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Home My WebLink About73157❑CAMA / - DREDGE & FILL NO. 73157 GENERAL PERMIT Previous permit # A B C D ❑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 I SA NCAC El Rules attached. Applicant Name Project Location: County Address City State ZIP Phone # ( ) E-Mail Authorized Agent Affected [ICW ❑ EW ❑ PTA ElES ❑ PTS AEC(s): ElOEA ❑ HHF ❑ IH ElUBA ElN/A El PWS: ORW: yes / no PNA yes / no Type of Project/ Activity Pier (dock) length _ a.. 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 jj Boathouse/ Boatlift " � fi ' - , I Beach Bulldozing_ �x Other < f=r Shoreline Length SAV: not sure yes Cno Moratorium: n/a yes ) Photos: yes I no _ Waiver Attached: yes n} A building permit may be required by: ( Note Local Planning jurisdiction) . Notes/ Special Conditions T,,t�rJ Street Address/ State Road/ Lot #(s) Subdivision City ZIP r Phone # ( ) River Basing',. ` Adj. Wtr. Body "t (nat Icnan /unkn) Closest Maj. Wtr. Body a (Scale: 4 I i k °' ❑ See note on back regarding River Basin rules. Agent or Applicant Printed Name ` Signature Please read compliance statement on back of permit i Application Fee(s) Check # PermitOfficer's Printed Name'r Signare 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 L 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/ 1-888ARCOAST 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 ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to �` s am Property Owner) property located at I 4�1 (Address, Lotrz ck, Ro etc on '640 , in -l�y�� , N.C. (Waterbody) (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 AND/OR DRAWING OF PROPOSED DEVELOPMENT (individual proposing development must fill in description below or attach a site drawing) Y '^C P I 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. (Adjacent 7PrZrty Owne Information) Sig 2 -7- J-.— Print o pe Name Mailing Address ! ►V 1 L /A i.� 1� - City/State City/StatelLip —� Telephone NUfl7ber Telephone Num er Date Date (Revised 611812012) ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to�t.�'S f Property Owner) property located at �7"'wzFf�-� --. / (Address, Lo loc o d etc. on �'�' , inIVI k '� %� , N.C. (Waterbody) (City/To n 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) IV 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. Owner Information) , q, A / M?� 71l ✓e Telephone/N�u�� / �8 Date (Adjacent Pro erty Owner Information) City/st te/Zi Y�X 7l�". - 7, Telephone, m fey �j •�C�O Date (Revised 611812012)