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_
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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
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