 1/a 1� _..__- biimntu e tivakue wvuy l applicant has described to me, as shown below, the development proposed at the above ration. - I have°no objection to this proposal. _._,,,,_,. --I— aYe-Qbjecti,o,w1 - his-pMposaL ____ ___ _ DESCRIPTION AND/Olk DRAWING OF PROPOSED DEVELOPMENT ndividuaf proposing development must fiH In description below or affach a site drawing) c %rw QGIGS J u ---7 W 1u5.�r' WAIVER SECTION I undersland'thal a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set (jack 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 imortnauvil; r Ctit(rrit�lU Nu�ntnar faa3r (Adjacent Property O t- f} .l i:, •YES% ��`��"��"'"' Sl e Print or µ Namo A Information) A 63-7 (f?evtsed 6 gW)012) etc_ ■ u e W A a g O 40 MU F 4 a y Ya r» W I is T Eli fi iE a� it m n l nfi ri E eg I�g 'fig$ 5 N 0� O N M 0 O O 00 N � x w z 0.1 O N {xrj N wV x O U O ��F •• �G N cGOn o Wpq n a. ram" Y yj y N rR pq 6 I� � h! � a Y�r F F D � Ci � F v�i G P• A f�-0 AGENT AUTHORIZATION FOR CAMA PERMIT. APPLICATION Name of Property Owner Requesting Permit: j1VVU4 ";21A Ca¢d. 0l 61 Mailing Address: /6q1 Mod, U0, Phone Number: Email Address: I certify that I have authorized q/q-goq� -qTo( <x C] R '_' c Contractor to act on my behalf, for the purpose of applying for and obtaining ail CAMA permits necessary for the following proposed development: z2 6 (_ i I d F 1 n'5C_*-s a F 104A -�_e- at my property located at _ in 4L A} z i zr-ci — County. f furthermore certify" that 1 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: �l7di�tL D/��C %�n,�/,P,�,�+✓%C�iiie �tl l�vioit.��p Signatures Print or Type Name S / K 1 2dg- Date This certification is valid through /_ ADJACENT RIPARIAN PROPERTY OWNER STATEMENT Sh` I hereby certify that I own property adjacent to 's (� n (1) r of Property O ner) property located at 1j" (Address, Lot, Block, Road� etc.) on in („) ]5 N.C. _ (Waterbody) (Cityfrown and/or County) The applicant has described to me, as shown below, the development proposed at the above location. I have no objection to this proposal. _ I haYP objQcSi-ons_to�liis-propos-al------------. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (Individual proposing development must fill in description below or attach a site drawing) 0 ca e,'lt 15�-�w5 Jen.wq[ 1 Ntw �a� 6 - a I rh F iw,w—r�4 Ro44,— 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. (Property Owner Information) Signature Print or Type Name Mailing A dress 1YAShU11iyA% — City/statelOp Telephone Number _ gtIG- of60-q7a I# . (Adjacent Property Owner Information) Telephone Number /�6 2 Date (Revised 611812012) 0 M J a ADJACENT RIPARIAN PROPERTY OWNER STATEMENT Qar� s� I hereby certify that I own property adjacent to An �_1ntYv n- ram j 4 h-'Y l 's ofperty O ner) PrA property Located at _ l II / (�I �/ l S YI % "'��( (Ad Tess, Lot, Block, mad etc.) on in (.L N.C. ,. (Waterbody) (City'rown and/or County) The applicant has described to me, as shown below, the development proposed at the above location. I have no objection to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (Individual proposing development must fill in description below or atFach a site drawing) Patcs/ L��E, Ncw a'd� �J��•r- __ 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. (Property Owner Information) to C"�s��� Siglwture Print or Type Name l5 k M06(P Mailing A dyes SS ull�otC City/Stata0p 1� 553 Telephone Number q I G-_ CW -` 0a ri . (Adjacent Property O� formation) Sj e rnnt or iype rvame n ref �UCi11,%. Date � 7— IMAM (Revised 611WO92) NE rej