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Home My WebLink AboutCleeveland, Don'' f n"fit r` .� -'CAMA / DREDGE & FILL No. 73180 C�fVfRAL PERMIT A B D 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 ResourcesJQommission in an area of environmental concern pursuant to 15A NCAC Applicant Name � � � ❑Rules attached. A PP" (/ { Project Location: County Address r 1°ti( r t.) Gc. l Street Address/ State Road/ " * (s) ---------------- City State_ ZIP '`v s Phone # % J E-Mail Subdivision Authorized Agent Affected ❑ CW AEC(s): ❑ OEA ❑ PWS: L"[ W ❑.PTA ❑ ES ❑ PTS HHF IH ❑ UBA ❑ N/A ORW: yes / no PNA yes / no Type of Project/ Activity Pier (dock) length Fixed Platforr Floating Platfc Finger pier(s) Groin length number Bulkhead/ Rip avg dista max dist Basin, channel cubic yai Boat ramp Boathouse/ Bc Beach Bulldoz Other Shoreline LenF SAV: nc Moratorium: Photos: Waiver Attach A building pe ( Note Local Planning jurisdiction) Notes/ Special Conditions Agent or Applicant Printed Signature Please read compliance statement on Application Fee(s) City_ t.. "?' rs_ ZIP ._. Phone # ( ) ver Basin Adj. Wtr. Body -i. /` :` t man unkn Closest Maj. Wtr. Body 1- (Scale: ) PermitOfficer's Printed Names...__.-- - -- - Signature j Issuing ate 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, certifythatthis 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 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) 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.ncdenr.org/web/cm/dcm-home Revised 7/06/ 17 RECEIVED Hurricane Florence Repair Request Form Name of Property Owner: Address of Property: Mailing Address (If different than above): Telephone Number: Q P — ;�W NOV 0 7 2018 ICM-MHD CITY Date: 1 I �cQ c c-�---�- Repairs due to hurricane Florence will be made in the existing footprint of the previous permitted structure. Signature: 'Please note that if the structure is within the 15' setback of the riparian line and/or any dredging you must have the adjacent riparian property owner notification/waiver form signed.