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Home My WebLink AboutSkubinna, NeilIVA --CAMA / i DREDGE & FILL 2 71688 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 71 1 % -i f" and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC / Rules attached. Applicant Name t ' ' Project Location: County ,.e Address 1( !,� 1 a 1` �' Street Address/ State Road/j Lot #(s) - City- —_ State if ZIP ( Phone # ( -) E-Mail Authorized Agent Affected CJ CW ❑ EW C PTA ❑ ES ❑ PTS ❑ OEA HHF ElIH ElUBA El N/A AEC(s): D PWS: ORW: yes / no PNA yes / no Agent or Applicant .r4ge&-H e .5 Sign "Please read compliance statement on back of permit" wa jApplication Fee(s) Check # Subdivision City i r wr r, ZIP _ Phone # ( ) River Basin '• Adj. Wtr. Body ' r ' l t r na man Junkn) Closest Maj. Wtr. Body Permit Officer's Printed Name Signature J A 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 400 Commerce Ave Morehead City, NC 28557 252-808-2808/ 1-888ARCOAST 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) http://portal.ncdenr.org/web/cm/dcm-home 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) Revised 7/06/17 08/20/2018 09:25 9103251500 SKUBINNA HOME MEDICA PAGE 01/03 PO BOX 252 SWANSBORO, NC 28584 PHONE: 910-325-1300 . . FAX: 910-325-1 500 ical To:Liar\ From: S k-A�� Haw x, M ed.i r a(. Fax: 2, ?. 14 - �- Pages: 3 Re,. Date: � . ZO . DOB: cc: kvnx — 2,ASZ-34),,-11b I Special Confidentiality Notice The documents accompanying this transmission contain health infolmation that Is legally privileged. This Infonmatlon Is intended only for the use of the individual or entity named above. The authof¢ed recipient of this Information is prohibited from disclosing this information to gny other party unless required to do so by law or regulation and i5 required to destroy the information after Its slated need had been fulfilled. If you are not tho intended raclplent, you are hereby notfned that any dlsdosure, copying, distribution, or action taken In rellance on the contents of these documents Is strictly prohibited_ If you have received this information In error, please notify the sender immediately and arrange forthe rotum or destruction of those documents. y 08/20/2018 09:25 9103251500 SKUBINNA HOME MEDICA PAGE 02/03 September 09, 2017 Re: Letter of No Objection Neil and Donna Skubinna, of 237 Wild Oak Dr., Swansboro, N.C. 28582, are requesting a CAMA Permit to add a floating dock for a jet ski, to the existing permanent dock. This would be placed on the South facing side of the existing dock, We are requesting permission of both adjacent neighbors. Your signature indicates to CAMA that you have "no objection" to the above said proposal. lNebland Donna Skubinna 09-�D9= Signature Date *A�k+F �R eR a��k �k*x:►Ai �krt*iM***w�*YSM+t �e �t��****�fk�Ne�*Now��**��***ffi**wMetww �kx�t*M�MMr***#WfM�M��** 235 Wild Oak Dr. �li911 MAI WATZ Z. ; 7"� 239 Wild Oak Dr. Dan a Signature ick Date 08/20/2018 09:25 9103251500 SKUBINNA HOME MEDICA PAGE 03/03 m Q'I 08/06/2018 08:54 9103251500 SKUBI14NA Hoi E ►•►EDICA PAGE 01/ 02 RECEIVED September 09, 2017 ,,� �,, Re: Letter of No Objection Illy, . DCM WILMINGTON, NC - - - -- _ Neil and Donna Skubinna, of 237 Wild Oak Dr., Swansboro, N.C. 28582, are requesting a CAMA Permit to add a floating dock for a jet ski, to the existing permanent dock. This would be placed on the South facing side of the existing dock. We are requesting permission of both adjacent neighbors. Your signature indicates to CAMA that you have "no objection" to the above said proposal. Neil and Donna Skubinna n Signature Date 235 Wild Oak Dr. Chris ' d Marge Walenta v --11r- t e �--q7 Sign W V , — `FY/ Z�-1 �"�. 239 Wild Oak Dr. Dan a ick Signature G I Date I 08/06/2018 08:54 9103251500 SKUBINNA HOME MEDICA PAGE 02/02 u DECEIVED AUG 0 c 2018 ``:: AUG 0 6 2013 Uf `D - DCM WILMINGTON, NC 7u ro C7 �' � o �r 0 Ur 08/06/2018 08:54 9103251500 SKUBINNA HOME MEDICA PAGE 02/02 �r 0 RECEIVED AUG 0 6 2018 1 AUG 0 6 2018 DCM WILMINGTON, NC rsy: - _ RECEIVED AUG 10 2018 DCM-MHD CITY 08/06/2018 08:54 9103251500 September 09, 2017 Re: Letter of No Objection SKUBINNA HOME MEDICA PAGE 01/02 RECEIVED,;:: i a, AUG 0 6 2011� AUG 0 6 2016 DCM WILMINGTON, NC Neil and Donna Skubinna, of 237 Wild Oak Dr., Swansboro, N.C. 28582, are requesting a CANAA Permit to add a floating dock for a jet ski, to the existing permanent dock. This would be placed on the South facing side of the existing dock. We are requesting permission of both adjacent neighbors. Your signature indicates to CAMA that you have "no objection" to the above said proposal. Neil and Donna Skubinna Signature Date i�W•�k!YiM�k �h•1k �YMIk�1k+R �k fk �k �RR�**it'k �k fkKfk A(��#MeMf�#M�1R 1k�**+Itf�t#�*fk �tM*#�M•��*nl at*7k��**�+le fR**�#�*M+M �k fk 235 Wild Oak Dr. Chris d Marge Walenta v l ��te Sign 239 Wild Oak Dr. Dana ick Signature Date