HomeMy WebLinkAboutSmallwood, William H.%�6AIVIA El DREDGE & FILL S A 4 10 66, '07 A B
Previous per it # GENERAL PERMIT Jou P,
ew - EJModification E]Complete Reissue 0 Partial Reissue Date prev1qu permit issued
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As authorized by the State of North Carolina, Department of Environment and Natural Resources
and the Coastal Resources Commission in an areaof nviropmental conqep p t to I SA NCAC ursu ,
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R61es attach
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Applicant Name Project Location: County
Address— Street Address/ State oad/,Lgt #(s)
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Ci 0,� State 1.1V zip
I LIOL
Phone # Subdivision
-Mail
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Authorized e City
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Affected A OES 0 PTS Phone #
AEC(s): 0 OEA IF IIH El UBA 0 N/A Adj. Wtr. Bod
OIRW: yes PINA yes no Closest Maj. Wtr. Body
Type of Project/ Activity x,
Pier (dock) length
Fixed Platform(s)
Floating PIatform(sJ-_--1
Finger pier(s)_"-
Groin length
number
Bulkhead/ Riprap length --
ayg distance offshore, --
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing ,
Other � ;Y
Shoreline Length
SAM not sure 0
Moratorium: n/a yes Q_e 1 11
Photos: y?*'\ 0
Waiver Attached: no — — —
A building permit may be required by:
Note Local Planning Jurisdiction)V
Notes/ Spe�al Conditions
0`
A-
(Scale:
❑ See note on back regarding River Basin, rules.
I
�jeAgent;or—Applicant Printed Name
Permit Office Ps,,P rinte d Name
Si Vease read compliance
e
statement on back of permit
Signature
�a?e_,,
4t 4/
V.
Application I
,Check#
U
ss ing!Date,�,.
Expiration Date
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:
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/ 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.nett
Revised 08/27/ 14
1iiO��il�fs��r1/��'
■■■�llf/�Irii��d/'
AGENT AUTHORIZATION FORM FOR PERMIT APPLICATIONS
Name of Property Owner Applyingfor Permit: 110 A i a M 41, S I"A l l u1 d 4
Mailing address:
z4Z S
Telephone Number: q % C/ - 5-.3 '�— R el(J
1 certify that I have authorized xvkt (agent/contractor),
to act on my behalf, for the purpose of appljVng and obtaining all CAMA permits
necessary for the proposed development of / h em&
at my property located at
This certification is valid through (date).
4f
(Property Owner Information)
Signature
u�;!(►�,� H.:5"141wa50J
Print or Type Name
Title, co. owner or trustee for property
,30 c -he 1,
Date
qly"`r/.:z��ii
Telephone Number
RECEIVED
NOV 0 2 2015
DCM- MHD CITY
@ ot7 b&Ck 6f4r f 5fill vi c e , Cory]
Email Address
RECEIVED
NOV 06 2015
DCM- MHD CITY
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
1 hereby certify that I own property; adjacent to 1A) 1 r✓ta m R .S�,.rti1114 pbj
's
property located at 83 l 4 (Name of Property Owner)
(Address, Lot, Block, Road, etc.)
on lit' a �>'n C rz e ek , in --!I- r^
(Waterbody) , N.C.
(City/Town and/or County)
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
gfn�des iplion below or attach a site drawing)
{—~ A --�
WftAIV,ER C 10 j�1[
I understand thatLthe
ring pilings, at ra rea e , oaiivu c, fi i
must be setbackce of 15' fro my a a f rip ri n access unless waived yEIVED
me. (If you wish tk, you must, . " 1 a opi e blank below.) ., lNOV 2015
t//T do wish to waive the 15' setback re u' t.
o
1 do not ish to waive the 15' setba requirement �C�e CITY
t
(Property Owner Info a ion) T(Adee Pr pe y Owner Information)
Si nature
R°
?D 4dlf, A", 1-14Y���s
runt or Type Name Pnnt or Type Name
�
Mal g Addr� Mailing Address 0-
- Sl1�l ) L f
Crfy/Sta%/Zip y
—9 ! t � +y-/ � City/State/v
Telephone Number/ email address — -� 72
;eJ , s:111�
a
Te ephone Number/email address
Date
Date* '
*Valid for one calendar year after signature* (Revised Aug. 2014)
Lw
. 4
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
` I'hereby certify that I own ro e p p rty adjacent to a �S���lGt1 DDG� is
property located at '8 3 (NaMe of Property Owner)
/ ,'� C�S� (Address, Lot Block Road, etc.)
on a , in 'N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
lo7ti�'o���
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must rill irk disc 1ption below or attach a site drawing)
I understand that
must be set back
me. (If you wish t(
, dock, mooring pilings,
imum distance of 15' frc
the setback, you must
x kz C--I do wish to waive the 15' setback
I do not &sji to waive the 15'
(Properly Owner Inforri�a io )
Signature
`�i.7111 %a �► �60
Print or Type Name
Mailr— ng dress
City/StateQip
Teiephone Number/ email address
/a AZ) /-.-, A/ - i
Date
*Valid for one calendar year after signature*
f
boathouse, lift, r in
;cess unless wa1v
ank below.) .
ry (Adjacent Property Owner Information) V 6 201
re
r i( N e C�
1 C �� Vc®
MailiqqAddr ss � / NO C
C� ate 1p L ®2 2015
late e��
Tele,hNDrmiaddress ss C�LII 'T
Y
Date*
(Revised Aug. 2014)