HomeMy WebLinkAboutSmelcer, Williamr. KCAMA / ❑ DREDGE & FILL No 72096 A B C D
GENERAL 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 � u R"
'Rules attached.
Applicant Name
Address
! i
City____4
State ZIP
Phone # (� )'.�
E-Mail,. �
i 'l
`4
Authorized Agent
1" `
❑ CW
❑ EW NPTA ❑ ES ❑ PTS
Affected
AEC(s): ElOEA
❑ HHF ElIH ElUSA ElN/A
❑ PWS:
ORW: yes / no
PNA yes / no
Type of Project/ Activity
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
s
Finger pier(s)
Groin length
number x
Bulkhead/ Riprap length
avg distance offshore
max distance offshore =--
Basin, channel
cubic yards �-
Boat ramp ! '
Boathouse/ Boatlift"
Beach Bulldozing f
Other
Project Location: County r'
Street Address/ State Road/ Lot #(s)
Subdivision
y l
City ZIP
Phone # ( ) _ _ River Basin
Adj. Wtr. Body (nat'/man /unkn)
Closest Maj. Wtr. Body -
Shoreline Length
i
SAV: not sure yes ff io, i
Moratorium: n/a yes no
Photos: yesno f
Waiver Attached: yes no I a.y
A building permit may be required by:
( Note Local Planning Jurisdiction) t y
Notes/ Special Conditions" _) ) �` ��ti" t (�
Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit
Application Fee(s) Check #
(Scale: )
❑ See note on back regarding River Basin rules.
Permit Officer's Printed Name /
Signature !
t -2 r
7
Issuing Date f Expi tion 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/ 1-888-4RCOAST
252-946-6481
Fax: 252-247-3330
Fax: 252-948-0478
(Serves: Carteret, Craven, Onslow -
(Serves: Beaufort, Bertie, Hertford, Hyde,
North of New River Inlet- and Pamlico
Tyrrell and Washington Counties)
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
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
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
i�!nme of Prc,�erty 0�:.;ter Requosting Permit: i
Mailing Add- S:-
? -7 '
Phone i lumbe; :
Email Address:
I ct,rtify that I nave a-ithorized
Avant i (,ontractor
t,) act on m� ;)ehalf, fcr the purpose of applying for and obtaining all CAMA permits
nec(. 3sary for the fc.11owing proposed development: T c, :'_'`A" I ' r
rr!j property located at
in `_�. l f L .__ COun
l furthermore certify that i am auth+ trized to grant, and do in fact gro nt permission to
Division of Coastal Management stun; the Local Permit Officer and their arem's to enter
on the aforementioned lands in connection with evaluating information rela.od to this
permit appication.
Property Owner information:
Siyrr_rture
I fl, CIA, '�5_ IA:2�e ILC
."rir,t or TZpe Narn,
Titb
'k I_Za 17-
Jot .
This certification is valid through _ _I- /
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❑CAMA / ❑ DREDGE & FILL N2 7206
GENERAL PERMIT Previous permit# A
11'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
ff ulT�attach
Applicant Name %A' C Project Location: County ,;� i j Cf
Address # r i' �V
ri Street Address/ State Road/ Lot #(s)
City ' State ZIP ;
Phone # ,� P E-Mail
Authorized Agent= _
Affected ❑ CW fEW A ❑ ES ❑ PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
ORW: yes / no PNA r es,/ no
Subdivision
B (C D
City ` fx i f� E ZIP 71
Phone # ( ) River Basin N i"
Adj. Wtr. Body )'rl$- (1 man unkn
;� r {
Closest Maj. Wtr. Body VeN_
Oil .
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0 See note on back regarding River Basin rules.
All U l-'
Agentor Applicant Printed; ame f I
Si 114 Pie read cdn ipliance statement on back of permit
Application Fee(s) Check #
Permit Officer's Printed lie
Signatore
Iss ing Dat,O Expi tion Date