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Home My WebLink AboutHicks, Scott 77177 110 Arborvitae Dr.®LAMA / ❑ DREDGE & FILL " v N9 77177 A B D GENERAL PERMIT Previous permit# INNew ❑Modification ❑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 0 �,.��,., C � Rules attached. Applicant Name S CD.J Project Location: County 6tJt`tit Address I o n 6,z V f I I ole_ J -1ye, Street Address/ State Road/ Lot #(s) S5 State ZIP AR9 Phone # ) - r E-Mail Authorized Agentl'(�'� Affected ❑ CW 1<CW _kOTA ❑ ES ❑ PTS AEC(s): ❑ OEA ElHHF ❑ IH ❑ UBA ❑ N/A ❑ PWS: ORW: yes(/no PNA yes _noy Type of Project/ Activity Pier (dock) length Fixed Platform(s) x Floating Platform(s) ,%Z U Finger pier(s) Groin length -� number Bulkhead/ Riprap length avg distance offshore / max distance offshore / Basin, channel s I — cubic yards Boat ramp Boathous Boatlift r Beach Bulldozing Other EJ(JL Shoreline Length II I SAV: not sure yes Moratorium: n/a yes n Photos: yes n — ................. Waiver Attached: yes no -- A building permit may be required by: ( Note Local Planning jurisdiction) Notes/ Special Conditions TInOtA6 or Applicant Printed Name V Signature "Please read compliance statement on back of permit" Application Fee(s) Check# Subdivision City ZIP Phone # O River Basin Adj. Wtr. Body_ J_'JN, Closest Maj. Wtr. Body (Scale: N// ) ❑ See note on back regarding River Basin rules. 9 �10A C, A l7e, A A Permit Officer's Prin "ame / e, Signa ture 3 Issuig Date I Expiry ion Date AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: SGc-FTi 111GdCS. Mailing Address: %/o A,MXylogs -plgl c" 'V//'4" k/VOLL 5110 ees Phone Number: 119 - 610 _ q716 Email Address: SC�l��. �►i=<,�s �' w/n%fie fg,"��NpP�s Gpv�, I certify that I have authorized Alyp)-Ze- p e'-&Y Agent / Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: 44 i X 3p" �G1�ni "��c% N�3 �` lZ / i��✓/!�/i41� %l��D00 %h ;voT" G/ at my property located at //V 4)C"o V j;/,f -;21*k -S(jo , in CAR -Ciedr County. 1 furthermore certify that l 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,: Sig re Print or Type Name D"^UZ—t-- Title f / P / /fl Date This certification is valid through f / '�—' , / i--p OV, CERTIFIED MAIL • RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM Name of Property Owner: 560% % A// clle- Address of Property: llb IM&Wi 06e 7/Z/V- �/�% lk G - (Lot or Street #, Street or Road, City & County) Agent's Name #: Allppwoe A16 Agent's phone #: 2 `6b15 •- 937 Mailing Address: -�Y/; oz.,p ? 1 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 tlescr ption br dravving with dimensions' mustbe provided with this letter. h P i7l have no objections to this proposal. I 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 http .//www nccoastaimanagement. netlweblcmistaff-listin p or by calling 1-888-4RCOAST. No response is considered the same as no objection if you have been notified by Certirred Mail. 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 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. /o I do not wish to waive the 15' setback requirement. (Prop e .y Owner Info nation) (Ri a Pr ner Information) wy, Signature 1 Si e Print or Type Name Print or Type Name Mailing Address City/State2ip '51/� - Telephone Number/Email Address Do - Date Mailing Address ,tea C -y&e City/State/Zip one WmberlEmail Address ,;Z0 (Revised Aug. 2014) CERTIFIED MAIL • RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONMAIVER FORM Name of Property Owner: 454.o% % Y/ eX_1� Address of Property: //& /�1��i�y/% );;I'K11-'1- �� o�� %/✓ �� (Lot or Street #, Street or Road, City & County) Agent's Name #: /41y Pxez 6v Agent's phone #: `05Z -(,K5 "/3:& Mailing Address: !�y13 04P )4T Alez, 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 the are roposing. A description or drawing with dimersions,`.must be provided with this letter. '� t•�'�' I have no objections to this proposal. I have objections to this proposal. a�i c 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 h_ttp.11www.nccoastaimanapement.net/web/cm/staff-listinct or by calling 1-888-4RCOAST. No response is considered the same as no objection if you have been notified by Certified Mail. 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 waived by me. (If you w1ahAawaive the setback, you must initial the appropriate blank below.) V05V I--1%PL' r,,612c;(,J I dwish to waive the 15' setback requirement. 011%�s 6 i Or OL14,V J'-1vrdgVe/J I do not wish to waive the 15' setback requirement. (Prope y Owner Info ation) (Riparian Property Owner Information) r r �. Signature Sig -nature Print or Type Name Print or Type Name Mailing Address CitylSState/Zip y 1'/� , 6 / o — / 7q Telephone Number/Email Address t p /0 $ A)z8'oRW 1-rxE -�PX/�� Mailing Address City/State/Zip J- �L- a7 / �e(� 0 Telephone Number/Email Address �f71i7/a0 Date Date ( 1 (Revised Aug. 2014)