HomeMy WebLinkAboutFerrell, Michael 76719C❑ VAIVIA / ❑ DREDGE & FILL
N9 76719 A B C
WNERAL PERMIT
Previous permit #
evw ❑Modification ❑Complete Reissue ❑Partial Reissue
Date previous
/it/issued
As authorized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources CommEsion
in an area of environmental concern pursuant to 15A NCAC 11
/ ❑ Rules attached.
/
Applicant Name G e—r Fcrtr (/
Project Location: County
Address ) V ` K «�
Street Address/ State Road/ Lot #(s)
Ci State/VCZlP a� �-,
ty
► -� c 1."
Phone # (� ' /G Mail
Subdivision
�'
ZIP
Authorized Agent L'4
City__
❑ CW ❑ EW ❑ PTA -;;It ❑ PTS
Affected ElOEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
n
Phone # () River —Basin,
//
lam' C
AEC(s):
Adj. Wtr. Body l C �rl nat man unkn
ElPWS:
ORW: yes / no )
PNA �s / no
Closest Maj. Wtr. Body
Type of Project/ Activity
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)
Groin length
N---awg'dist—ante offshore 1L/
max distance offshore
Basin, channel
cubic yards_
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
Shoreline Length
SAV: not sure yes l n -- -- -_
Moratorium: n/a yes no
Photos: yes n
Waiver Attached: yes no
A building permit may be required by:,
( Note Local Planning jurisdiction)
Notes/ SpeM
n itions
CY.A C6
r,9
�f e —7J❑//See note on back
C'-i'eP(.P11?U1'1
Agent or Applicant Printed Name
fu
Signatu
onFee(s) Check# Issui g
(Scale:/V —1f )
g River Basin rules.
V e" -111 ell,
ADJACENT RIPARIAN PROPERTY QWNER -STATEMENT
I hereby certify that I own property adjacent to
(Name of Property Owner)
property located at
(Address, Lot, Blockt Road, etc.)
on in w, N.C.
(Waterbody) (CitylTown 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 have objections to this proposal,
DESCRIPTION ANDIOR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development most rill in description below or attach a .site drawing)
2- 1�q}
10
yy 4 at
�.�`'1'� ` `•1 .ate-.4`4^^�+.........,�*.+ ..�.»-�jil i
101 i[ j t.._
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_)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Properly Owner Information) (Adja P 0 wn Information)
0zaccl __
Print or TypeNarne Phrif or Type Name
Mailing Address Marling Address
Ci toliip r cit}+f ttt�,lZ U 2 7y
Telephone Number Iamail address TelephoneNumberla address
S Dan, Date
(Revised Aug. 2014)
"Valid for one calendar year after signature'
• Complete Items 1, 2, and S.
• Print yoUritame and address an the reverse
so that we.can return the card to you.
• Attach this bard to the back of the mailpiece,
or on the front If space permits.
1. Article Addressed to:
)V- /U117 I-e e
e Va
X 0 Agent
0 Addressee
S. Received b /(Printed10, Date of Delivery
D. Is derrv;4 address 6ifferent from Item 17 ElYes
If YES, enter delivery address below; [I No
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3. Service Type
LJ Priority Mail Express®
0 Adult 8:gnaturo
Ll R.9istered Me! I-
11 Adult 6 g"'ture RestActed Delivery
0 F4Wered = Restricted
9590 9402 5494 9249 0138 17
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Q Collect Or, Delivery Restricted Delivery 0 Signature
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Isured mail
0 rAgnture Gonfirrnn.V-
ResIfloted Delivery
- -
lMd Mall Restricted Del"
'�o $500)
PS Form 3811, JUIY2015 PSN7530-02-000-9053
Domestic Return Flec4t
Postal Servi(
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Domestic Mail Unly
For delivery information. VIS11 OUT �'Iek)Slle at W—'�.U$P9-COn?t-
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9590 9402 5494 9249 0138 17
United States
Postal Service
Sender: Please print your name, address, and
/7- 9 13,-00 &1 4,e
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First-Cla§s Mail
Postage & Fees Paid
USPS
Permit No, G-10
,lili-0,1iiih1111-1Ilii
PARCEL NUMBER: 53941.9611679000
OWNER: KELLEY,DEBRA NYSTROM TRUSTEE
PHYSICALADDRESS7117 ARCHERS CREEK DR
EMERALD ISLE
MAILING ADDRESS: PO BOX 1062
LUCERNE VALLEY CA 1062 92356
LEGAL DESCRIPTION: L35 S2 BG ARCHERS POINT
DEED REF:1528-59
PLAT REFERENCE:16-53
NEIGHBORHOOD: 560035
SALE DATE:12/14/2015
SALE PRICE: $0
ACREAGE: 0.339
LAND VALUE: $383,680
BUILDING VALUE: $0
EXTRA FEATURE VALUE: $0
PARCEL VALUE: $383,680
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
hereby certify that ! own property adjacent to m'.ckIs
t (Name of Property Owner)
property located at 1 c
(Address, Lot, Block Roa , etc.)
on N.C.
(Waterbody) (City/Town 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 have objections to this proposal.
DESCRIPTION ANDIOR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must fill in description below or attach a site drawing)
000e__1 &
-5_`"?5--
M liti L<
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_)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information) (Adjacent Property Owner Information)
zz"ca 2
Signatzre
Print or Type Name
I _Isi � p zzAt S AC
aril g Address
C fstat Zip
q- -79 - q 071�1
Tele hone Number/email address
Date
Signature*
Print or Type Name
Mailing Address
city/state2ip
Telephone Number/email address
Date'
(Revised Aug. 2014)
*Valid for one calendar year after signature'
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