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HomeMy WebLinkAboutParks, Rayi. CAMA / DREDGE & FILL FJ NO. 73444 GENERAL PERMIT Previous permit # A B 6 D _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 iJ Rules attached. Applicant Name' '" t� a C +e Project Location: County . � Address �'-� +/ � � � r � (C,;, I Street Address/ State Rfoja�d/�, Lot #(s) City ` �` `y StateA,/('- ZIP .A. '' ❑i Subdivision Phone # () " �-Mail Authorized Agent Affected CW EW -17r TA AEC(s): — OEA HHF ❑ IH PWS: ORW: yes / no PNA yes / no Type of Project/ Activity Pier (J ' Fixed Floati Finge Groir Bulkh Basin Boat Boad Bead Othe Shon SAV: Morz Phot, Waiv A building permit may be required by: ( Note Local Planning Jurisdiction) Notes/ Special Conditions City t i ZIP ��--• El ES ❑PTS Phone # ( ) River Basin ❑ USA ❑ N/A Adj. Wtr. Body_ )tall 11 4 . n t man unkn Closest Maj. Wtr. Body R. /-) ;-) h/1 it, r, Agent o kplicant Printed Nam Signature Please read compliance statement on back of permit Application Feels) Check # Permit Officer's Pr Signature Issuing Date (Scale: V ) ❑ See note on back regarding River Basin rules. 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 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: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 AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: Mailing Address: I (p & 16 Phone Number: Email Address: I certify that I have authorized Agent / to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: Oct- �v at my property located at CP 6 /6 in azr(er4-f- County. l furthermore certify that l 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: W Signature '4 Lt. �� 00 A c e- f - Print or Type Name Title - 3 1 1 / Date This certification is valid through I r sl