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Home My WebLink AboutBland, BillL� CAMA / -]DREDGE & FILL No. 73271 r. %ENERAL PERMIT A B °C, D _ Previous permit # 'New - Modification Complete Reissue Partial Reissue Date previous permit issued As author :ed 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 ❑ Rules attached. Applicant Name j = ` ' Project Location: County_ Address % {; at t. S City c t StateA..r/( ZIP„ 1 Phone # O,� / E-Mail Authorized Agent Affected ❑ CW ElEW ❑ PTA AEC(s): 1-1OEA ❑ HHF ❑ IH F_ PWS: ORW: yes / no PNA yes / nc Type of Project/ Activity Pier (dock) length Fixed Platform(s) Floating Platform(s) T- Finger pier(s) _ Groin length number Bulkhead/ Riprap length avg distance offshore max distance offshore L. ' Basin, channel € i cubic yards -- Boat ramp _ Boathouse/ Boatlift Beach Bulldozing Other Shoreline Length SAV: not sure yes no Moratorium: n/a yes no Photos: yes no Waiver Attached: yes no A building permit may be required by: ( Note Local Planning jurisdiction) Notes/ Special Conditions S ❑ PTS ElUBA ❑ N/A I-) i i ;3(„ P ,-, d Agent or Applicant Printed Na e ® ,6,, - . Signature "Please read compliance statement on back of permit" Application Fee(s) Check # f treet Address/ State Road/ Lot #(s) Subdivision + City .-' / zip a '`+ Phone # t River Basin Adj. Wtr. Body i ✓'', f t i' i F> jt r at man /unkn Closest Maj. Wtr. Body-'< " ` f ✓ �.~' (Scale L {,/` ❑ See note on back regarding River Basin rules. PermitOfficer's Printd Signature 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 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 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 ' ADJACENT R€PARIAN PROPERTY OWNER STATEMENT " eta.,,._-a� I5 I hereby certify that !ovum properly adjacent to (Name of Properly Owner) property located at 7 6 a S $rt,�crs Cn� k rD r► ��- (Address, Lo Bloc€c, Road, etc.) <�C�C� PJ.C. on �i,�t C�icek 1�5 Creel<, inv�trp•� Tale �� (Waterbody) (City/Town skid/or County) The applicant has described to me, as shown below, the development proposed at the above ' cation:. I have no objection to this proposal I have objections to this proposal" DESCRIPTION AND/OR DRAWING Or PROPOSED DEVELOPMENT (Individual proposing development must fill in description below or attach a site drawing) oa '70 a _7 111VAIVER SECTION �fq-30sb understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or gro�l must be set back a minimum distance of 15' from my area of riparian access unless waived by me. elf you wish to waive the setback, you nest irzisiai the appropriate blank below.) _ '0l do vtish to waive the 15' setback requirement. i do nat wish to waive the 15' setback requirement. (Property Owner Information) (Adjacent Propperty Owner infor9 Lion) rv/J er-c-�-� Print or ; ype Name Print or Type Na e Cmek ; 9ailina Address l:bailing ddrless LL CiiyiSiaie/Zip Ci ylStaterio 7�� . � a- • a.�ta � elephone Number/ email address r eleohone Number / e sit address Date Date` 'Valid for one calendar year after signature` revised Aug. 2014) ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to 91 L�L SLAdiD s (Name of Property Owner) property located at - l 02 s A &,ikcs 0eak-- rvc (Address, Lot, Block, Road, etc.) on A (�Geus JQHb►c in �M4-a,h - � L'e /v, C' N.C. (Waterbody) (City/Town and/or County) The applicant has described to me, as shown below, the development proposed at the above locatiL 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) O -- n -- c.) —10 - 0 Y " x'lS Alit GHW-WOG WAIVER SECTION 'C3/i1303b 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) Signature Print or Type Name IaO - F Gv MAW g Address �0y.y(n 5yrc-,-/ AIC z7i9� City/State/Zip qK/ , `t 7 -a -7 %O Telephone Number/Wail address (0- - l 8 Date ILI Signature M27e, &, 50LZ Print or,�-ype Name 1-0 C3vy 411212 Mailing Add ss City/State ip ;�q2 - in-235Fg 1. 7 .E Gl�,t✓�Sa b Telephone Number/email address tv _ q- IV Date* 'Valid for one calendar year after signature* (Revised Aug. 2014)