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Home My WebLink About73208_iCAMA / f-� DREDGE & FILL NO. 73208 67 ^ A B 'C D GENERAL PERMIT Previous permit # ❑New _.Modification ❑Complete Reissue El 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 r; Rules attached. Applicant Name Project Location: County Address Street Address/ State Road/ Lot #(s) City State ZIP Phone # ( ) _ E-Mail Subdivision Authorized Agent City _ ZIP Affected J cw EW i PTA ❑ ES p PTS Phone # (_ ) _ _ River Basin AEC s : OEA J HHF IH ❑ UBA ❑ N/A Ad'. Wtr. Body y - --. (nat /man /unkn) ORW: yes / no PNA yes / no Closest Maj. Wtr. Body Type of Project/ Activity Pier (dock) length 'jtOF -- -- - -- _ Fixed Platform(s) Floating Platform(s) -- ----._-. Finger pier(s) qdl Groin length -- 1 I number Bulkhead/ Riprap length - -� avg distance offshore m-( max distance offshore Basin, channel cubic yards i Boat ramp Boathouse/ Boatlift4 Beach Bulldozing i 5 Y {{ 1 Other i� t l'3'�i+l 5.i Ail Shoreline Length SAV: not sure yes a_ __ Moratorium: n/a yes no Photos: yes no Waiver Attached: yes no A building permit may be required by:iA— Note Local Planning jurisdiction) Notes/ Special Conditions Agent or Applicant Printed Name ,3 s r Signature "Please read compliance statement on back of permit Application Fee(s) Check # (Scale: y' ) I 1] See note on back regarding River Basin rules. Permit Officer's Printed Name Signature) fI + { �-% Issuin Date Expiration Date 1 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 I) 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 complywith these buffer rules. Division of Coastal Management Offices Morehead City Headquarters 400 Commerce Ave Morehead City, NC 28557 252-808-2808/ 1-888-4RCOAST Fax: 252-247-3330 (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) 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) http://portal. ncden r.org/web/cm/dcm-home Revised 7/06/ 17 AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: Mailing Address: Phone Number: Email Address: I certify that I have authorized - j �-'C)- G �67--5 J- ->C) to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: /lz; ,— A.c, _►�! 1�E jN �J at my property located at in County. 1 furthermore certify that 1 am authorized to grant, and do in fact grant permission to Division of Coastal Management staff, the Local Permit Officer and their agents to enter on the aforementioned lands in connection with evaluating information related to this permit application. Property Owner Information: 5 70 Signature C 14AA -L i F A k K i /vS Print or Type Name Title tSatel�— This certification is valid through / l IF�—Aln `U.S. Postal Service'' CERTIFIED MAIL° RECEIPT Domestic Mail Only ru N r0 N rq r9 C3 O CJ C3 C3 m m Ln r-9 0 N ■ Complete items 1, 2, and 3. A. ■ Print your name and address on the reverse X so that we can return the card to you. ■ Attach this card to the back of the mailpiece, B. Received or on the front if space permits. 1. Article Addressed to: D. / �% D. Is delivery address different from item 1? ❑ Ye: �t�e� 1Y�rx•G�4- If YES, enter delivery address below: ❑ No ❑ Agent C. Date of Delivery Service e El Priority Mail s® II I Illill III III I III I III IIII IIII III I �) II I3. ❑ Adult Signature ElReg Registered Mail - El Adult Signature Restricted Delivery ❑ Registered Mail Restricted 9590 9402 1595 5362 5851 32 Certified Mal® ❑ Certified Mail Restricted Delivery Delivery returnReeeipt for ❑ Collect on Delivery ( Merchandise 2, Article Number (Transfer from service label) ❑ Collect on Delivery Restricted Delivery ❑ Signature Confirmationm 7 015 3430 0000 1211 767 2 ail all Restricted Delivery ❑ Signature Confirmation Restricted Delivery PS Form 3811, July 2015 PSN 7530-02-000-9053 Domestic Return Receipt ■ Complete items 1, 2, and 3. ■ Print your name and address on the reverse so that we can return the card to you. ■ Attach this card to the back of the mailpiece, or on the front if space permits. 1. Article Addressed to: U99 #B y7"Sco`I>r Q� , J ❑ Agent �—r� X ❑ Addressee B. Received byy d Name C. Date of Delivery yGrin D. Is delivery address different from item 1? ❑ Yes If YES, enter delivery address below: ❑ No 3. Service Type ❑ Priority Mail Expresso I III I III III' IIN 1111111111111111 ❑ Adult Signature ❑Registered Mail'^' II I'III'I I'll III ❑ Adult Signature Restricted Delivery ❑ Registered Mail Restricted 9590 9402 1595 5362 5851 49 ❑ Certified Mail® ❑ Certified Mail Restricted Delivery Delivery ❑ Return Receipt for ❑ Collect on Delivery n r."I—t �n Delivery Restricted Delivery Mercha, ,dise ❑ Signature ConfirrnationTO 7 015 3430 0000 1211 Sail 7689 tail Restricted Delivery ❑ Signature Confirmation Restricted Delivery PS Form 3811, July 2015 PSN 7530-02-000-9053 Domestic Return Receipt ; RECEIVED SEP 0 6 2018 DCM-MHD_CITY