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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*