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Home My WebLink AboutKing, Doug__ CAMA / DREDGE & FILL No 71636 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 Address City - - ``, ci Statew ZIP > ��_�.• Phone # Authorized Agent; Affected ❑ CW EW _.PTA ❑ ES ❑ PTS AEC(s): ❑ OEA _ HHF ❑ IH ❑ URA ❑ 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) f Groin length number Bulkhead/ Riprap length avg distance offshore max distance offshore - Basin, channel cubic yards Boat ramp Boathouse/ Boatlift Beach Bulldozing Other Project Location: County Street Address/ State Road/ Lot #(s) Subdivision City ZIP Phone # O _ River Basin ej Adj. Wtr. Body } __ (nat /man /unkn) Closest Maj. Wtr. Body -- Shoreline Length SAV: not sure yes no Moratorium: n/a yes no Photos: yes no / i Waiver Attached: yes no -- A building permit may be required by: (7) ( Note Local Planning jurisdiction) _ �• Notes/ Special Conditions Agent or Applicant Printed Name Signature *"lease raad ctfmpliance statement on back of permit (Scale: ) �r See note on back regarding River Basin rules. �r A Permit Officer's Printed Name Signature Application Fee(s) Check# 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 comply with 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 0 RECEIVED JUL 13 2018 DCM-MHD CITY "- A oj 0i fl+ M 4 C4 cc CL M cA gY AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: b Mailing Address: Phone Number: <6-,�-a- 6 S. n) 9W 6C61 �13 C, 2--6 S-(,'Z Email Address: "G !-i61100 "C-o�`" I certify that I have authorized Agent I Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: _e at my property located at in County. 1 furthermore certify that I 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: �1 VzL4, Signature) Da,,,2IdL-S S : - -, Nw L ", Print or Type Name Title / 0\ �O1� Date This certification is valid through 6�-1 I 1 �� RECEIVED — 'JUL 13 2018 DCM-MHD CITY ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to GO 0 S IGS y 4T4,1 q 's (Name of Property Owner) property located at A f (Address, Lot, Block, Road, etc.) on /��Tr^ W e 5 T Gre- in Ale W 1'3eVd N.C. (Waterbody) (City/Town 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) C(reo((j in/ j o -C S (: pS Gild immedtc-T2 /1 CdJ GCeNT WaTev-" CI,�5r0M q-r•Te,c�eJ 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,/- I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Property Ow er Information) U Si ncr rc Print or Type Name G, le,� Mailing Address M ,,) /3 e,lv, /v City/State2i �1q•ly2�37 Telephone Number/email address 3 ,- ��a--� I ff bate *Valid for one calendar year after signature* (Adjacen rope y O er Information) � . ; �� t! 11 t i Le ►� Prin or T pe am M�i![r�q 9d ress V-, City/State/7 2S�?d3-7965� Telepho e Nurpber/email address I_?ate A11 3 (30tKOyg. 2014) Pin s 1 inr 03AI333H AAvj A4 14, e-t C4 ci ("er-2 (T C)IqcAo ),'e RECEIVED 3 2018 DcM-MHr) CITY %ERSTATEME� 's OPERT`� OW DACE%T R%PAR%A% PR 7-2� l�e oKpropertY Owner) A erty atl}acent to (Nam N.C.i that 1 own Prop ; e v- dock, Road, etc.) 1 hereby cer<tY �r✓ County) �S c7 C` iAddress� %-ot, BnJ e� IToWn andlor ove property located at in kGity at the ab C r^ P�' i� ment Proposed �„ e5 > oC I the develop on e,^ (\N rb below , to me, as shown licant has described The apP ection to this proposal. to n. 1 haVe no ob) osal. T op ections to this PrOP PROPOSED DEVE Mach a ;site drawing) ve 1 DRAW%% OF tion below or lha G �--- ANOIORt must fttt in descrip DESCR%pT1ON Posing developmen C' cD que ^� ondividval prop GN d 0� s1,rS Gk i a jraM boathouse, Vitt, or groin WAIVER SEAT%ON ater, waived by mooring pilings, boat ramp, breakw aGCess unless from area of riparian ier, dock, mY ro riate blank below.) 1 understand that a prnrnimum distance of 15 must be set back a ou must initial the app P me f u wish to waive the setback, y etback requirement. I do wish to waive the 15' s uirement. I 11 do not wish to waive the 15' setback req t rty Owner Information) (Adl�Cennope.�f_ ,✓,� property owne Information) ure --�— S S� ro -ram T Print o / ca 375 (AP burnl�� l�� Mai'ng Ad Tess 77"i 1 l!,, 77 / City/State/ZIP 3 7 f i ci Telephone Number/email address 3I Dale Si Fr -in —tor Name L C►t !St )L- ��-c �3- 3__. La .s Telephone Number / email ad ess - Date RECEI 'Valid for one calendar year after signature* M\- I % 2_