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CAMA /❑'DREDGE & FILL
GENERAL PERMIT Previous permit# tc
ew ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
i
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 I SA NCAC ( t
Rules attached
Applicant Name. �, } ! i Project Location: County
Address f i ~' i 4 _: J ' r Street Address/ State Road/ Lot #(s)
o t
City State s f. ZIP
Phone # ( ' i ; Jr..y'';E-Mail _ _.�_.�. Subdivision
Authorized Agent - Cityi ZIP
❑ CW 4'"• `CPTA ❑ ES ❑ PTS Phone # O 1 i :'..7 River Basin
Affected ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
AEC(s): Adj. Wtr. Body *•--• 'gnat /man /unknl
❑ PWS.
F,ti Closest Maj. Wtr. Body /
ORW: yes /� PNA eyes,;/ no
Type of Project/ ActiVJq. , `,..:b ; ' i V� _
Pier (dock) length , f
Fixed Platform(s)
Floating Platform(s)'
Finger pier (s) '"""
Groin length
Bulkhead/ Riprap length —'
avg distance offshore �" �"`
max distance offshore
Basin, channel
cubic yards `
Boat ramp
Boathouse/ Boatlift
Beach, Bulldozing
�,.. 1
Other ! ` fit; �.,,.•,,,`��.7.
T�
Shoreline Length
SAV: not sure
yes
(, not
Moratorium: n/a
yes
Photos:
yes
/rno
Waiver Attached:
yes
f
A building permit may be
( Note Local Planning Jur
,Notes/ Special Conditions
by:
c , .-,2
Scale:
'�, (�. }❑ See note on back regarding River Basin rules.
r }
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, 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:
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 comply with 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
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I hereby certify that. I own property adjacent to
(Name of
(Address, ot, Block, Road
on ogse gfgrsk
(Waterbody) ®'
perty O er)
and/or County)
y�?5=na�h
N.C.
The applicant has described to me, as shown below, the development proposed at the above
locatio
I 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)
r
RECEIVED
4MAR o5 1015
A�.y
WAIVER SECTION
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.) RECEIVED
I do wish to waive the 15' setback requirement. MAR 1.3 2015
DCM-MHD CITY
a. wisb-to waive the 15' setback requirement.
(Property Owner Information) (Adjacent Prop Owner Information)
Print or
Telephone Number
Date
or Type
City/state/Zip I
Telephone Number
Date
(Revised 611812012)
I hereby certify that. I own property adjacent to 4E r
_;braerty lc�caficl._at.f' ar
(Ad ess, Lot,
on jg� at 04rom , in A/t
(Waterbody)
(Name of Property Owner)
own and/or County)
N.C.
The applicant has described to me, as shown below, the development proposed at the above
location
have nb 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)
t
u)tik A Xo1 s L*7'- -0,w-A
WAIVER SECTION
W
Lim
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.41f y*
wish to waive the setback, you must initial the appropriate blank below.) 0 Vp 04-
_ I do wish to waive the 15' setback requirement. o ado
0
1 do not wish to waive the 15' setback requirement.
(Property Owner Information) (Adjacent Property Owner Information)
00
Sin re c
t Asti Vic �`r�d �: , �,�, All
Print or T pe Name Print or Type Name
Mai mg Address IF r� Maa n %ress
F A S ��,cV �� l���o RECEIVED
City/State ip City/State2ip ?ptc�
� 1� � %a�' O'er �� MAR � .
Telephone Number Telephone Number
gzkc
Date Date
(Revised 611812012)
•
Pat McCrory
Governor
KTA
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Braxton C. Davis
Director
Date —�— Aee / 5_
Applicant Name
Mailing Address
70
John E. Skvarla, III
Secretary
I certify that I have authorized (agent) to act on my behalf, for the
purpose of applying for and obtaining all CAMA Permits necessary to install or construct (activity)
at (location)
This certification is valid thru (date)
Signature
REMVED
400 Commerce Ave., Morehead City, NC 28557 NOI'e1CaT01llla
Phone: 252-808-28081 FAX: 252-247-3330 Internet: www.nccoastalmanagement.net yr /
An Equal Opportunity l Affirmative Action Employer Aa al`'y