HomeMy WebLinkAboutScull, William 77333C...
AMA / El DREDGE &FILLN9 77y 3 A B OC D
NERAL PERMIT Previous permit #
ew ❑Modification [-]Complete Reissue El Partial Reissue Date previous permit issued
As thorized by the State of North Carolina, Department of Environmental Quality �
and the Coastal Resour es Co sion in an area of environme tal concern pursuant to 15A NCAC (J
❑ ules attached.
_,-
Applicant Name 11s
I� Project Location: County
Address ' C" f"r" h Street Address/ State Roadot,
# s)
City StateAfC zip', / 1�l /J
Phone # fL %73' -Mail Subdivisions
Authorized Agent
Affected ElCW ElEW ElPTA �ES ElPTS
ElOEA ElHHF ❑ IH / ❑ UBA ❑ N/A
AEC(s):
❑ PWS:
ORW: yes /(no j PNA yes n.
Type of Project/ Activity
Pier (dock) length
Fixed Platform(s)
Floating Platforms)
Finger pier(s)
Groin length
6n��
max distance offshore
Basin, channel
cubic yards_
Boat ramp
Boathouse/ Boatlift
Beach Bulldozi
Other
Agent or Applicant Printed Name
r¢�` j��jPleAse read compliance statement on back of pe mi_ t �
City S (,fC'.4- 3-) ZIP_
Phone # O River Basin
Adj. Wtr. Body '~
Closest Maj. Wtr. Body
Permit
C111
(Scale: /1j j (` )
arding River Basin rules.
y",
licationFee(s) Check# Isstinf lEe 1 / Expfation Date
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
hereby certify that I own property adjacent to \ l ',, I I', c,((4 L2 Cu- � � is
�Cxy-�el
ame of Property Owner)
erty proplocated at __� �} 1 1r�i 1, ; e r� v�
(Address, Lot, Block, Road, etc.)
on (� Lyt in - .�y ! a n�2nrc) N.C.
(Waterbody) (City/Town and/ County)
pr7=,-, -i e �f"e,�
The applicant has described to me, as shown below, the development ooposed at the abo e
location.
1 have no objection to this proposal.
I have objections to this proposal.
ANDIOR DRAWING OF PROPOSED DEVELOPMENT
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin
must be back a minimum distance of_16 from my area of riparian access unless waived by
me. (if you wish to waive the setback, you must Inklal the appropriate blank below.)
1 1 do wish to waive the 16 setback requirement.
I do npt wish to waive the 15' setback requirement.
Print or Type Name
/email address
I
Valid for one calendar year after signature'
71�0
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Sign
Print or,
Mailing Addre
City/StatefZip LA
Telephon N oC rf i! address
Date* D
(Revised Aug. 2014)
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
1 hereby certify that I own property adjacent to , 1 � i a-, � � 's
ii (Name of Property Owner)
property located at j i+
(Address, Lot, Block, Road, etc.)
on _ e , 1, C)1-� CA `s G in ,,Lv'f!a-Y2 � V:) s� � c� N.C.
(Waterbody) (City/Town and/or County)
CQ�ct-c'r
The applicant has described to me, as shown below, the development proposed at the abo
location,/
I have no objection to this proposal.
i have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
f�rt�taa�l�ar��®sdng?dq�t�mu��ll r�r id��c,�r�tr�air ��oi��rcBa,a�,�eie eV"r�vuri�g)
WAIVER SECTION
1 understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin
must be set back a minimum distance of 16 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 16 setback requirement.
do r)qt wish to waive the I & setback requirement.
Print or Type Name
P0, bnX .5 �3+
Mailing Address
telZip
e/pphonp Number/email address
Dlite
Valid for one calendar year after signature*
( jacent Property , er Information))
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Print or Ty N me
1117 W �c7- tt F'-�uy� Li
Mailing Ad ress
City ate,¢ip
Telephone Number/ eWm# address
S/ / z 7 / z" Z.G,
Date*
(Revised Aug. 2014)
Lot
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
property located at
of Property Owner}
's
(Address, Lot, Block, Road, etc.)
on a1 YY--mn( 5 !7 ULt in .�i ra.� 1;, hnx"c� . N.C.
(Waterbody) (Ciityfrown and/ County) \
The applicant has described to me, as shown below, the development pr posed at the abovve
location. �
lion/_' I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
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_16 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 16 setback requirement
I do npt wish to waive the 15' setback requirement.
Print or Type Name
/email address
1+
7,7ni 777
10 on}
SiRn
Print or��j�e
Mailing Addres�j
City/SfateJZip
Telep__ address MM40
hate*
(Revised Aug. 2014)
'Valid for one calendar year after signature"
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to s
(Name of Property Owner)
property located at l `� W L't b �A c f' 0 ,"-x Lo`n -e.
r (Address, Lot, Block, Road, etc.)
on _ ���x �I, ��� n_ r �. l G U-t in 7v�f ,�, �r � 1r_- Qg—o N.C.
T(Waterlbody) (City/Town and/or County)
G '�
The applicant has described to me, as shown below, the development pr000sed at the abo
location,/
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(ixdrtrrlaaalanara�g adYeiofat mushd1►in des?rptap �ao`or Wiwi
WAIVER SECTION
I understand that a peer, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin
must be set back a minimum distance of 16 from my area of riparian access unless waived by
me. (If you wish to waive the setback, you must initial the appropriate blank below.)
_X I do wish to waive the 15' setback requirement.
do rfegt wish to waive the 15' setback requirement.
ztI 't rA�.G
Print or Type Name
V n, bax 5 3
Mailing Address
rty 5�telZip
,) 7-75--
el hon Number/email address
te
----
( jacent Property , wner Information)
Print or Ty lV m
147 t�� e fl <>�,)�,
MAiling Ad Tess
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(fir,,JjJba,'O aG
oip!(cy, �izc i l;bto✓j
Telephone Number/ rr ll address
Date*
(Revised Aug. 2014)
Valid for ene calendar year after signature'