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Home My WebLink AboutConstandia House, LLC n 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 I) 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 ❑ 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 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 LAMA /DREDGE & FILL GENERAL PERMIT ��' : v A B cJ o Previous permit # ew ° ❑Modification ❑.Complete Reissue El Partial Reissue Date previcus'permit issued I,,ar zed by the State of North. Carolida, Department of Environment and I.uraII Resoumes..--. _,. __ Ir Coastal. -I Resources, Commission in an area of enVironmental concern pursuant to SA NCAC , M ules attache. ` ant Name�_ tt - Project Location: County t, ,• ' Street Address/ State Road/ Lot #(s) StateZlP °✓ -—ail Subdivision'17 rized Agentr`� �;, .e City ZIP, ❑ CW l-EW -PTA ES XPTS Phone # (_) , River Basin yd ❑ OEA ❑,HHF ❑ IH ❑ UBA ❑ N/AEl ). yt Adj. Wtr. Body r !:2 9 , nat n, unkn PWS: no PNA yes �'` n�sr Closest Maj. Wtr. Body — �i -ti of Project/ Activity ..: Oh,: . ; k i f ?,'> 0101 W_-Wmmm ■■■=■■■ ::::::■:::::::::■:::::::::::■:::::::::: = ■:■■■■■■■■■i■■:■■■■■■■:■■■■■■■:iNMI 1101 clistance offshore �distance offshore ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■17A�1��7�i:"!1■li9A®■■■■■::■■■:: ■■■ ■ ■ ■ ■■:■: ■■■■■■:■:::: cubic Y.ards ■■■■:■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ::■:■::■■■..II ■.■. ■ ■■■■■■■■■■■■■■■a■■■■®■■��ru■■■■■■:■■■■■■ ■�iii��1■■■ .�iiZ ■■■ � i 3�il■�� ■■■■■■■�I�1MIN ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■®■■■®:■■®■ ■■■■■■■■■■■�■■■■■■■■■■■■■■■■ia'AH■■AW■ ■■■■■■■■■■■■■■■■■■■N■■NN■■■■■■■■■■■■■■■n i■■■■■■■■■■■■■■■■■■■■■■■■■■■■■em s ■■■ W5 :::::■::::■::::::::::::: : r■mom ■■:®:: ■■■■■■■■■■■■■■■■ 45, 1:1 See note on back regarding River Basin rules. NJIM Jill III ®. •.... AGENT AUTHORIZATION FORM FOR PERMIT APPLICATIONS Name of Property Owner Applying for Permit: o �0"V I Ci''L�-r Mailing address: '; 7-P W 1 O-4 SI DIY a Y li I Inz Telephone Number: �u(u- 543 .,5� q2 I certify that I have authorized E�d -PTt (agent/contractor), to act on my behalf, for the purpose of applying and obtaining all CAMA permits necessary for the proposed development of J v1 at my property located at �D Lc TN- —Pine- 1 VZ o l l S)/\ my. tiC, 6p,IS S 1 a This certification is valid through 1) Q (- e. w.1 c.r (date). (Property Owner Information) io, �0 u$C Signature —Pa-v i o`4of y�Print or Type _Name 1 1 V V�9 V� �,�', ) vt S� Ati cl 0 uS I--, �- - C, Title, coowner or trustee for property Se i e w•. to C"r C) Date Telephone Number C�eI v '� Email Address RECEIVED JAN 0 9 ?C Dcm- f '. ADJACENT RIPARIAN PROPERTY OWNER STATEMENT ica I hereby certify that I own property adjacent to U�jN'v�a„��os� �o�ScLL-Q- 's (Name of Property�O�ner) property located at � 9 -B� o x- B In,? /'�.a . (Address, Lot, Block, Road, etc.) on o a U `e Sdv n' in �Pi fke- ("11 'S" P-t-_ , N.C. (Waterbody) (City/Town and/or County) s The applicant has described to me, as shown below, the development proposed at the above location. t✓ 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 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 Information) (Adjacent Property Owner Information) X1—P'-1 4-:/-6 11(' 9 pop'- Lu-- Signature 1 1 v S cl L-LQ. Print or Type Nam I A W ( y-1 5k.. 14 A Mailing Address City/S�t r te2 p Telephone Number �'- \00 - �� 0 i �p Dat �l Signatu �7p4arj c _ 6, l Print or Type Na�17e Mailiw-4ddress City/State2ip jAl0 9 2017 iJ C 2. Q, Telelo � � , Number ®� �� w s ._^y s a � m Date. //_ 2-/-- %G ice (Name of Prope '�ner) `property located at - �, r1 U 0 �C 1 n,d�t►� 1�l — (Address, Lot, Block, Road, etc.) on 10 a U NIL Ov rtc� , in -- fm N.C. (Waterbody) (City/Town and/or County) i t`. Th plicant has described to me, as shown below, the development proposed at the above c I have no objection to this proposal. have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (individual proposing development must rill 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 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.) 11riD I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Property Owner Information) Mailina,Mdress City/S afe Zip w Telephone Number n tEcEivr- JAN492017 r3