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Home My WebLink AboutWalsh, EdN -. � CAMA / DREDGE & FILL N2 70972 A B C D GENERAL PERMIT Previous permit# New ❑Modification ❑Complete Reissue El 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 I SA NCAC D Rules attached. Applicant Name Address State ZIP Phone # (' ) `,_ , E-Mail Authorized Agent r : A ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Affected ElOEA AEC(s): ElHHF ElIH ❑ UBA El N/A ❑ PWS: ORW: yes / no PNA yes / no Type of of Project/ Activity Pier (dock) length Fixed Platform(s) Floating Platform(s) f Finger pier(s) Groin length number r Bulkhead/ Riprap length ? avg distance offshore max distance offshore Basin, channel cubic yards Boat ramp Boathouse/ Boatlift Project Location: County Street Address/ State Road/ Lot #(s) Subdivision _ .T-- City ZIP Phone # ( ) River Basin Adj. Wtr. Body i Oat /man /unkn) M. r Closest Maj. Wtr. Body I it (Scale: ) Beach Bulldozing Other ' % 1 Shoreline Length- SAV: not sure yes ,, na,.� Moratorium: n/a yes no i Photos: yes no] - �h i Waiver Attached: yes nq' A building permit may be required by: `! (�.� (. f A i -> )_}T! See note on back regarding River Basin rules. ( Note Local Planning jurisdiction) / P Notes S cial Conditions / Agent Please read compliance statement on back of permit Application Fee(s) Check # Ll Permit Officer's Printed Name / 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 Washington District 400 Commerce Ave 943 Washington Square Mall Morehead City, NC 28557 Washington, NC 27889 252-808-2808/ I-888-4RCOAST 252-946-6481 Fax: 252-247-3330 Fax: 252-948-0478 (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) (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://portal.ncdenr.org/web/cm/dcm-home Revised 7/06/ 17 AGENT AUTHORIZATION FORM FOR PERMIT APPLICATIONS (J onl cnJ \\ 4� \ ) ' \y Name of Property Owner Applying for Permit: 0 ILO fir'x Mailing address: WTA GdQ t;1r!n 0 (' Telephone Number: '�A%'35� -026AO I certify that I have authorized 1 3 x Me, V� V\ C (agent/contractor), to act on my behalf, for the purpose of applying and obtaining all CAMA permits necessary for the proposed development of N e-vy at my property located at � D U I6e AGV CA % This certification is valid through (Property Owner Information) X '4"' Cox Signature Print or Type Name Title; co. owner or trustee for property Date 919- L-etc = DI%-k!� Telephone Number 1 Cox o \ u\Y ( I - C;:�'rn Email Address (date). Ms 1a I ll in 9142 1092-4 3 re.f2 3067 iM�.fge 149; 4 21 9032 ST f7 1b33 109'_-4-32 0924! Of so ef tfAxa 1923 9932 1092-4-3 1092-4-40 ° - 4$29 111.94 i 092-4-20 f#D.f3 - tat.lA xit2,1 t2f.# m I WO 3M 9749 •�.e 1092 Mal Ov faa ) fla37 i53-!' " 3760 -r, f.>., 4623 Pamlico County, NC Pin 6487404829000 mapid 1092-4-20 calacres: 0.73809580298628 Disclamer: mm,..cn vm cR ft. �cc� r owner name WAISH 6;DWARDJW a, �� ..mnnc c keai accwncm. AND owner adds 11721 COPPERGAIEDR #108 e Ue'p� owner_ cilR . RALEIGH L deedbook 000608 20m Feb/23/2018 dmc!Mg 314 X sxrao� IT t1 kW. 1:1200 Lam.... .. _.... _ ....... � �_. _.. 'T£ 121/ r++ar 9074 5031 ios�-s 1 I hereby certify that I own property adjacent to a`r property located at on 4 01 �cn 10 O ItACNII GTcey- (Waterbody) -A\5\,\ ILON `U 's of Property Owner) (Address, Lot, Block, Road, etc.) �N.C. in (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 DEVELVPmtN i (Indivi&YAl nrnno-gina develoument must fill in description below or attach a site drawing) WAIVER SECTION I understand that a pier, dock, mooring pilings, boat ramp, 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. I do not wish to waive the 15' setback requirement. (Property Owner Information) (Adjacent Property Owner Information) Signature Print or Type Name / 5` 900 1 0 Mailing Address ({s City/State/Zip Telephone Number/ email address X Signature Al h Print or Type Name Mailing Address 34tC7 ��oo�_ City/StatelZip ;tphn ` OC, 215 71 � Telephone Number/email address Z 1 ZL/ / Z 8 I hereby certify that I own property adjacent to r property located at 100 1 el, on Vk �leo' (Waterb Name of Property (Address, Lot, Block, Road, etc.) G�C2�L in 0 r^� ',ew, , N.C. ody) (City/Town and/or County) The applicant has described to me, as shown below, the development proposed at the above location. 1 have no objection to this proposal. I have objections to this proposal. DESCRIPTION ARID/OR DRAINING OF PROPOSED DEVELOPMENT (individual proposing development must fill in description below or attach a site drawing) CO3rk w'A sly\ ( t V, WAIVER SECTION I understand that a pier, clock, mooring pilings, boat ramp, 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. I do not wish to waive the 15' setback requirement. (Property Owner Information) Signature Print or Type Name Mailing Address City/Statelzip Telephone Numberl email address Date `Valid for one calendar year after signature" (Adjacent P_r �e,rtly%Own Information) r4ture * r I�r�l.-.s LA.; . Print or Type Name Mailing Address I 1C A `\ Ct , CitylStatelZip r per.^ 0(, 25 5 71 , Telephone Numberlemail address 2LIT o914/ Date" (Revised Aug. 2014)