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Home My WebLink AboutBruno, KeithCAMA / DREDGE & FILL �J NO. 73217 A 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 ❑ 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 ❑ CW EW PTA ES PTS Phone # ( ) River Basin AEC(s): ❑OEA HHIF IH UBA N/A Adj. Wtr. Body- ❑ PWS: ORW: yes / no PNA yes / no Closest Maj. Wtr. Body Type of Project/ Activity Pier (dock) ler-'` Fixed Platforn Floating Platfc Finger pier(s)_ Groin length number Bulkhead/ Rip avg dista max dist Basin, channe cubic yai Boat ramp Boathouse/ B, Beach Bulldo; Other Shoreline Len SAV: n Moratorium: Photos: Waiver Attacl A building permit may be required by: ( Note Local Planning jurisdiction) Notes/ Special Conditions /man unkn (Scale: - ' ' i ' F.-,� / h'__ See note on back regarding River Basin rules. Agent or Applicant Printed Name 1 } Signature ** Please read compliance statement on back of permit Application Fee(s) Check # Permit Officer's Printed Name) Signature f / 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 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 howto complywith these buffer rules. Division of Coastal Management Offices Morehead City Headquarters 400 Commerce Ave Morehead City, NC 28557 252-808-2808/ I-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: 9 10-395-3964 (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 RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacx-nt to h P (+Y I �runz `s (Name of Property Owner) property located si 501 D Y i e voa i M �- �y� r {Addreaa, Lot. Black, Road. etr} on (� I_� U IiPj1J��ll�. n „C1 PEER ( ) FhVt.,t e o Co : N.U. I (yeatterbody) (City own andlor County) - The applicant has described to me, as shown below. the developtocilt proposed at the above locabon. I have no objection to this proposal. I have objections to this propoc,,a . DESCRIPTION ANDIOR DRAWING OF PROPOSED DEVELOPMENT (k+' Q► dwWopm&Wmust and orrbe+fowolr a ift �rU�'� l7rcw�.ol� UAYJSA i 6A6J Qro6rm P WAIVER SECTION I understand that a pier. dock. mooring prlrngs, boat ramp. breakwater, boathouse, lift, or groin must be set back a minimum distance of 15' frorn my area of riparian aLces-s unless waived by rre. { 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 1 T setback requirement. (Property Owner Information) -- Sigrkztur8 * — _ -01 .S'� Q+ttlt F'MI fX i y00 Aroow l!� L rt .:'S%rr rn ��AJ LX L i e)ephorw Numbtert ernaii adldmss Nu ner / amait address (Revis-oV AuV. 20,41, 'Vatid for one calendar year after signatute' ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adomc nt to Q 1 f gruKT) I property _ �� I D Y 1 e �1 a l (Name of Property Owner) located at y� (A dress, Lot. Block. Road, ety an �//�� h o �1 I�(•(�C—fit' .:n __ L-`, inJGL (� i" K- i o Ca , N.c,_ aterbodyi (City own and/or County) The applicant has described to me, as shown below_ the developrMnt proposed at the above Iocabon. i have no objection to this proposal - I have objections to this prowl. DESCRIPTION AND:OR DRAWING OF PROPOSED DEVELOPMENT (knftvxkW Proposing d vek* vtt must iir w descripbou below or attoch a sft drawing) aoprm f roprviy rqc{ ', bklk-h,za�t At— _f C-1� S � WAIVER SECTION I understand that a pier. dock. mooring p,lrngs, boat ramp. breakwater. boathouse, lift, or grcir, must be set back a rninirnurn distance of 15' from my area of riparian atzess 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 requirenent. I do not wish to waive the 15' setback requiremen L. (Property Owner Information) .tiJ£'77t2IllJ'8 Pratt rsr i yOc N*r7w Maihn•j 7ddrew i olop.f?Grjc Number! email addims 'Vaexi for one calendar year after signatwe' "Adon/tJProperty Owner Information} // Q� i 4aure N alJI'l eti� - �y Maiffr%7 AcOdrcw r'ru��fs �U RO A/ r^ T&- FPho ra+ Number / email addrrs.¢ j ReWSW Aug. 2014;