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Tucker, David
OCA,MADREDGE & FILL " - ` No 70425 A g C D �NERAL PERMIT Previous permit # ❑New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued As authorized by the State of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC Q Rules attached. Applicant Name ° �1` i # !`' - Project Location: County f City Phone # ( _) Authorized Agent Affected ❑ CW❑ oEA AEC(s): ❑ PWS:_ ORW: yes / no i State ZIP r u EW ❑ PTA ❑ ES ❑ PTS ❑ HHF ❑ IH ❑ UBA ❑ N/A PNA yes / no ) Type of Project/ Activity Pier (dock) length ,_ Fixed Platform(s) Floating Platform(s) 47._ Finger pier(s) .. Groin length number .+ Bulkhead/ Riprap length avg distance offshore max distance offshore r Basin, channel cubic yards Boat ramp Boathouse/ Boatlift_=_ Beach Bulldozing Other 1 3 r Shoreline Length_ SAV: not sure yes 11 i Moratorium: n/a yes no Photos: yes no JL Waiver Attached: yes . no A building permit may be required by: ( Note Local Planning Jurisdiction) Notes/ Special Conditions �) l Agent or Applicant Printed Name ! Signature* Please read compliance statement on back of permit* I i b )v Application Fee(s) Check # Street Address/ State Road/ Lot #(s) ; ,' :# t Subdivision City ':i ZIPf r.t Phone # ( ) River Basi'- Adj. Wtr. BodyJ& man, unkn Closest Maj. Wtr. Body "`. .h d (Scale:1 ) ❑ See note on back regarding River Basin rules. I I ku. ✓ . r 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: 252-247-3330 (Serves: Carteret, Craven, Onslow - North of New River Inlet- and Pamlico Counties) Elizabeth City District 401 S. Griffin St. Ste. 300 Elizabeth City, NC 27909 252-264-3901 Fax: 252-264-3723 (Serves: Camden, Chowan, Currituck, Dare, Gates, Pasquotank and Perquimans Counties) http://portal.ncdenr.org/web/cm/dcm-home 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 7/06/ 17 V AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: �� t'G Mailing Address: Phone Number: Email Address: �O (v Cy o,-esf C?'-. pks,' NC- z e5-17- Zsz-sz8-3 117 f I certify that I have authorized f ly — C-he'01 Agent / Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: 06C k f°"'` at my property located at in County. sf 67`- tq)(-S , JJL 2 9 SI Z I furthermore certify that / am authorized to grant, and do in fact grant permission to Division of Coastal Management staff, the Local Permit Officer and their agents to enter on the aforementioned lands in connection with evaluating information related to this permit application. Property Owner Information: &" 1-0" " Signature Print or Type Name �crrh,-er— Title O y / Z° / Vag RECEIVED Date APR 24 2018 This certification is valid through Z I 3 I g DCM-MHD CITY 1 CERTIFIED MAIL • RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM Name of Property Owner: Address of Property: &V,, J ,Lke-- 6 y w,ess C-F At- S (Lot or t eet #, Street or Road, City & t c- Z-0 1 Z Agent's Name* 81tte (d,*c..- 64-15 "- Mailing Address: Agent's phone #: 25Z- -u )32 hfooeAe LiF 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. �C 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 nccoastaimanaaement.net(web/cm/staff-listing orby 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. (P Pp Owner Information) &, � i —4 � �— Signature Print or Type Name v� �P Gt- Mailing Add ss City/State ip Telephone Number/Email Address 9—/Is Date �cZ Print or Type Name GT / " N r / ? j Mailing Address P K, y, /V; n n City/State/Zip m m z 5-2- - z,v-7 Telephone Number/Email Address © o m n � v Dat (Revised Aug. 2014) CERTIFIED MAIL • RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM Name of Property Owner: D &Vi -TLkc - Address of Property: G-/ (Lot treet #, Street or Road, City & Agent's Name #: ��1�'�- '�` `' �c�sf Mailing Address: fo° s'e'` 611 Agent's phone #: 25 L ' S�y'y) 3 /►1 n ;ems C � AIL- 21�5 1-7 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. V--"-, 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 athttp•//www nccoastaimanagement.netlweb/cm/staff-listing orby 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) Signature f� Print or Type Name Mailing Ad ss AX City/StateTZip Telephone Number/Email Address Date (Riparian Property Owner Information) 17 , 1� />, �, � Signature Print or Type Name Mailing Address i\j C �� Z City/State/Zip v Telephone Number/Email Address -C Date (Revised Aug. 2014) m m m O 16) 6 jppne>5 RECEIVED APR 2 4 2018 DCM-MHD CITY 1-S KI