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Home My WebLink AboutPlozizka, CherylAMA El DREDGiE & FILL IV N5 101 3- 3 A 11 D 9GENERAL PERMIT V, Previous67 perm0it # 1AFew ElModification El Complete 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 n areaof environmental concern pursuant to I SA NCAC CE-Rules attached. -o- Applicant Name Project Location: County Address— J1 13 Qx Street Address/ State Road/ Lot #(s) City State_*e ZIP -o,� Phone # rm�lMaj< Subdivision W Authorized Agent City— ZIP 0 CW ZVW .# PTA El ES 0 PTS Phone # River Basin Affected El OEA El HHF El lH 0 UBA El N/A ?j—&4-1, /man /unkn) 0 Pws: AEC(s): Adj. Wtr. Body ORW: yes /no PNA yes /(no) Closest Maj. Wtr. Body Type of Project/ Activity 6JO Ir i- -4 100 1 f /-,p 10 !!Gale'A / Floating Platform(s) 71 Finger pier(s) It, Groin length number Bulkheadft�' ngth _j ,k avg distance offshore max d' tan ff h Basin, channel Elm EMEMEMEMEMI L111HIMMINIMMMEMMMINEEM 0 EMEMEMEMEM WREEL 'COME M I MIN cubic yards Boat ramp Boathouse/ Boatlift M M Beach Bulldozing Other MEMI MIMME Shoreline Length SAM not sure yes Moratorium: n /a yes Photos: yes In Waiver Attached: yes ME UN mmmmmmm-mmommluummmmmEEMENESEEMENEEN MEN A building permit may be required by: C r, ❑ See note on back regardi g River Basin ules. Note Local Planning jurisdiction-) Notes/Special Conditions f-" Agent or Applicant Printed Name Permii0ffic4rsArinted Name Signatq& ** Please read compliance statement on back of permit Signature Application.Fee(s) Check# h;s4injDate 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 consistent with the North Carolina Coastal Management Program. River Basin Rules Applicable To Your Project: Tar - Pamlico River Basin Buffer Rules ❑ 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/ 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/ ❑ DRED.GIE& FrIL ®' f, IN? 67503 FNERAL PERMIT , Previous permit#:: A B D w ❑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 in ar of environmental concern pursuant to I SA NCAC 1 6i 8 �n Rules attached. Applicant Name i� / t . , � 4 Project Location: County Address +E�.+ C3'to} Street Address/ State Road/ Lot(s) City Per C t° .+S State ZIPS ` !V s,{ c Phone # " 10 E-M • Subdivision Authorized Agent 4P/I �' City rr c f5 ,, o° 'w` ZIP ❑ CW A ES PTS River Basin AA Affected t' -"'wE'M1r ■ ■ Phone # (_) ❑ OEA ❑ HHF ❑ IH ❑ USA ❑ N/A AEC(s): Adj. Wtr. Body ."•� na man unkn ORW: yes / no PNA yes / no Closest Mai. Wtr. Body - Type of Project/ Activity + , oPl�»,pf �• t�- w-,1 t i :-' �" r F4A 4r - (Scale• Pier (dock) length .' Fixed Platfo.0) 4411•0 Floating. Platforms) # Finger pier(s) / Groin length number Bulkhead 'pray ngth . avg distance offshore max distapce offshore TV Basin, channel Cubic yards Boat ramp Boathouse/ Boatlift Beach Bulldozing Other .. . - - - i'�"'��_1III�II1�gII1��IIA��'�'.1if1►i�d��?xf;�l�sl ApplicatiorxFee(s) Check# lssuin L`Jte ? Ex ,"tion ate ,, v 0 LO CV LO N vie ca fl- 0 - `v3 o I o • f ff0 �xistt►cS c �_ � � � I I �+2 Pee.lk 3 e PRoro�� o�k �ewkr��( l�X �2r �xl��✓5 ��.k �1r1 jr-r' 41JV5el4 �reits `. !ee x 4� �xr5tid �5 Doak n, r m m "d m m -�o4 -Lo4,D -'A-,-� �o RECEIVED JUL 17 2015 10 7'koz,ZkA 5 gLe- P 4 ' D�t� w r.vs s •73 y ��,✓�c� Pr&w k:5 Q, Plozizka dock and boat lift Note: Not drawn to scale. Current Additional proposed 100' length 180 feet length --� ---------- — 88 12 100 6 feet wide walkway 4 foot walkway - centered on 6ft 12 ft x 12 ft deck walkway 12 foot by 6 foot deck Fish clean table • • • • Boat lift inserted Boat lift removed Pilings for lift 180foot 2 inches Water depth at 11:30 AM, 5-28-15 (1 hour before low tide) 3 3/4 inches 19 3/4 inches ..a . oOFFICIA —00 Postage $ t� p Certified Fee 3 30 14 rti o(Endorsement Post e4u 1pt re 0(• 7 RY 2 9" 5 C3 Restricted Delivery Fee (Endorsement Required) O 0 Total Postage & Fees $ e Y m m ent o '� p street, dpe N. - 2 7 / 8 SA r-&, PO Box N-- -- OW,, state, ZIP+4 Char /a/v4- Nc- 2 �Zi! PS Form :,, Postal CERTIFIED MAIL,,� RECEIPT m(Domestic p -111 In For delivery information visit our website at www.usps.com , . in p I f s t7 Postage $ AF O tS �j Certified Fee Q- fU p p f Postmark Return Receipt Fee p (Endorsement Required) p p Restrcted Delivery Fee (Endorsement Required) / Rl Total Postage &Fees � Co. p m RECEIVED m Sent To ,6esY - V- S®,7 o `` -- - - - - jam- ._........... orPOBoxNo. see, t;O; - - -//� �Yv JUL 21 20b ^. ------ bC��cj �7 �` "Z /`j -- . ._ OV if zrP+a 3 �f' Plozizka dock and boat lift Note: Not drawn to scale. Current Additional proposed 100' length — 180 feet length —� 88 12 100 4 foot walkway - centered on 6ft 6 feet wide walkway 12 ft x 12 ft deck walkway 12 foot by 6 foot deck Fish clean table • • • • Boat lift inserted Boat lift removed • Pilings for lift 180 foot 2 inches Water depth at 11:30 AM, 5-28-15 (1 hour before low tide) L C 3 3/4 inches 19 3/4 inches y Plozizka dock and boat lift Note: Not drawn to scale. Current 180 feet length Additional proposed 100' length 88 12 100 6 feet wide walkway 4 foot walkway - centered on 6ft 12 ft x 12 ft deck walkway 12 foot by 6 foot deck Fish clean table I• • • • Boat lift inserted Boat lift removed Pilings for lift 180foot 2 inches Water depth at 11:30 AM, 5-28-15 (1 hour before low tide) 3 3/4 inches 19 3/4 inches • Complete items 1, 2,and 3. Also complete item 4 if Restricted Delivery Is desired. • Print your name and address on the reverse so that we can return the card to you. 11 Attach this card to the back of the mallplece, or on the front if space permits. 1. Article Addressed to: kOA V,- e e. '71 2- -7 1-11 i LJJarlo,4 AIC A. 1 Date of De 16, 3i> , D. Is delivery address different from Rem 1? 13Yes If YES, enter delivery address below,:--- io 40�7- e; xj 3. r�S�ce Type pe *Certified Mail [3 Express Mail C eg: 0 Registered E3 Return Receipt for Merchandige I 0 insured mail El O.O.D. Re : A Restricted Delivery? (Extra IF e) 4 a xtra FL 13 yes 2. Article Number . ............ . -- ............ . ... .. . . . ......... (transfer fmm service kbeq 71113 3020 oa02 0670 0610 .......... PS Form 3811, February 2004 Dom -tic Return Reompt 102595-02-M-1540 • Complete items 1, 2, and 3. Also complete item 4 if Restricted Delivery is desired. • Print your name and address on the reverse so that we can return the card to you. • Att#` r r ' " his card to the back of the mailpiece, ofe front if space permits. ' 1. Articl4i-Akfdressed to: Q'7,53q'- A. Sig nature X 0 Agent El Addresses B.,Pacelved by (Printed Name) Q. Date of Delivery rem different from item I? UYes If 48, lelivery address below- 0 No 3, Sepke Type Lf Certified Mail 13 Express Mail 13 Registered 0 Return Receipt for Merchandise 0 insured Mail 13 O.O.D. 4. Restricted Delivery? (Extra Fee) 13 yes 2. Article Number Mansferfromserylbelabeo ____7013 3020 0002 0.670 11603 PS Form 3811, FebruM 2004 Domestic Return Receipt 102595-02-V RECEIVED JUL 21 20b KyU-IIIANQ " CERTIFIED MAIL . RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM Name of Property Owner. Address of Property: 1.16 QS'r L.ti r$-1 ,P— rs (Lot or Street #, Str6et or Road, City & County) Agent's Name #: Gls 4 Agent's phone #: /N A Mailing Address: f1i r+ ?Ue 22g53 ( hereby certify that I own property adjacent to the above referenced property. The individual I have no objections to this proposal. I have objections to this proposal. If you have objections to what is being proposed, you must notify the Division of Coastal Management (DCM) in wrfNng within 10 days of receipt of this notice. Contact Mtbnnation for DCM offices Is available at www.nccoastaimanaaementnet/contact dcm.htm or by calling 1-888.4RCOAST No response is considered the same as no objection if you have been notified by C�erftfied Mail. 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 Inf tion) Signs Print or Type Name D. 63x 55 Mailing Address G rkers IC?nNC City/State/Zip is :3 7, y- 6 Yo 7? Telephone Number `P/Z3 /Z j Date i LD 01, ( ce t Pro er In anion) S' e Print or Name Mailing Address G(X)S%Q tjC `2.753y C#y)State/Zip Teleptpne Number RECEIVED 7,} j JUL 21 2015 � a Revised 6/18/2012 CERTIFIED MAIL • RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONMAIVER FORM Name of Property Owner: c9fflAQ LkS d- J • *- L �Y1C�1" u f b , j-'(` ,D_'z , 'Z K Cam_ Address of Property: I_ I_ b 0 C, rde- , qq rI� r-s 5 [a n�l� A] C. 29,",3( (Lot or Street #, Stneet or Road, City & County) Agent's Name#:3er\4-) e-U" rr�� _ Mailing Address: 50'7 ✓� e-,,r Agent's phone #: 250 - -2- 1- '7 0 9 Z. � otr k", -T:'s (CL r� cto C. Z Fg5 3 I rna� t db�ooKs eC• rr. Cara I hereby certify that I own property adjacent to the above referenced property. The individual applying for this permit has described to me as shown on the attached drawing_the development they areroposing. A dtdptktrt or °wit: Est tie iarovided with this . V I have o b' t a n objections o this proposal. I have objections to this proposal. /f you have objections to what is beingpropos" you must noftMe Division of Coastal Management (DC&Q in writing within 10 days of receipt of this notice. Contact information for DCM offices is available at www.nccoestalmanapement net/contact dcm hfra or by calling 1.888.4RCOAST. No response is conskbred the same as no objection if you have been no6fred by Certified Mail. 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 it Wal the appropriate blank below.) I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. Properly Owner Information } Si: f'1(� -Lk s+ 1 (b2tzkg, Print 6Y Type Name P. b. & � S Mailing Address 1 ( 1 + c c r k4,r.S ys \ Ql ld ,. Ci)oWa1e0p Z �� -76q-logo, 4 -77b Telephone Number to%�-312t►.s (Adjacent Property Owner Prin t or Type Name Mailing Address Criy&YatW27p r? 04 Rns 9rd4 Telephone Number RECEIVED i JUL 21 2015 Date f W40,14P. C,u" Revised &1a2012 RECEIVED JUL 16 2015 5 Reasons Why You Are Not Training Hard Enough 7/14/15 1:50 PM http://swimswam.com/5-reasons-why-you-are-not-training-hard-enough/ Page 6 of 6 Davenport, Ryan From: Cheryl Plozizka <cpzizka@gmail.com> Sent: Tuesday, June 23, 2015 10:17 AM To: Davenport, Ryan Cc: dbrooks62@ec.rr.com Subject: Agent appointment - Plozizka, 118 Westbay Circle, Harkers Island Hi Ryan, You mentioned that we could appoint Bentley Brooks as our agent for the permits that we need for our dock extension and seawall maintenance. We hereby authorize Bentley to act as our agent in these matters. If you have a form that we need to complete, would you please send me a copy? We will fill it out, sign it and return it to you. Thank you, Cheryl and John Plozizka 704-640-4776 RECENED JUL 21 1015