HomeMy WebLinkAboutMagens Bay HOA 76704CgAMA / ❑ DREDGE & FILL 976704 A B / C / D
` ENERAL PERMIT Previous permit# `O
�ew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality -�J/ ��I
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC /
Rules faached.
C Cam/ Project Location: County
Applicant Name Pro I
Address 12, S Street Address/ State Road/ Lot (s)
City � cr -�/G og`'� State( v� ZIP
Phone # 60.E �a/ —1VkMail # Subdivision o _
�ti'�� r ^
Ch-I
CityG�
Authorized_Aggeent
/ "EW A
DES ❑PTS
Phone # ( )�
Affected
AEC(s): ❑ OEA
❑ HHF ❑ IH
❑ UBA ❑ N/A
Adj. Wtr. Body
PWS:
Closest Maj. Wtr. Body
ORW:ryes)no~
PNA yes / no
Type of Project/ Activity
Pier (dock) lei '
Fixed Platforn
Floating Platfc
Finger pier(s)
Groin length
number
Bulkhead/ Rip
avg dista
max dist
Basin, channe
cubic ya
Boat ramp
Boathouse/ B,
Beach Bulldo:
Other
Shoreline Len
SAV: n
Moratorium:
Photos:
Waiver Attacl.__.
A building permit may be required by:
( Note Local Planning jurisdiction)
Notes/ Special Conditions
Agent or Applicant Printed Name
Il
tu, Please read compliance statement on back of (ciitt ion Fee(s) /Check #
Permit
f'4't— ZIP
River Basin
cJ C v" - J �4A ✓J
(Scale: /( /V )
P See note on back regarding River Basin rules.
e'ill
1-0
AGENT AUTHORIZATION FOR LAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit:
MQ9cr,s
Brly Homrownmrs
Assocla tor?
Mailing Address: "Jg;� S
C'00r+,
cxrjar POWt , rac
Phone Number: 910 -S94 -9030
Email Address:
certify that I have authorized J"S' },
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development- d:)Cx dumcx<,- #rc,
frYlCC4fS" !h Sarn1C -Fk,oii'-i':I`."
at my property located at ion, MagGnS +Cour+ i f rdor Pcirit , NG 2%584 ,
in r-rhC¢ C,{ County.
1 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:
ign re 7
?l�r L A- J-11
Print or Type Name
Title
Date
This certification is valid through / /
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
Ihereby certifythat Iown Prop" adjacent to mcLee-„s c�, ��m,��v,,,.� Aszociv-tior, is
property located at � �� o _ens c o u' �N � e of Property Owner)
(Address, Lot, Block, Road, etc.)
on in CYdnr point/C.,
(Waterbody) N.C.
(City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
la a ' n.
I have no objection to this proposal.
1 have objections to this proposal.
DESCRIPTION AND/OR DRAVVING OF PROPOSED DEVELOPMENT
(individual Proposing development must fill in description below or attach a site dnwAna)
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 1S' from my area of riparian access unless waived by
me. (if you wish to waive the setback, you must initiaF the appropriate blank below.)
I do wish to waive the 15' setback requirement.
' I do not wish to waive the 15' setback, requirement.
Jam"
(Property Owner information) (Adjace erinf ation)
Print or Type Name Pnnt or Type Name
i�t Rosat da!=a 6��.+t3• i0`Fr�v�r Mg_ er+ Mailing Address Mailing Address
Gtdor Po;n+. Me 24rR-1 -Gcgar ramr i nG ,"S pi3v`I
City/statwZip Cdy/Stafe/ZiP
10 54rabtrt tnn'taiaC0Tn27;1.e6rn 3',�'i t F 1.
Tele hone Number/email address Tele ne Number/ema#address J
Date ate
(Revised Avg. 2014)
;Valid for one calendar year after signature*