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Home My WebLink AboutCrows Nest Yacht Club (3)L`7CAMA / ❑DREDGE &FILL /esr t' ° ` S' GENERAL PERMIT Y144: TR I Previous permit# ttslew ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued 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 I SA NCAC I ' 11t ') ,� C r A I / Q Rules attached. plicant Name t f- , ` s'/r'l tj a.{! tr1 �" Project Location: County Address - �, r'�i .� Street Address/ State Road/ Lot #(s) City . 0 i'fvl t # ;' State ZIP Phone # CI-f t�Fax "" Subdivision uthorized Agent y i uP fir. 1 " f', #J € City ?'�,, i Ik �t `�� } ZIP j }� r ElCW €W �PTA El ES ElPTS� Phone # �?j) N J-) ~' f � r River Basin Affected AEC: ❑ OEA ❑ HHF H ❑ UBA ❑ N/A s AdI '. Wtr. Body�--� i----� �6 _, (not /man /unkn) ORW: es ' Closest Maj. Win Body y f no') PNA, yes It"'D Crit.Hab. yes / no i Type of Project/ Activity, 1.E;'�r r { !r i t i f v t ; ? `.' V. { (Scale: ■■■■■■■■■■■■■■�■■■■�■■■■■■■■■■�■ ■■■■■ ■■ ■Q■i■■■■■■■■■■■■■■■■�QQQQQ�Q®■■■Q■■■■Qe ■■ ■■■■■a■■Q■■■■■ ■■■■Q■■Q■ ■■■■ramp ■■■■■■■■■■ ■■■■Q■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■Q■■■■■■■■■■■■o■■■■ ■■■■■■®■■flt�■■■■■■■■®■■■■■■■■■t�.'■■■■■ ■■■■■■■■■■■■■■■ ■■■■QQQQ■■■■Q ■■�■ ':-I Bulldozing ■■■■■■■■■■■■■■■■■■■ ■■■■■ram, , ■■■■ � A bwldin permit b ( g p may be required uired q y " V (� (� Notes/ Special Conditions Se note on back regarding River Basin rules. Agentbr{(ApRUmnt Printed Name Permit0 `cers ignaturg Sigg ature Please read compliance statement on back of a('j1jit Issuing Date , i Expitation Date ApplicationFee(s) Check# Local PlanningJunsdiction 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, certifythatthis project is consistentwith 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 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 complywith 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/ 1-888-411COAST 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, 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 -below New River Inlet- and Pender Counties) Revised 08/09/06 AGENT AUTHORIZATION FORM FOR PERMIT APPLICATIONS Name of Property Owner Applying for Permit: Mailing address: TP. Telephone Number: 2S2 �ZCo� �oyg I certify that I have authorized M L0YS�C-xd1 �5 (agent/contractor), to act on my behalf, for the purpose of applying and obtaining all CAMA permits necessary for the proposed development of a"4,o y 15-)474q► r- at my property located at qc)--? AL,9-4,*, This certification is valid through (date). (Property Owner Information) Signature RECEIVED APR o 8 2015 Print or Type Na a�� 4WWY"--Z '�niwe Title, co. owner or trustee for property qA 6.1S Date RECEIVED 25Z 2-( gOYS APR 13 2U1� Telephone Number f*"�-M-M"DC ry Email Address ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to _C r o w '(AC u h 's H'� �+ Name of Property Owner) property located at o r\7 �-� ►•- L — L ►1 Cq Ll-S.,C-4.- (Address, Lot, Block, Road, etc.) on (» oaN Lt�tvtt �ti , in Lat-Ak 131z1n -% , N.C. (Waterbody) (City/Town and/or County) The_a applicant has described to. me as shown below, the developmentproposed- - _ _. _ pp at the above p location. V I have no objection to this proposal. 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) h I ti s. <-- L,;C►- H;rE 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.) FCFi�FO S I do wish to waive the 15' setback requirement. . nhra. � 1015 do not wish to waive the 15' setback requirement. "ECEIVED (Property Owner I formation) 4AdJacent Property Owner Information) APR 1 31015 Signature - ern G ' ate Pam► or e Nam g 4 cis Print or Type me ailing Address Mailt ailing City/State/Zi City/State/Zip , u,` 077 Telephone Number. Telephone Number Date Date (Revised 611812012) ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that. I own property adjacent to Cr 0 w'5rl----5 �i 4 (Name of Property Owner) _pLqt '. v�►--4.1•t. .- . -)?, C'6 C� L (address, , Block, Roac6etc.) on ` 1�"1 Ili , in!_Ar. �� [1E�9 G , N.C. (Waterbody) (City/Town and/or County) The applicant has described to me, as shown below, the development proposed at the above loc ion. I have no objection to this proposal. 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) AIVER SECTION I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin m ss e' set back a minimum distance of 15' from my area of riparian access unless waivedby me. (If you wish to waive the setback, you must initial the appropriate blank below.) RECENED G m I do wish to waive the 15' setback requirement. APR 13 2015 I do not wish to waive the,15' setback requirement. IYA P#PHt-fN (Property Owner Information) C,r o ..-S oe P-Tit or Tyle Name ►1'ng Address City/State/Zi "2S2-YZ 40q`6' Telephone Number 1, 7- I 'T-- Date (Adjacent Property Owner Inform on) e/1, Signaturel�`� P int or Type Name `JL1/0 L'JoodVlccJ Mailing Address 2�� a Dc,r � hAvN•C. City tate/Zip C6 `i 22� ai9 Telephone Number 3. zC—. 15 Date (Revised 61I M012) j vti-� C U e in @-. r oni"-e r -(- om