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Home My WebLink AboutBurnette, BrantleyACAMA IDREDGE &FILL A B fC , D PERMIT Previous permit# �ENERAL New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued As authorized by the State of North Carolina, Department of Environment and Natural Resources t J 1 and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC p Rules attached. Applicant Name + F': t i + Project Location: County t r' ' ��1' Street AddressState Road/ Lot # s Address � t 7 �� / ( ) � 99 , City +State l ZIP� Subdivision•Phone#� -a � Authorized Agent1, �, , �..�, 1 -� 4. =_C s 1 . City ` i >>f T� ;? ZIP --� ❑ Cw El ElPTA S ❑ PTS Phone # (! ��'�) ^ } ` /, Z River -Basin --T V Affected • i ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A AEC(s): Adj. Wtr. Body (hat ' /man /unkn) ❑ PWS: Closest Maj. Wtr. Body ) V �. _.. ORW: yes /(no PNA yes / no t a Type of Project/ Activity (Scale: Pier (dock) length`----•----' Fixed Platform(s) -- Floating Platform(s) Finger pier(s) � Groin length _. number --- "' iBulkhead/ Riprap length t V avg distance offshore , max distance offshore Basin, channel cubic yards Boat ramp Boathouse/ Boatlift Beach Bulldozing r ti 7 Other ( l i r Shoreline Length SAV: not sure yes f no - Moratorium: n/a yes ;no' 1 I Photos: yes �no Waiver Attached: yes no A building permit may be required by: 'i'"i^� 1 l ' ��t j�.-� ❑ See note on back regarding River Basin rules. ( Note Local Planning Jurisdiction Notes/Special Conditions i �.. �� l_+. ;'1� ; { `/ f ., -Tr, -k ent or Applicant PrintedNamePermit Officers Printed Name / /J r Q6];atture' ** Please re d plianceStatementon back of permit * Signature Application Fee(s) Check# , Issuing Date Expiration Date 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, certifythat this project is consistent with the North Carolina Coastal Management Program. River Basin Rules Applicable To Your Project: ❑ Tar- Pamlico River Basin Buffer Rules ❑ Neuse River Basin Buffer Rules ❑ Other: 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 Resources. Contact the Division of Water Resources 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 Morehead City Headquarters 400 Commerce Ave Morehead City, NC 28557 252-808-2808/ I-888-4RCOAST Fax: 252-247-3330 (Serves: Carteret, Craven, Onslow - North of 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, Bertie, 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 - South of New River Inlet - and Pender Counties) http://www.nccoastaimanagement.net/ Revised 08/27/ 14 [Mili sq-jv]�,50*n rom, tmn urdl�-pzac--K Appilcarit: �3� Date: HABITAT isturbances for the. application. . ion. All values should matt the name, and I u I nits of measure . ment Describe below the H d m found in your Habitat code sheet.. Habitat Name • DISTURB TYPE Choose One TOTAL Sq. Ft. (Applied for. Disiurb;�hce-total 'Includes any anticipated restoration or temp impacts) FINAL Sq. Ft. (Anticipated,final disturbance. Excludes any restoration and/or temp impact amount) TOTAL Feet (Applied for. Disturbance total includesExcludes any anticipated restoration or ternp impa FINAL Feet (Anticipated final disturbance. any restoration and/or temp impact amount) Dredge 0- Fill x Both D Other ❑ Dredge El. Fill'D Both D Other ❑ Dredge ❑ Fill [I Both El Other D Dredge ❑ Fill [I Both D Other ❑ Dredge E] Fill'[] Both El Other ❑ Dredge D Fill [I Both- D Other D Dredge El Fill 0 Both El Other [I Dredge ❑ Fill [I' Both El Other 11 Dredge D Fill 0 Both El Other Dredge ❑ Fill ❑ Both D Other El Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both [I Other El . Dredge [I Fill El Both 0 Other ❑ Dredge Fill D Both El Other 0 Dredge Fill ❑ Both ❑ Other rr a n daa-%e vevized- N.C. DIVISION OF COASTAL MANAGEMENT AGENT AUTHORIZATION FORM Date 1` A a- 15 Name of Property Owner Applying for Permit: Iu rN e--17f 7 Mailing Address: -P o "B O)C 13 5 9 Roy- b o r co 1�1 C oA -7 5 13 I I certify that I have authorized (agent) k c W% A 5 L A %W e N c -e— to act on my behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to install or construct (activity) 5e-�1 la c e bit, I h e� 01 n at (my property located at) l o g P4 1 P o* k C'BeC, r �i C `•a �.-hes 12 This certification is valid thru (date) RECENED JAN 27 2015 p ,M;.MHD CITY RECEIVED APR 2 9 1015 prom: rla P!rf ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to l�s��v7'�/� 2� Is (Name of Property Owner) property located at _1O 9 �i,es � Sf"' .� (Address, Lot, Block Ro etc.) Z on e �riw� in C �� re , N.C. (Waterbody) (City/Town qddlor County) The applicant has described to me, as shown below, the development proposed at the above locati 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) WAIVER SECTION I understand that a pier, dock, mooring pilings, 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.) 0&_ 1 do wish to waive the 15' setback requirement. RECEIVED 1 do not wish to waive the 15' setback requirement. n APR 2 9 1015 { 1 ---- _.._�_. Fy�s.►�thnnc� �Inr (Property Owner Information) (Adjacent Property Owner Information) N or Mailing 4ddress 911YAPor0 N e a7.5 ? 3 City/StatelZip Rl �)0- Telephone Number / -S0-aolS— Date 190 Si are Y Pnot or Ty eQme /0 7 -. Mailin Add ess ity/Stateop a5-0 - 72 (a dd 3 Telephone Number . Date (Revised 6/18/2012) RECEIVED JAN 2 71015 bbwtWPH t-ny CERTIFIED MAIL • RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM Name of Property Owner: 51�Atl1-34ei'A-) e-77- Address of Property: Zd 9 %,es f � d-A�i� N 11 c ��a cdt"' tare4A&a95 ! 2- (Lot or Street #, Stree(or Road, City & County) Agent's Name #:�co,,,5 L(4,,,orr%N e- e Mailing Address: J,2I 6 SSla N-1,eoi Agent's phone #: e2 5 A - ZA S"- 0132 1411)? klWs 7Z'�4 Aa. AJ C- 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 yareprposing. A description or drawing, with dimensions. must be provided with this lettehave no objections to this proposal. I have objections to this proposal. If youhave objections to what Is being proposed, you mustnotify the Division of CoastalManagement (DCM) In writing within 10 days of receipt of this notice. Contact Information for DCM offices Is available at htta:/Avww.nccoastalmonaaement.net/web/cmistaff-listing orby calling 1-888-4RCOAST. No resnonse Is considered the same as no oblection if you have been notified by Certified Mail. kh C CLo r WAIVERSECTION 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.) 1 do wish to waive the 15' setback requirement. RECEIVED do not wish to waive the 15' setback requirement. APR 2 9 201, (y#�MS��I5N1-7C1(c� (Property Owner Informa (Riparian Property Owner Information) i Signature Print or Type Natne Print or Type Name 0 Roil /3 6-9 3700 V),01 ou.Ae Mailing Address Mailing Address RECEIVED l�oX�oro, NC 73 City/State&ip -7(p 05 City&tat p JAN 272015 1?19-,10-a `i1j R-70-8`1-1'7 Tolophono Number/Email Address Tolephone Number/Email Address J1,AO //S- Il)�lls Date Date (Revised Aug. 2014)