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HomeMy WebLinkAboutChambers, Alan 77125C/ V LAMA / 1-1hT DREDGE & FILL ? 77125 r. • GENERAL PERMIT Previous permit# A B CC, D 6 ew ❑Modification El Complete Reissue ❑Partial Reissue Date previous permit issued As authorized by the State of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC 'Rules a tached. Applicant Name �i Project Location: County Address C C �� Street Address/ State Road/ Lot #(s) 1 City ii State � ZIP Phone #) E-Mail Subdivision Authorized Agent �t°� CityZIP ❑ Affected ,`w _,*TA ❑ TA ES PTS Phone # ( ) River Basin AEC( ): ElOEA ❑ HHF ❑ IH ElUBA El N/A Adj. Wtr. Body �na�m/�unkn) ❑ Pws: ng) PNA yes"/ n Closest Maj. Wtr. Body ORW: yes / Type of Project/ Activity 1�� %pD� --tI aq P (amyl IVL Pier (dock) length Fixed Platform(s) _ T_ Floating Platform(s) ln� L 1(0 Finger pier(s) .—' Groin length number Bulkhead/ Riprap length avg distance offshore max distance offshore Basin, channel cubic yards Boat ramp Boathouse/ Boatlift I-- Beach Bulldozing_ Other Shoreline Length SAV: not sure yes Moratorium: n/a yes Waiver Attached: A building permit may be required by: ( Note Local Planning jurisdiction) Notes/ Special Conditions <S;nl or Applicant Printed Name Si nature **Please read compliance statement on back of permit � 1L� Application Fee(s) Check # (Scale: El See note on back regarding River Basin rules. Permit Officer's Printed Name Signat re I n Iss mg Da a xpirati n Date Lt NT AUTHORIZATION FOR CAMA PERMIT APPLICATION RECEIVED Name of Property Owner Requesting Permit: 1 JUL 2 3 2020 Mailing Address: j 2(Y DCM-MHD CITY �e� c Phone Number: 2fe Email Address: I certify that I have authorized Agent / Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: �'x /( L at my property located at / L q Z -cN �,r)Z, in CP"9il�6T County. l 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: Signature Print or Type Name C> -7 / G 7 l Date This certification is valid through I I CERTIFIED MAIL • RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONMAIVER FORM Name of Property Owner �(,eAV l,i'�/- Ci✓/'�:.'�f�S address of Property./3 AnAXL (Lot or Street #, Street or Road, City & County) A gent's Name # ,�/N.7.El !✓ / ' Mailing Address: ?0(/ g/,Q&92- 14"1 Agent's phone # i GS -��� "y3`�c�, �tJ&'Jv �c�jv /Vt6�- I hereby certify that I own property adjacent to the above referenced property. The individual applying for this permit has described to me as shown on the attached drawing the development they are proposing. A descdotion or drawing with dimensions must tiff nE vl .with this Ietter- �l. , / v �CL I have no objections to this proposal. 1 have objections to this proposal. 1 �+ If you have objections to what is being proposed, you must notify the Division of Coastal Management (DCM} in writing within 10 days of receipt of this notice. Contact information for DCM offices is available at htip://www.nccoastalmanaoementnet/web✓crn/staff4istJn4 or by calling 1-8884RCOAST. No response is considered the same as no objection if you have been noted py Certified Mall. WAIVER SECTION I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift must be set back a minimum distance of 15' from my area of riparian access unless waive "IVe1) you wish to waive the setback, you must initial the appropriate blank below.) I do wish to waive the 15' setback requirement. JUL 2 3 2020 I do not wish to waive the 15' setback requirement. ° CM'MFiD CITY (Property Owner Information) (- -1) 0 Sig Manure Print or Type Name Mailing Address ( parian pie Owner Information) Signature F� ,Yov-sPrint or or Type Name I o 4&A-vrV6� -Rktl.K Mailing Address City/StateMp City/State/Zip Telephone Number / Email Address Telephone Number / Email Address Dale 1202t, Pale (Revised Aug. 2014) CERTIFIED MAIL - RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER MOTIFICATION/WAIVER FORM Name of Property Owner W/,,• ;;'/�,c t�✓/�r °:' f, S Address of Property. 124' Erc%/�✓ J �,�'/Ll- tt (- u' «� (Lot or Street #, Street or Reed, City & County) Agent's Name #: /J�,Et I✓c=� Agent's phone #: `irq Mait' !gAddress: ,4o�r > '� I hereby certify that I own property adjacent to the above referenced property. The individual applying for this permit has described to me as shown on the attached drawing the development they are proposing A description or drawing, with dimensions, must be provided with this letter. I have no objections to this proposal I have objections to this proposal. If you have objections to what is being proposed, you must notify the Division of Coastal Management (DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is available at littp:, uAl"it,.r7ccoastafn:anaaemerlt.r)e✓webicrn/staff-listing orby calling 1-888-4RCOAST. No response is considered the same as no objection if you have been noted by Certified Mail. WAIVER SECTION I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or must be set back a minimum distance of 15' from my area of riparian access unless waive GGIM) you wish to waive the setback, you must initial the appropriate blank below.) I do wish to waive the 15' setback requirement. JUL 2 3 2020 I do not wish to waive the 15' setback requirement. DCM-MHD CITY (Property Owner Information) .S'i,s,Jrrawre Print or Type Name Mailing Address City lStatelZip Telephone Nur b r / Erfrail Adrfr&se— )-0) �u1�• (Riparian Property Owner Information) .tr,.! � •%cam-•�,'i ,S'i�Jrral rrr¢ Print or Type Name 6(si z1AKi,r Mailing Address '�iE/a /Vt Z76bP City/State2ip Telephone Number / Email Address i:>rrr. (Revised Aug. 2014)