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Home My WebLink About73212CAMA / DREDGE & FILL NO. 73212 q B C D GENERAL_ PERMIT Previous permit # 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 15A NCAC L3 Rules attached. Applicant Name - _ _ - -- __-_- -- -_ - -_ Project Location: County _ Address °, Street Address/ State Road/ Lot #(s)�')�>'r'f City - - --- -- -- State Phone # ( -_) - -. E-Mail _ -_- Authorized Agent CW C EW ❑ PTA ❑ ES ❑ PTS Affected AEC(s): ❑ OEA ❑ HHF ❑ IH ElUBA ❑ N/A ❑ PWS: ORW: yes / 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 Boathouse/ Boatlift r Beach Other Shoreline Length -I i�-,l SAV: not sure res no , _. Moratorium: n/a yes j` no Photos: yes Ono _ Waiver Attached: yes , no A building permit may be required by: ( Note Local Planning jurisdiction) Notes/ Special Conditions f"' ,'i k, P` n f` fA 0-1 Agent or Applicant Printed Name t faA Signature "Please read compliance statement on back of permit Application Fee(s) Check # Subdivision City - - -- ZIP e Phone # (-- ) River Basin Adj. Wtr. Body atIman /unkn) Closest Maj. Wtr. Body (Scale: See note on back regarding River Basin rules. PermitOfficer's Printed Name Signature d Issuing Date Expi ion bate 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 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 400 Commerce Ave Morehead City, NC 28557 252-808-2808/ 1-888-411COAST 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) 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 &// 13 AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: r ors (-1 Mailing Address:« cln �� u f y �� k�' k- Phone Number. Email Address: I certify that I have authorized rl ent 1 Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: at my property located at c-, i t 1 r /\k ram, in r County, I 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 0 form�ati • - �^- .Wgnarure iI�L Print or Type Name Title f aj Date This certification is valid through I I 6 RECEIVED AUG 2 8 2018 QCM-MHD CITY ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent tos (Name,gf Property Owner) property located at 3 �j� I C Gi t t" ILS (Address, Lot, Block, Road, etc rr,n on &C `l, A- _, in �I ( 'fC,. , N.C. (Waterbody) (CitytTown 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) P wF-iVED AU DW-MHD CITY 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. Z� (Property Owner Information) St titre Print ar Ty qm, 4) 1 � Ada* Aridness City/atep Telephone Number / email address Date `Valid for one calendar year after signature` (Adja r Property Owner Information) .CismrYlurn �, - :•t- P 'nt or Type Name 4 i 1 Mailing Address City/Statemp Telephone Number / email address Date* C Pt�� 1ht1�t.1�.�Y (Revised Aug. 2014) ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to t�k \(Name of Property Owner) c~ � � �� ' t• I t C Cti �1 property located at ) Road (Address, Lot, lock, in CY tom` N.C. on (Waterbody) (City(f wn 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. Cy+l El~' L_ ► t -' _ I have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVLLUF t:N i (individual proposing development must fill in description below or attach a site drawing) 1 er-MO DG1y,-,viHU CITY 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) (Adjacent Property Owner Information) tig-nn�alture Si hire PnnTu^�p Na P `t _ 1 � r� � 1 U.� '� � �..(` 1 Print or Type Name (' •i3�-p __-'-y,J Mateo Ar/rirPvc ,� M4ng Address , O 48v $9 _ q _ ci /st te/Zi ty P c - CityrStat� dip PtJe N G his51Z Telephone Number /email address Telephone Number / email address — -- --- Date-- [kite* (Revised Aug. 2014) `Valid for one calendar year after signature` �— Z a Oro 5L,�f) 1 fit V' r Ci 1 Pro,�o�e S+q �cc RECEIVED AUG 2 8 2018 DCM-MHD CITY �� G �ct")