HomeMy WebLinkAboutGranger, DougType of Project/ Activity
'loll
(Scale:
—Pier dock I
Fixed Platform(s)
Floating Platform(s)
Finger pier(s), e0f,
Groin,length
number
MENC�■■■■�■■■■■■.■■■■■■■■■■■■■■■■�■■■■■■
N
mom
NONE
1110
S
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 ❑ 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 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 howto complywith these buffer rules.
Division of Coastal Management Offices
Morehead City Headquarters
Washington District
400 Commerce Ave
943 Washington Square Mall
Morehead City, NC 28557
Washington, NC 27889
252-808-2808/ 1-888ARCOAST
252-946-6481
Fax: 252-247-3330
Fax: 252-948-0478
(Serves: Carteret, Craven, Onslow -
(Serves: Beaufort, Bertie, Hertford, Hyde,
North of New River Inlet- and Pamlico
Tyrrell and Washington Counties)
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)
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
C/S1MA / w DREDGE & FILL
d
GENERAL PERMIT
h
A B C - D
Previous permit#
New -❑Modification ❑Complete Reissue ❑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
A ' Iicant Name s `'
pp - 3a
El Rules attached 3
Project Location: County - +
Address;° a� r.
Street Address/ State Road/ Lot #(s).�,�/f,�5';T
City'j l A i , � A� � �� State] ZIP 3 ��
:�
O E Mail
Subdivision _.
t K
Authorized Agent e 1 R { ; !4Ys
g � � .�`" � ��, �; �
) }gam p
�h: im , $
City ZIP
Affected CW ''tfEW ' p PTA n,p ES PTS
Phone # ( ) River asin ' ' '',)
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
AEC(s):' .
Adj. Wtr. Body (natF/ma /u kn)
❑ PWS:
r 1 y e
=`
ORW yes no' PNA yes !go
t
Closest Maj. Wtr. Body �
e of Project/ Activity
XV
Pier (dock) length.
-Fixed Platform s
mom
ON
MOEN
No
0
No
M
M
NONE
M
01
max distance offsho re
Basin, channel
cubic yards
11MMIM1100111
NEE
No
M
Beach Bulldozing
ON
EMMMENUMENEEMEME
1
NNEENNEMEMMEM
EMMEMENEMEM
ME MENEM
mom
r�
PermitOfficer's Printed Name
r
Signature
Issuing Date
`Y
Expiration Date
Name of Property Owner Requesting Permit: 111\0156
Mailin:g Address: VAZA
Phone Number: CAL Q-7"
Email Address,
I certify that I have authorized C,
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all LAMA permits
necessary for the following proposed development:
at my property located at NC �ZT'5!Z_
inCAe-4e-e'__1 —County.
I furthermore certify that / 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:
__��Ggnature
LMOS�A R. Gee4aa&
Print or Type Name
L\N��'j-=
Title
Date
This certification is valid through Co IL-a—L-201_7
01/02/2017 14:21 2527261562
BERT'S SURF SHOP PAGE 01
►l
ARAMUMBE&OW EBQEZW QWM STAVEMff
I hereby c omy ! own pMperty+ adjmwt to O u 5 I xi 14, G auv2ge- ` 's
pr($peft located at `-? .�6 fo 1 # (Mom* of Prop" owner)
: 44 -T �2r4c-5 . N.C.
. - (fir) (Cayrrown anditr Camty)
The appont bw desamed io me, as shown betocnt, the oevWopmeRt p oposed at #w abase
lo�tt/
✓✓ I have, no obn to this provosai.
I nam opjeoons to v* pmpcs^
OAR ANmit mAYvlme OF PROPCOM DEVELOPMMT
(kpWml*mFpjWpomft dbvWWprrMW mttztt ON Art dBMW*Ow WSW drat a MO drOwkW
�id'T'it�`6�r�i �S • v
UiAM
i cam that a pier. dock cnoo*V per. bW FM94 &Oakwatw, boa . Ok or gmu►
must be at heir a mirienue3 didarsce of tv tram my area of dparim accom unless warred by
ere. (it yov wish to waive ft seftm*c you must inMA the approp&ft t bebw.)
t tto wish to waive the 15, 300"* titl
i alo not wish to waWo the IV sstb'aek rayukenw t.
@Rra m*,,owner Wo=w dwo (Add Prey Ownw fin)
arrypenrame
�q
i(ct,.a�� 3�aci►
releph W& NcunWhomai odwltesa
17- )2 - !fa
VaQd for am cowriftr vow after abrmk "
.10=0 ss ,
Sur' iAe.5 ��'�[�.vfivha, �• cc) v�
Dm*
is u )3x' uss5 K 1
Z,� Z4# 15N
(Rovbed AUA 204)
I hereby car* that l own property adjacent to 0 U 1165
,
property located at 1 S`-7 L-« 6 jo 11,,
{Name of Property Owner)
(,Address, `Lo . ock, Road, etc.)
(Waterbo�dy) N.C.
(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.
t nave objections to the proposal.
DESCRIPTION AND/OR DRAVWNG OF PROPOSED DEVELOPMENT
(1h& dual proposing developrtient tftt Win des�p#iort>befow or attach. a sine draw ty#r
s�zI*'� P i14c'.-
WAIVERSECTION
i understand that.a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift or roin
must be set bads a min. 1murn distance of 16 from my area of riparian9
me_ (it you wish to waive the setback, access unless waived by
you must iniitiaf the appropriate blank: below.
I do wish to waive the 15' setback requirement:
I do not wish to waive the 15' setback requirement
Owner tnformaiianj (Adjacent Property Owner information)
0e 1 r/
Print o r TType Name zp �n L
t 4 'Z'- 'F) - � � tl Print r Type,name
Add Afar%' Add
7.1
12 �k�er `dig",' �„1G�fc)lflG,
CitylSCata2ip Gr7ylState ziip
Telephone fUMberl e ati add mm
l2� 1&
iJats
I elepWne Numberl ernad address
*Valid 1br one calendar vow after stanaWW (Revbed Auy. 2014)