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Home My WebLink AboutMartynowski, ThomasZAMA `�ODREDGE & FILL a GENERAL ENERAL PERMIT Previous permit # �,New ElModification DComplete Reissue OPartial 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 15 A NCAC Y_- Applicant Name MPUles attached. - Project Location: County7- -h ddress .,7 Street Address/ State Road/ Lot #(s) C, State Ity r 14_ Zip Phone # Fax # C_ Subdivision Authorized Agent i t Vfiq City Zip Affected F-1 CW EW _EJ PTA ES 0 PTS .4, Phone# River B I D IDEA El HHF 011H El UBA E3 WA AEC(s): Adj. Wtr. Body—;';- rL, (nat man, un n) 0 PWS: 0 FC: "-% ORW: yes 4 no PNA yes Crit.Hab. yes' Closest Maj. Wtr. Body—L" t 1. i Q_7��9 Type of Project/ Activity 1,; -t P(Scale: Pier Platf Fing Groff < B r6 'Ik' Bash Boat Boat Beac Oth Shor SAV-1 Sand MJr Pho rm(s)Giui� Eia�■ii� r pier(s) ioiiii�i length pimber �'11 'K iead� Riprap length L" loom avg distance offshor6 max distance offshore MOMME No M MEMNIMMEM MEN ONE moll ,channel cubic yards —MENEM EMEMOMEM M H MEMEMEMIN MEMOMMEME ramn iouse/ Boatlift -1 Bulldozing�I�CC::�C' ::a:��000C�I NONE kline Length MEN MEN NONE ONE mommmom MEEME NOON not sure yes ni I OEMi■�■■ MEMEN MEMEMEMOMMEMEME lags: not sure yes Inol, i000■o■ torium: n/a yes nol,MMMM—M s: yes no:MMMM11MMMMMMMMM MEN MEMEMEME MEMEMMIMMEMEMENE Lr Attached: yes /M es 0 00 A building permit may be required by: Notes/ Special Conditions J-A See note on back regarding River Basin rules. V ',Agent or Applicant Printed Na me, PermitOfficer's Signat_&6 Signature "Please read compliance statement on back of permit i*, Issuin , g Date If I , Application Fee(s) Check # Local Planninjjuriscliction Expiration Date 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 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 R 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 howto 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/ 1-888-4RCOAST 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, 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 N.C. DIVISION OF COASTAL MANAGEMENT AGENT AUTHORIZATION FORM Date ) • 2 ) 4 Name of Property Owner Applying for Permit: —Tho-mas F PlnQlYno Ski Mailing Address: rL PAS IV, C. 2--6S 12- gECEIVBA J AN 21 Z014 DCM 1VII1D CITY I certify that I have authorized (agent) M Up A -c ?,ct^l ��5 , N� to act on my behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to install or construct (activity) '5tz✓1 moo- I , at (my property located at) aq tom/ ti t �,— This certification is valid thru (date) x Property Owner Signature Date i ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to IhorK oS f 7714 eA y Ndws Z 's (Name of Prop rty Owner) property located at I CP4 L1614c AS 1 eo cle2T (Address, L4P Block, Road, etc.) on �9 ►--Jg L , in le, 28 I Z , N.C. (Waterbody) (City/Town and/or County) The applicant has described to me, as shown below, the development proposed at the above location. 4 1 have no objection to this proposal. RECEIWD I have objections to this proposal. JAN 2 1 2014 DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (Individual proposing development must rill in description below or attach a site drft&CUY C pjv5-i-�,G�f—' �/'e=�.,/' ��p �g � ( � �.r-�rs�I'' cs-� ��i li�►�s wall 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 I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Property Owner Information) (Adjacent Property O per Information) g - � / Signature Signature h�{�-- To' r Type Name '^ Print or Vy Name' k (OVA l� tom✓ ��i�4.Lo� U Mailin Address MailingPddrepsF1Y5 tip. 2�� 1Z 4-Yc- City/State/Zip City/State/Zip 2432 222 O/Z) Telephone Number Telephone Number - iq 11 2.- ICI Date Date (Revised 6/18/2012) ADJACENT RIPARIAN PROPERTY OWNER STATEMENT hereby certify that I own property adjacent to s m 40 (Gr 's (Name of Property Owner) property located at (Address, Lo Block, Road, etc.) on C �� L , in k-� , N.C. (Waterbody) (City/Town and/or County) The applicant has described to me, as shown below, the development proposed at the above locilon. I have no objection to this proposal. RECEIVED I have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT JAIN 2 1 2014 (Individual proposing development must fill in description below or attach a site drawing) DCM MHD 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.) I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Property Owner Information) (Adja9fint PropertypwAr Information) ature 1 o ,S or lb so , w o i.-s ki Print or Type Name ^^ t oy k/ (n IJ-C F< %7 M Address City/State/Zip 2 2Z2 C��21 Telephone Number 2 . `4 Date (Revised 611a,2012)