HomeMy WebLinkAboutBennett, Harry 76325C.•. cAMA /�REDGE & FILL No. 76325 A B
ENE L PERMIT Previous permit#
New ❑Modifcation ❑Complete Reissue [-]Partial Reissue Date r ioKermit' ed
As auth ruedby the State of North Carolina, Department of Environmental Quality1and the Coastal Resources Commission in an area of environ en I concern pursuant to 15A NCACach
Applicant Na Project Location: County
Address Jk An bn 1 i 1 0 Street Addressl State Read/ Lot #(s) /
Cityi��'/.R�V0'Vlfi_Lr l�l ��iltlill ��l�it�P.T•►�11�
.Phone -Mail SubdivisioAl
law A!F
Authorized Ajzent City �WFJOZHAAAHULWFWA
rN
El CW
glqwl Jr Basin
Affecte ■. ■ ■ ■ [I N/A�'
fORW: ye Closest Maj. Wtr. .. ► ,�51-.
El
rr:,'"ilAl�t1�
Type of Project/ Activity E)t 1 4�/A,
(Scale:
Pier (dock) length
Fixed Platform(s) - : --
Floating Platform(s)
Finger pier(s)
Ll
—
Groin length
er
Bul head/ prap length
avg distance offshore f
max distance offshoreBasin, channelcubic
7V"V
yardsBoat ramp
Boathouse/ Boadift
--
-—
Beach Bulldozing
Other
-
!
Shoreline Length _
SAV: not sure yes o -
Moratorium: n/a yes o
Photos: yes no
Waiver Attached: yes o
A building permit may be required by:
( Note Local Planning Jurisdiction)
Notes/ Special Conditions
n % h a . r1
Agent or Applicant Printed Name
Dy t
tre
Signature *•PI eadcompliance statement onback ofpermit *'* SignDAppliFee(s) Check# lZ
❑ See note on back
River Basin rules.
Date
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: ar r// v le NNf'-t
Mailing Address: %o c,.o,%.< I rg ; /
AlF oN c a ej-:�-d
Phone Number: r '7 90 a
Email Address:
1 certify that I have authorized /4r
Agent I Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: �1ii N7v '4
at my propertylocated at /� % a S"f.
in Gar4fre-
4 County.
I 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:
i
f - i�r `
/
i 9FNN
rint or Type Name
vot'rr,
Title RECEIVED
3 / `,S- / �2 ��
Date MAR 17 2020
OCM-MHD CITY
This certification is valid through -3 / /S / :� i
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
� 's
I hereby certify that I own property adjacent to r-r(Name of Property Owner)
property located at 1 �o �� Sf-
(Address, Lot, Block, Road, etc.)
C c / in
on N.C.
(Waterbody) (CitylTown and/or County}
The applicant has described to me, as shown below, the development proposed at the above
location.
have no objection to this proposal.
I have gTzjQctionto this_proposal---_--------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill In description below or attach a site drawing)
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)
nA
Mailing Address
A/E,-� RFrd NC a 8
Telephone umb
3�
Date
(Adjacent Property
jOw�nnee_r—information)
Signature
ZZ&dn �✓�- FIE ! --
Print or Type Name
,-kr- 1 NZ al'sra
d"-/0
RECEIVED
(ReviseA408/049zo
DCM-MHD CITY
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
property located at
�FN�f7� s
( am e of Property Owner)
/So u1 F,✓ Y -t
(Address, Lot,
on �'eL r✓ '. / , in
(Waterbody)
etc.)
r. R-.'f 4 , N.C.
own and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
L,-" I have no objection to this proposal.
--
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must fill in description below or attach a site drawing)
7�r t o Y
Cc
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 t aive t setback, you must initial the appropriate blank below.)
Ul I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement -
(Property Owner Information)
Print or Igpe Name .�
��� %, +tea ��� •('f5- /r9 � /
Mailing Address p (/C a8s�
Al_
_
:J L1F(FJ /V
Telephone Nupber
Date T
(Adjacent Property Owner information)
Sionature
S�F✓F WiJSoJ�
Print or Type Name
n
/ 7 /tea iJE,,/ Sf
Mailiyn� ddress1 aBSJa
rl �il' f� 7 i L �E/1 �
City/StatelLip
Telepon n� Number
3 //s/3o -----RECEIVED
Date
(RevisedW/fM020