HomeMy WebLinkAboutAvolis, Joeril-
?CA-MA / DREDGE & FILL
�. GENERAL PERMIT
New ❑Modification Complete Reissue - Partial Reissue
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
N9 71347 A
Previous permit #
Date previous permit issued
ui Rules attached.
Applicant Name"'"` ) Project Location: County
C
Address K 'A Street Address/ State Road/ Lot #(s)
_
City ; ,. State zip —
Phone
Phone # (_)_ _ E-Mail r P" Subdivision
Authorized Agent City___
ZIP
B D
CW ❑ EW _.--N PTA El ES ❑ PTS Phone # (_) River Basin _
Affected OEA HHF IH ❑ UBA N/A
AEC(s): Adj. Wtr. BodyEl [I'' , El%� >____(nat.-/man /unkn)
PWS:,Iw
Closest Maj. Wtr. Body -
nRW vac / no PNA yes / no
Type of Project/ Activity
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore ,
max distance offshore
Basin, channel
cubic yards
Boat ramp A
r
Boathouse/ Boatlift (,
Beach Bulldozi
Other
Shoreline Length
SAV: not sure yes
Moratorium: n/a yes (no'
Photos: yes
Waiver Attached: yes
A building permit may be *uired by:
( Note Local Planning Jurisdiction)
Notes/ Special Conditions
Agent or Applicant Printed Name f r
•
Signature Please read complianCe sta ent on back ofrmi; j
Application Fee(s) Check #
(Scale:
See note on back regarding River Basin rules.
PermitOfficer's Printed Name.
Signature,
Expiration DateP�
Ex i
Issuing 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 E3asin 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/ 1-888ARCOAST
Fax: 25 2-247-3330
(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
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BED OF TRENT RIVER BETWEEN
PIN TRACT 2
NOT RENT RIVER CHANNEL
SLIRV�QQ YYED
. IZ�XZs TRENT RIVER
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to S&s l� 6 4 KA9 T / VO s
(Name of Property Owner)
property located at 2 ��°� fi ��� ��
(Address, Lot, Block, Road, etc.)
on nL 1 [1F-�� in of Cv , N.C.
(Waterbody) (City/Town and/or Coun
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)
WAIVER SECTION
I understand that a pier, dock, mooring pilings, 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) (Ad'a�cent Property Owner Information)
Si�te ignature
Print or Type Name Print or Type Name
Z 61)&6�4W Pe1-'Y;916 -2, L'o�4So-A
MailingAdd�r��l�!. /U� Z� Z Ma ng'esAddress e,,Cya �
City/State/Zip �l�! City/S1t��
2 a
Te phone Number Telephone Number
&-C/49 I
Date Date
6
(Revised 6/18/2012)
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to ; "gp f C. 4 VARY r AyvzXS I
property located at 2 W U-50-D P° tA)T (2oAV (Name of Property Owner)
on t{►e TR6�r [ZivF.lL
(Address, Lot, Block, Road, etc)
, in I R-Et-yT DODS 6C04V64Y coxN.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location. j
,/ 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)
WAIVER SECTION
I understand that a pier, dock, mooring pilings, 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.
V— I do not wish to waive the 15' setback requirement.
(Property Owner Information)
Sig a re
J vs�oN C, Avo cis
Print or Type Name
2 LJi 60,-) ?D W7' F-0A4'p
Mailing Address
NEw a�,ea. ,Av& Zgsfo2
C "ty/StatelZip
Z5
elep one Number
Date
(Adjacent roperty Owner Information)
i a
Signature
Print or TypeName(Name (
L1
�or1
(�
i �x1SJII
1�t�c
Mailing Address
�- � �
-s-, a er r � N C
City/State/Zip
Telephone Number
7/ 31►5`
Date
(Revised 611812012)