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Home My WebLink AboutChleborowicz, Gregory❑CAMA / ❑ DREDGE & FILL NO. 73204 A B C D GENERAL PERMIT Previous permit# -lNew ❑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 i Rules attached. Applicant Name r _ " �� i'� Project Location: County _} Address ¢ ! ' • ` ( Street Address/ State Road/ Lot #(s)E' Ch 4 CityState ZIP Phone # ()___ E-Mail Authorized Agent D CW ❑ EW ❑ PTA `<JES Affected ❑ OEA ❑ HHF ❑ IH ❑ UBA AEC(s): ❑ PWS: ORW: yes / no PNA yes I_ng.' Type of Project/ Activity ''` -c" Pier (dock) length Fixed Platform(s) Floating Platform(s) Finger pier(s) Groin length r number ,,,e, Bulkhead�Riprap length 1 avg distance offshore max distance offshore, Basin, channel cubic yards Boat ramp Boathouse/ Boatlift_ Beach Bulldozing s^ Other Subdivision City _ ZIP U PTS Phone # ( ) River Basin ❑ N/A Adj. Wtr. Body. (nat /man_/unkn) Closest Maj. Wtr. Body --- -- Shoreline Length SAV: not sure yes Rio -- -- - -i - , Moratorium: n/a yes no Photos: yes no -- ❑ - Waiver Attached: yes no p A building permit may be required by: ( Note Local Planning jurisdiction) Notes/ Special Conditions Agent or Applicant Prin ed Na e Signature Please read compliance s ent on back of permit Application Fee(s) Check # (Scale: / r r-1- 0 ) 7_1 ❑ See note on back regarding River Basin rules. Permit Officer's Printed Name Signatur� Issuing Date Exp' 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 howto complywith 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) (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 RECEIVED CERTIFIED MAIL • RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT SEP 0 4 2018 ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION[WAIVEDCOWD CITY Name of Property Owner: re Z Address of Property: (Lot or Street #, Street or Road, City & County) Agent's Name #: Agent's phone #: Mailing Address: %3 3/mow%Ncr�c,� I hereby certify that I own property adjacent to the above referenced property. The individual applying for this permit has described to me as shown on the attached drawing the development they are �proposing. MUMM— ,.,n ust b Y" iid nttf lk Psd f€`er. > ' I have no objections to this proposal. I have objections to this proposal. J P P J p P if you have objections to what is being proposed, you must notifythe Division of Coastal Management (DCM) in writing within 10 days of receipt of this notice. Correspondence should be mailed to 400 Commerce Ave., Morehead City, NC, 28557. DCM representatives can also be contacted at (252) 808- 2808. No response is considered the same as no objection if you have been notified by Certified Mail. 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 Signature (� /7! CGGv�ck•�i �� Print or Mailing Address City/State/Zip 4 /S- - Y7s Telephone Number Date (Adjac9pt Property Owner Information) Signature urn Yrl Print or Type N e 10 AI'OWS , �)l Mailing Address Y[C5 IBC City/State/Zip (�5c�, 24� I Telephone Number 1(m�$ Date Revised 611812012 CERTIFIED MAIL • RETURN RECEIPT REQUESTED RECEIVED A DIVISION OF COASTAL MANAGEMENT ��p n 4 2018 ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM Name of Property Owner:✓ DCM-MHD CITY Address of Property: (Lot or Street *, Street or Road, City & County) Agent's Name #: Agent's phone #: Mailing Address: / 3/mow%�''�� y✓�'" 1D.re,s12 I hereby certify that I own property adjacent to the above referenced property. The individual applying for this permit has described to me as shown on the attached drawing the development �'-�"�"� newt ' �wwl,+i.1'�7s z�� -"a� . - z' u ,�' '°°'""i.�' n- ,�--.hrr�, zn _ T ^'ems '�•.}r v�{ they are proposing. �%adscf�tror�or,tlry akittti'enons riusf beptQ�trtle�fiarttGthrs�aetter,. 'i have no objections to this proposal. I have J p p e objections to this proposal. If you have objections to what is being proposed, you must notifythe Division of Coastal Management (DCM) in writing within 10 days of receipt of this notice. Correspondence should be mailed to 400 Commerce Ave., Morehead City, NC, 28557. DCM representatives can also be contacted at (252) 808- 2808. No response is considered the same as no objection If Lou have been notified by Certified Mail 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 Signature Print or Tv6e Nake Mailing Address / Ai 't G %�h City/State/Zlp 7.a7 -ek Telephone Number Date Dn) r utn yr i yva IVanro Mailing Address City/State2ip ?- F Z 17 � Z— >a -3 Telephone Number Date Revised 611 KO12 F ^L• sr r ,t 9�. rl Jl jr dt z 1 _ ; / D fZ� RECEIVED SEP 04 2018 _. DCM-MHD CITY a,�, W. i y c A 3 RECEIVED SEP 0 4 2018 DCM-MHD CI Ty