HomeMy WebLinkAboutWilloughby, R. L.-i CAMA / -- DREDGE & FILL A B C D
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GENERAL PERMIT t Previous permit#
'';New CModification El 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 an area of environmental concern pursuant to 15A NCAC
❑ Rules attached.
Applicant Name Project Location: County
Street Address/ State Road/ Lot #(s)
Address
City
State ZIP
Phone # ( )
E-Mail
Authorized Agent
❑ CW
❑ EW PTA ❑ ES ❑ PTS
Affected
ElOEA
❑ HHF ❑ IH ❑ UBA ❑ N/A
AEC(s):
❑ PWS:
ORW: yes / no
PNA yes / no
Type of Project/ Activity
Pier (dock) length_ II ;(;
Fixed Platform(s) f x
Floating Platform(s)
Finger pier(s) _
Groin length
number
Bulkhead/ Riprap length_ �. _..
avg distance offshore
max distance offshore
Basin, channel - -
cubic yards
oil
Boat ramp .■■■1IMF
Boathouse/ Boatlift
Beach Bulldozing
Other■■■_■■�►s��
�-
e~
Shoreline Length
SAV: not sure yeso
Moratorium: n/a yes
no
Photos: yes
�b
Waiver Attached: yes
no '
f' l
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 **
Subdivision I
City— ZIP
Phone # O River Basin
Adj. Wtr. Body nat /man. /unkn)
Closest Maj. Wtr. Body
SLUM
jf
(Scale: µ- )
❑ See note on back regarding River Basin rules.
Permit Officer's Printed Name
Signature $
Application Fee(s) Check # 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
Neuse River Basin Buffer Rules
Other:
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 (252-946-648 I) 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/ 1-888ARCOAST
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)
http://www.nccoastalmanagement.net/
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)
Revised 08/27/14
CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION[WAIVER FORM
Name of Property Owner:
Address of Property: A - t14�
(Lot or Street4, Street or Rdad, City & ounty)
Agent's Name #: 1,4Q Mailing Address:
Agent's phone #: cSsaE? SzL> - g a 7 �o ���o �✓ - G� d �SS�
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 are proposing. A description or drawing with dimensions must be provided with this letter.
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 writing within 10 days of receipt of this notice. Contact information for DCM offices is
available at http://www nccoastaimana-gement.netlweb/cm/staff-listing or by calling 1-888-4RCOAST.
No response is considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift 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 Information)
Si� -
Print or Type Name
/-?/ o//, i
Mailing Address
City/stiE fe/Zip
9/4-- 9 �/- oo
,ed",`
Telephone Num r/Email Address
Date
(Riparian Property Owner Information)
sign re /�/
u k KJ � 47�soh
�i%UI r Laa e
Print or Type Name
%o/ D/c' /(:�,�ht-� .-
Mailing Address
Citylstawzip
Telephone Number/Email Address
F--
i
Date
(Revised Aug. 2014) �,��
RL Willoughby
Observation Platform
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Note: % thru bolts
used at 4x10 girders.
5/8 thru bolts used at
hogslats and 6x6s
Drawing for:
Drawing By: Cliff Harris
RL Willoughby
Harber Contracting Inc
P.O. Box 4562
Emerald Isle NC 28594
252-342-9987
Postal
CERTIFIED o RECEIPT
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❑ Return Receipt Qiardcopy)
O ❑ Return Receipt (electronic) $ Postmark
❑ Certified Mail Restricted Dslivery $ Here
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Q ❑Adult signature Required $ �t�-YV'r• �r��
❑ Adult Signature Restricted Delivery S•��---
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Total Postage and Fees}3/1 5r'241$
$ $6.91
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CERTIFIED MAILP RECEIPT
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Domestic Mail Only
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For delivery information, visit our L
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Certified Mail Fee
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$ $3.45
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Extra Services & Fees (check box, add feel%--iw
[:1 Return Receipt (hardeopy)ry�
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❑ Return Receipt (electronic)
—$0.00
Postmark
ED
❑Gedifted Mail Restricted Delivery $
Here
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Adult Signature Required $
E] Adult Signature Restricted Delivery $ u -10
-Po—stage
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$ $0.71
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03/15/2018
Postage and Fe —es
$ $6.91
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Sent To
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Street anWApt. No., or POoxNo.
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RECEIVED
APR 0 6 2018
DCM® MHD CITY
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