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Home My WebLink About61121_CONATSER, BERNIS_20121024C CAMA / Ej DREDGE & FILL GENERAL PERMIT D,New ❑Modification ']Complete Reissue ❑Partial Reissue As authorized by the State of North Carolina, Department of Environment and Natural Resources and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC N o . 61121 Previous permit # Date previous permit issued i] Rules attached. Applicant Name r �, n e%.R JrYe r J�o rv: << r Project Location: County t_ Address i :'�," Ail • n fa . S P ^. "(1 Street Address/ State Road/ Lot #(s) City ` lc,;+ Roe State /1J ZIP 4 6? Z Phone # (1a) 10 )- (,Sq(, Fax # (_) Subdivision - ;.:; i (J4. k Authorized Agent .+00r'in�r,^,<:.;vfnr City- ,+ r ZIP, a CW 51 EW E PTA T ES ❑ PTS Phone # ( ` ) 'SSL1 " ? River Basin Affected 1 OEA AEC(s): ❑ HHF C IH ❑ UBA ❑ N/A i' Adj. Wtr. Body (nat /man /unkn) ORW: yes / no PNA yes / no Crit.Hab. yes / no Closest Maj. Wtr. Body Type of Project/ Activity Pier (dock) length Platform(s) x f d Finger pier(s) Groin length number Bulkhead/ Riprap length avg distance offshore max distance offshore Basin, channel cubic yards Boat ramp - `` / s Boathouse/:Boatlli Beach Bulldozing Other 1o3 t Shoreline Length SAV: not sure yes .'no Sandbags: not sure yes no Moratorium: n/a yes no Photos: yes no _I Waiver Attached: yes no A building permit may be required by: Notes/ Special Conditions ,gent or Applicant Printed Name -� L k —i— Signature Please read compliance statement on back of permit" Application Fee(s) Check # (Scale: J �- ;. C ) 44- ---i - 7 See note on back regarding River Basin rules. Permit Officer's Signature Issuing Date Ex iration E5ate Local Planning Jurisdiction Rover File Name Statement of Compliance and Consistency This permit is subject to compliance with this application, site drawing and attached general and specific conditions. Any violation of these terms may subject the permittee to a fine or criminal or civil action; and may cause the permit to become null and void. This permit must be on the project site and accessible to the permit officer when the project is inspected for compliance. The applicant certifies by signing this permit that 1) prior to undertaking any activities authorized by this permit, the applicant will confer with appropriate local authorities to confirm that this project is consistent with the local land use plan and all local ordinances, and 2) a written statement or certified mail return receipt has been obtained from the adjacent riparian landowner(s) . The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available information and belief, certify that this project is consistent with the North Carolina Coastal Management Program. River Basin Rules Applicable To Your Project: ' Tar - Pamlico River Basin Buffer Rules ❑Other: ❑ Neuse River Basin Buffer Rules If indicated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules for the River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the NC Division of Water Quality. Contact the Division of Water Quality at the Washington Regional Office (252-946-6481) or the Wilmington Regional Office (910-796-7215) for more information on how to comply with these buffer rules. Division of Coastal Management Offices Raleigh Office Mailing Address: 1638 Mail Service Center Raleigh, NC 27699-1638 Location: 2728 Capital Blvd. Raleigh, NC 27604 919-733-2293 Fax:919-733-1495 Morehead City Headquarters 400 Commerce Ave Morehead City, NC 28557 252-808-2808/ 1-888-4RCOAST Fax: 252-247-3330 (Serves: Carteret, Craven, Onslow -above New River Inlet- and Pamlico Counties) Elizabeth City District 1367 U.S. 17 South Elizabeth City, NC 27909 252-264-3901 Fax:252-264-3723 (Serves: Camden, Chowan, Currituck, Dare, Gates, Pasquotank and Perquimans Counties) Washington District 943 Washington Square Mall Washington, NC 27889 252-946-6481 Fax: 252-948-0478 (Serves: Beaufort, Berrie, Hertford, Hyde, Tyrrell and Washington Counties) Wilmington District 127 Cardinal Drive Ext. Wilmington, NC 28405-3845 910-796-7215 Fax: 910-395-3964 (Serves: Brunswick, New Hanover, Onslow -below New River Inlet- and Pender Counties) , outlie w glass a zd Sndowzwe& 1127 G'eda-Youze 6' 4od 26-9-,354-t9S4 Cw(hm° rat; G2d'ja'4 6227 66-30/531 � / ✓ „L�/ „341 DATE PAY TO THE / i- OR�D—ER OFF l _ � � rtLARS First Citizens Bank FOR , ) ii'00 6 2 2 711' 1:0 5 3 100 3001:00 34 12 3 L L8 5 III N.C. DIVISION OF COASTAL MANAGEMENT AGENT AUTHORIZATION FORM Date ! D / tz-- Name of Property Owner Applying for Permit: CNis ooro s-r""- Mailing Address: I l 2- � (,J/ rt- ni 6)V, C A-Yl- 101- tjL )- �Yq-2- I certify that I have authorized (agent) �� h� "� `� rl-'6 (1-u4-- to act on my behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to install or construct (activity) Rt -t, 11L at (my property located at) q,l d q L-00(-a C -'r— tvL - This certification is valid thru (date) Property Owner Signature Date RECEIVED OCT 22 201Z Uct lb 12 09 09a Joseph Lutheran 252-354.1953 p,2 ADJACENT RIPARIAN PROPgRTY OWNER STATEMENT I hereby certify that I own property adjacent to Re-r-nllS s t� (Name of Property Owner) property located at 1 lkno'A \,OC- �.erK�.�_(' c 12-1- (Addra". Lot,JBlock, Road, etc.) on _ t c��ua� �Y1 , In EyAc iA T t- le, aterbody) (City own and/or County) N.C. The applicant has described to me, as shown below, the development proposed at the above location -._ I have no objection to this proposal. I have objections to this proposal_ DESCRIPTION ANDIOR DRAWING OF PROPOSED DEVELOPMENT jlndividua/ proposing development must fill In desc riptlon below or attach a site drawing) —Doc N Pe r r-\ +k2 RECEIVED OCT 2 2 Z01Z DCMI I M CITY WAIVER ECTION I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin 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. I do not wish to waive the 15' setback requirement. (Property Owner Inforrnatlon) (Adjacent Property Owner Informatlon) Signature Stg lure Print or Ty pe l�erne Pfint or Alamo 9ht- LC-d t-�_.�_ac r �- l dlT k- Mailing Address MeAg Adds J. �12"� q clty/Stetwzlp city ate�r � ka8- knit OJ4lt: _1 4 pAa5 Telephone Number Telapt7ons Number Date Daie (Revised 6/1&2012) Z0 O19vd NIA-10A 608EVSEZSZ 9b:LI b00Z/6Z/60 ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to l e-C (A ; 5 - to rl U+n" P, 's (Name of Property Owner) property located at C .-� (Address, Lot, Block, Road, etc.) on �)o�zC�E'. C�>i 10 in Emzra\d isle, N.C. (Waterbody) (City/Town and/or County) The applicant has described to me, as shown below, the development proposed at the above location. I have no objection to this proposal. I have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (individual proposing development must fill in description below or attach a site drawing) RECEIVER OCT 22 2012 DCvI-WiD CITY WAIVER SECTION I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin 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.) L/ I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Property Owner Information) Signature (� Kr n,, S l _ Print or Type Name 9,'loti I otrk irK Mailing Address Fsnerc 1c . , 1\5z Nc- �S�f City/State/Zip x J�- '70rl -0 S4(, Telephone Number le Ae//'` Date (Adjacent Property Owner Information) Signature Print or Type Name G Mailing Address r,,71�,C',x�� City/State/Zip Telephone Number Date (Revised 611812012) RECP,TVBD OCT 2 2 NIZ ' ncM-� cxrY' 1 IW Zota&etee(6v C-r- 9