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Home My WebLink AboutMidgette, Timothy & Cynthia/ ❑ DREDGE & FILL I�-' Q�jCAMA GENERAL PERMIT'` 1 Previous permit# tNew DModification ❑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 15A NCAC ' } ( Applicant Name t ' t ` _t i t i i ❑ Rules attached Project Location: County �, -'� Address �!; �. t ` ` `! �` ' Street Address/ State Road/ Lot #(s) l City e t_ State I Phone #( E -Mail', Subdivision i Authorized Agent City ' ! {` ZIP ElCw ~'gEw 'Q I❑ ES ❑ PTS Phone # (L 7�`t \'' j� (-River Basin PTA Affected f ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A AEC(s): a 11 Adj. Wtr. Body' ' (nat/man /unkn) - ❑ PWS. ORW yes / PNA / i •Closest Maj. Wtr. Body no yes iso' Type of Project/ Activity (Scaler n Pier (dock) length, r✓ ' Fixed Platform(s) i •L� Floating Platform(s) — - Finger ier s I — 1.._. --L—� Groin length '---" I 1, f� I number--""' I ( I 1 � Bulkhead/ Riprap length avg distance offshore---' max distance offshore•--- Basin, channel , cubic yards. ., . j Boat ramp Boathouse/ Boatlift Beach Bulldozing""""' ( { j►' I OtherLI . 4 i{ :f i j W Shoreline Length E d EJV'E U ALRID SAV: not sure yes no Moratorium: n/a yes no Photos: yes no., Waiver Attached: As i \, no P { t "`-t 1 t ` .� A building permit b� e ied g p y 9 b y tr ( t t .) \ Q See note on back re1garding River Basin rules.l ( Note Local Planning Jurisdiction , 'l `y { (jt 1;V� Notes/ Special Conditions i \ (�� L ,� 'l� �� is` �'rV �1 �i ;;,', j ��1 ((j l'`'�1 r'i;'j.t�'a.'�l`1 .. - ,. V .. Agent or Applicant Printed Name Permit Officer's Printed Name Signature "Please read compliance statement on back of pe SignatureJ Application Fee(s) Check# Issuingbate Expirltion Date W 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, certifythat this 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 how to 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/ I -888-4RCOAST 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 Citv 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.nccoastafmanagement.net/ Revised 08/27/14 )I- AGENT AUTHORIZATION FORM FOR PERMIT APPLICATIONS _ c Name of Property Owner Applying for Permit: 11,A104 Mailing address: zort� Telephone Number: (Ag ' 5ff6 7 J,, I certify that I have authorized / le 14� 1-a 4-> ) (a ent/contractor , g to act on my behalf, for the purpose of applying and obtaining all LAMA permits necessary for the proposed development of bCLI �Zej at my property located at This certification is valid through /0 31 —15; (date). (Property Owner Information) Signature E � � �. maz� A/,t-.-`tom/? t 7) Pri�Type Name OWA er Title, co. owneror trustee for property '7112. Z Q / t5- Dat Telephone Number 1 66 4e P-' , Email Address RECEIVED AUG 19 1015 N��,¢-cst�+b1 Fig ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to lmc il-1)NTH t'A s (Name of Property Owner) property located at 1 G 5 C�fc PotVT i Lu 3 fi rAr7 C ;ArC / Ff245"/ ��""� t (Address, Lot, Block, Road, etc.). on &rt001 60 USe Ci1'Q2�1� , in 0/1 Pf CA A`7 AE' % �tAr'IE245 T �'�' �, N.C. (Waterbody) (City/Town and/or County) The ap licant has described to me, as shown below, the development proposed at the above locaV I have no objection to this proposal. I have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (Individual propps1na deyehu nRnt rncsf till In description belowjaLattach-"ite-drawing) __._.:.,......__ _..._.._.......... __.... I 415 WILL g C K 1 is 1fYi% -t�tG t L rrI I(1 t i l� int u �.. WAIVER SECTION I understand that a pier, dock, mooring pilings, boat ramp, 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. r mature( Ptrnt or Type Name /06- Mailing 4 Mailing Address City/State&ip Telephone Number/ email address - 71a,gb 1i-5' Date (Adjacent Property Owner Information) { ' t Signature * 10' - Jae l I/ m ., /� . 1" '1"Z , Print orTName 308' ITFR/ %?Q! Mailing Address .51 . r�,Srve .. NC CiVStati0p �2- 393 - ell (4 Telephone Number/email address Da/3oI ' /S RECEIVED AUG 19 1015 (Revised Aug. 2014) *Valid for one calendar year after signature' ADJACENT RIPARIAN PROPERTY OWNERSTA,T'EpMENT p I hereby certify that I own property adjacent to � 'i /}rIA s (Nain6 of roperty Owe R property located at (%`J t dress, Lot lock, Road,on �&CUS= Jn. (rbo y) (CityfTown and/ County) sw he development The applicant has described to me, as shown below, proposed at the above t p location. ✓' 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 at#ach a site drawing) WAIVER SECTION I understand that a pier, dock, mooring pilings, boat ramp, 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.) '^' ?LPf'f.—Ido wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. ''Valid for one calendar year after signature* (Adj.�a-cee,n .Prp Owner Information) (S', tore* , 1 Print or Tyie Name t RECENED Cityl$tate2=i r ! 9101 cab � pUG1 Telephone Numbeqq/ em7l address Y Date* (Revised Aug. 2014) AGENT AUTHORIZATION FORM FOR PERMIT APPLICATIONS Name of Property Owner Applying for Permit: �� ('L,&/ 1 tom -j r7� Mailing address: �'✓(jiS 'yrtr" Telephone Number: (h I certify that I have authorized I,&, j'�'�' l� � (agent/contractor), to act on my behalf, for the purpose of applying and obtaining all CAMA permits necessary for the proposed development of dw� bzisA at my property located at This certification is valid through 10.-31.45; (date). (Property Owner Information) Signature j Priift or Type Name 0WA of Title, co. owner or trustee for property Dat I 0 " !f�o q12- & Telephone Number ; Email Address ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to i l mo il-IJ t (`) NTH IA M 1b(- C- 7_C E ,s Name of Prope Owner) property located at 105 CAPE j�01ti 1 L f C' rr ('rtie F%4'i (Address, Lot, Block, Road, etc.) . on & i001 k0 t)Se CrZeJ<. , in 0,4100 f rp7r,0E j ((Aj2Trii?T % N.C. (Waterbody) (City/Town and/or County) The applicant has described to me, as shown below, the development proposed at the above Iocati I have no objection to this proposal. I have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (Individual prop Wria devetenment must fill in descriAtion ke1Qw or attach.as11e..drawing) j -7 K t t• i 1 `' BS GLt,SCP- i f WAIVER SECTION I understand that a pier, dock, mooring pilings, boat ramp, 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. t/ I do not wish to waive the 15' setback requirement. (erty vwnerlpfo Ion)(Adjacent Property Owner Information) e 3� azure I Signature* /N • t I/� TfE ��f �� . i'C Jill Il/,I rrr6ae . Print or Type Name Print or Typ Name 106, our --e :vs f .�n�. 11cu/ ?� City/State/Zip .,�. Telephone Number/ email address Date 'Valid for one calendar year after signature' c.rryr�zarerup - RECEIVED �- 393 - 8'/!(,e Tn3o hone Number/email address AUG 19 2015 IS Dafes {;YOB AWI,) kl"' (Revised Aug. 2014) ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to --Tt ffy.4q 4 k1i, s L (NaVn6 otProperty Ow 'd property located at .''7,(Address, Lot lock, Road, tc.) fuy'aierb�o�dy� ��y,4�..-- (CltylTown and/diCounty) s The applicant has described to me, as shown below, the development proposed at the above location. I have no objection to this proposal. I have objections to this proposal. DESCRIPTION AMOR 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, boat ramp, 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.) 61-1`do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Adjacen ,Prep" Owner Information) .4 Print or Tye Name < RECEIVED Cit tatea. � AUG 19 1015 i5-->'-A� 17, Telephone Numbe !em 'l address 0 0 A4.4H'J -'r" Date* (Revised Aug. 2044) *Valid for one calendar year after signature*