Osprey Oaks Marina

ti
:_�CAMA / '—_ DREDGE & FILL A B C D
GENERAL PERMIT Previous permit #
New LIModification ❑Complete Reissue El Partial Reissue Date previous permit issued
c. ,a
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 ❑ Rules attached.
Applicant Name
Address
City State _ ZIP
Phone # ( )
E-Mail
Authorized Agent~
❑ CWW
A
Affected
,.
❑ OEA
❑ HHF IH
AEC(s):
❑ PWS:
nRW vPz / nn
PNA ves / no
Type of Project/ Activity
Pier (dock) length `- • - "�'
Fixed Platform(s)�—_
Floating Platfq (S,) ^�
Finger piers) ' _ ` l
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards -- "
Boat ramp ` _
Beach Bulldozing
Other
❑ ES ❑ PTS
❑ UBA ❑ N/A
Project Location: County _
Street Address/ State Road/,Lot #(s)
=t_
Subdivision
CityZIP-- 1
Phone # ( ` , River Basin
r j i
Adj. Wtr. Body �' L� � s / � , 4 nat /man /unkn) j
Closest Maj. Wtr. Body --�
Shoreline Length a 1
i
SAV: not sure yes no
I
Moratorium: n/a yes 114111
Photos: yes no�7
i
Waiver Attached: yes no
A building permit may be required by:
( Note Local Planning jurisdiction)
Notes/ Special Conditions
Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit **
Application Fee(s) Check #
(Scale: I :. __?l )
❑ See note on back regarding River Basin rules.
Permit Officer's Printed Name
Signature
Issuing 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:
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 comply with 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: [phone]
(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:[phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
http://www.nccoastaimanagement.net/
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax: [phone]
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-796-7215
Fax: [phone]
(Serves: Brunswick, New Hanover,
Onslow - South of New River Inlet -
and Pender Counties)
Revised 08/27/ 14

9., 2/5/18
252 247 3330
To: NC DEQ, Morehead City Office
Attn: Heather Styron
From - David Livingston, NCDOT Newport Office
Subject: Osprey Oaks Marina
Attached should be the applicable executed Riparlan property owner
statement.
TOO# ZGT'OH
v0:60 8TOZ/90/E0

DIVISION OF. COASTAL. MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONMIAIVER FORM
Name of Property Owner:.
Address of Property:
or streettreet#Street or Road, ok & County)
Agent. s Name #:
Agent! s phone 1#-. -�ID ag1
C4
Mailing Address:(i
4-
t 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. are proposing.
I have no objecdons to this proposal. I have objections .to this proposal.
if you have objections to what is being proposed, you must nonthe Division of coastal Management
(DCM) In wrltfng within 10 dap of receipt of this notice. Correspondence should bo mailed to 400
Commerce Ave., Morohoad City, NC, 28557. DCM rapr®sentatives can also be contacted at (252) BOB -
objection if you rlotifte CertlfledNlail:
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set
back a minimum distance of IS' from my area of riparian access unless waived by me. (If you
wish to waive the setback, you must Initial the appropriate blank below.)
do wish to waive the 15: setback requirement.
-I do not wish to waive the 1 6' setback requirement.
(Property Owner Informatio
Signature
Print or type Name
Mailing Address
�Jyy j r �70
Citylstaip
o�y
el ®phone Number
r.�
Owner Information)
Print or Type Name
/ IL
sili Address l'
��c �'L
C,tyistat p
Telephone Number
Z /U
Revised 6/10012
Z00tt N T*OH VO:60 8TOZ/90/E0

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to ' g
(Name of Property owner)
property located at
(Address, lot, Block, R d, )
on ; in.c?lr.n.T N.O.
(Water ody) (CitylTown 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.
have objections to.this proposal,
•DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must flll In descriptio !low or attach a site drawing)
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.
/f I do not wish to waive the 15' setback requireme
(Propert,�n► Owner'I%nf�omiati )
Date
(r-t ty Owner Information)
S/
Print or Type Name
• Mai in?Addrs —
citynfQ01Zip
Date
(Revised V180012)
COOS ZW ON S0 60 8T0Z/S0/C0

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