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Home My WebLink AboutOsborne, William ClintW, �DREDGE & FILL 669H7 GENERAL PERMIT Previous permit # A B D EINew ElModification ElComplete 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 15A NCAC ffrules attached. Applicant Name Project Location: County - Address 6 Street Address/ State Road/ Lot #(s) City State zip Phone # E-Mail, Authorized Agent Affected El CW 0,EW ETPTA EIES 0 PTS AEC(s): El OEA 0 HHF 011H 0 UBA El NIA 0 PWS: ORW: yes 1;,no) PNA yes,//'n'� Type of Project/ Activity Pier (dock) len-h Fixed Platforr Floating Platfc Finger pier(s)_ Groin length number Bulkhead/ Rip avg dist2 max disi Basin, channe cubic ya Boat ramp — Boathouse/ B Beach Bulldo; Other Shoreline Len SAV: n4 Moratorium: Photos: Waiver Attad A building permit may be required by: Note Local Planning jurisdiction) Notes/ Special Conditions Agent or Applicant Printed Name Signature Please read cop6pliance statement on backof permit** Application Fee(s) Check# Subdivision City ZIP Phone# River Basin 4 Adj. Wtr. Body (natr/man-Junkn Closest Maj. Wtr. Body — (Scale: 141 -7.f- El See note on back regarding.River Basin rules. r .a 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, certify that this project is consistent with the North Carolina Coastal Management Program. River Basin Rules Applicable To Your Project: 0 Tar - Pamlico River Basin Buffer Rules El Other: El 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/ 1-888-411COAST 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 ShorelineLength ■■■■■■■■■■��■■■■■■■■■■ ■■■■■■■��■■■■�t�■■ SAV. not sure yes . ■■■■■■■■■■II■■■■■ ■■■■■■■■ /I■■■■■■■■■■ ■■■■■■■■■■ �■■■■■■■�■■■■■■■■■■■■■ ,l ■.®11Ovotoso vas 111.1 c Rawamll Signature Please read co fiance statement on back of per it Signature Apphcatioo,Fee(s) ;. Check# I�suingDat@. El piratio Date N.C. DIVISION OF COASTAL MANAGEMENT AGENT AUTHORIZATION FORM —17 1 to Date ti- Name of Property Owner Applying for Permit: Mailing Address: /40 U14k, J9 pr t Ll;�y I certifythat I have authorized (agent) V (g ) / 9/ ` 6��to act on my behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to install or construct (activity) I IUIInn� '[� L,I'AIL"jV J , at (my property located at) ! V� ��$'%��Y-D RECEIVED /� } JAN 2 7 2016 This certification is valid thru (date) l 0^ 01 (Q DC M- M H D CITY IL Property Owner Signature Date ' RECEIVED G J J • JAN 2 7 2016 `�� - DCM- MHD CITY ADJACENT RIPARIAN PROPERTY OWNER STATEMENT hereby certify that. I own property adjacent to �&—R) 117 1 to .r�. _ _ _ (Narme.of Property Owner) (Address, Lot, Dlotk, Road, ) on AIR&9 POZECW6 (Waterb (dy) (City/Town and/or Cou I 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 AND/OR DRAWING OF PROPOSED DEVELOPMENT (Individual proposing development must fill in description below or attach a site drawing) `1 to vL -priDID) Tvlo cal- TU00 CP o �,(% Gl1Ot-�/L C. r0 G t /� T'p ,G�iJ rJ J4 10 �C � �l0?�} T �l�liC� !�7 ►9 �,�. WAIVER SECTION /fJ1�i1t�(eLL �Ci%i/2 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 waiv 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. (Propetty Ow er Information) (Adjacent Property Owner Information) W =� Sig�gture � �� Signature Print Ty Name Print or Type ame i 0'— 5 �J3 01- M r 'ng Address Mailing AddressRECEIVED: S C' /ate �p City/StatelZip ,jAt 21- 2016 rnMn� Tele hone. Number ��U' �-/C� -2ot i" ®CM- MHD CIT Date Date �-- -) ®CM- MH® CI (Revised 611812012) • I hereby certify that. I own property adjacent to L.Jr5,Gw I e4,.4.Q_AD,-r1 is ,.� ,::- ... ; ..:.....: �i�(3_Qi'iy,iGi..�t�G .�t:„�,k,� � ,.,,.�� (yt .►'M"; �,CJ ` (N4me . of Property� Owner) (Address, t, Block, Road, e on ►R AJ in (Waterbody (City/To and/or County) The applicant has described to me, as shown below, the development proposed at the above locati n 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) CJ�G�! v4G+-G d bf-?X�t�IIA�(� �. Tit= New lvewc-, cvJ o r- WC. W 0 " L_YO 2-11 C � $44� i� le l� �- -f; '`1Or�`"T"1J�C� �= 1 understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set(Sea_ back a minimum distance of 15' from my area of riparian access unless waived by me. (If your wish to waive the setback, you must initial the appropriate blank below.) I do wish to waive the 15' setback requirement. RECEIVED I do not wish to waive the 15' setback requirement. JAN 2 7 2016 (Property Owner Information) (Adjacent Property Ow rr"t) CITY W tig Lam]. ature /� Signature r I. A -AA C_.. 2 0-1 PrjnntoxTyp� ame Print or Type Name a in Address Mailin Addre e2i�% �� 6 CityWe pZ g�_ ,`- ff_ !/ r D T ephone Number � � Telephone -bye �_> b JAN 2 7 2016' Z5 Date (Q Date �O DDM- MHD C I `� (Revised 611812012)