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Home My WebLink AboutUtz, Charles & Maryr. "CAMA / DREDGE & FILL No 70461 A B C D GENERAL PERMIT Previous permit# JNew Modification ❑Complete Reissue Partia4Reissue 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 1 [Rules attac Applicant Name i �' i°: ! 1 1'_ Project Location: County(�&/ Address Street Address/ tate Road/ Lot #(s) 'J" City _ State ZIP Phone # E-Mail _ Subdivision Authorized Agent i' City _ _ ZIP__ _ --- Affected JCw ❑,EW jj'PTA El ES ❑PTS Phone # ( ) _-- River Basin OEA ❑ HHF ' ❑ &t ElUBA ❑ N/A AEC(s): Adj. Wtr. Body _ (nat /man /unkn) _ PWS: ORW: yes / no PNA yes / no Closest Maj. Wtr. Body __- Ito _ �1■■■■■��■■ :lei!■ EMOMMID10SIM mo■■■B■■■s1w. ■■!■ ■■■MMENN ;■■■■■■ ■■■!■■■[!■■�■■ ■■■ ■■■■ mmimmm■■om■■ ■■■ ■ ■■IN�M■■■■ � w ■i■�■ .ate ■ Emrommil 010. ■■■m■■■nr�■ �!■■■ICI■■I�110Ggo MEN■■ IMEMMOINESHIM a M. ■ ■■■ loom ■■■■ ■i 111111MUNIM Ni■i ■■Uir■■1��■r.��■■■�►��■�®�®r��A■�■■■i 10210110101 ■■■■ • ��■■■■M■■ ■®■■■■■■■■LR■■■f■I■■■■■.�..� �■■■■■■®■■I�I�■�■■�■■1��■■■■■�■■■■ ��■■■■ IN01210 MMM ■■■■ ■®■■ ■■■■■■■■ mini ■■■■■■O1M■■■■■■■■■■ ■EM NONM■■■�1[1■iii�■■��■■�1�■■■■■�■■� . .. MIA o ■■ ■■■■■■.NSee note on back regarding River Basin Agent or Applicant Printed Name Signature ** Please read compliance statement on back of permit ** PermitOfficer's Printed Signature Application Fee(s) Check# Issuing Date Expiration Date f 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) http://portal.ncdenr.org/web/cm/dcm-home (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/ 17 252- 778- 81(oa Cea Tina RIPARIAN PROPERTY OWNER STATEMENT ierty adjacent to Iz � at" cu tS Ll-k 's (Name of Property Owner) (Address, Lot, Block, Road, etc.) in MGv . vCQ N.C. (CityITown nd/or County) o me, as shown below, the development proposed at the above :ion to this proposal. s to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (Individual proposing development must fill in description below or attach a site drawing) mbVI WAS I ( 0 0 a� + ID � ack 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. ,f I do not wish to waive the 15' setback requirement. (Property Own r Information) (_Adjacent P=wner Information) (gnature ure * '1 �1�5 �' Q� Wova. ' _ � �c��✓ Print or Type Name Pri t or Typ Nar .e�j � V T)ro fCanDl Mailing Address Mailing Address Mur > C�h tiL 2�55� /yt ,e City/State/Zip City/State/Zip 252 - 22q - (A31 Z C ,LLt2- 0) G i rds ofn 2- �z6 Telephone Number/email address Telephon Number/email address 5_l_l �i Date Date* (Revised Aug. 2014) *Valid for one calendar year after signature* ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to tw_ 41 Ma_L,� LUZ I (Name of Property Owner) property located at � �tilY1(�VvQ.F��. �Q-nc (Address, Lot, Block, Road, etc.) on goqu� Sou„ -,in CNAi , N.C. (Waterbody) (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 DEVELOPMENT (Individual proposing development must fill in description below or attach a site drawing) Side bf4ve dock f 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) Signature C%D(ee Print o Type ,a me l I � d .M n Telephone Number/'email address S-(_IP� (Adjacent Property Owner Information) 4�6� Signature* Print or Type Name a\ V\5\Ncc Mailing Address ` ' � N �5 City/State/Zip Telephone Nu er/email address b - A- IbW Date Date* *Valid for one calendar year after signature* (Revised Aug. 2014)