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Home My WebLink About73809A_Simpson, J. David & Leah_20190812-CAMA / - DREDGE & FILL GENERAL PERMIT XNew ❑Modification ❑Complete Reissue El Partial Reissue No. 73809 ✓ B C D Previous permit # 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 b4 Rules attached. Applicant Name Si ' ri to 30h Project Location: County(2, mote a Address I Smr,1 1�r Street Address/ State Road/ Lot #(s) City L 1; ZaIOC�h C��,, State �_ ZIP 12d Phone # (Z5 Z) -20Z "i!o II E-Mail �' +�'�dCF�Subdivision �1�i �^G C S Authorized Agent 1 City ',.l rt dh'C1,Cy1 ZIP ElCW MEW ® PTA ❑ ES ❑ PTS Phone # ( ) -- River Basin o Affected ❑ OEA AEC(s): ❑ HHF ❑ IH ❑ USA ❑ N/A Adj. Wtr. Body nat an unkn El PWS: ORW: yes /.no PNA yes / Closest Maj. Wtr. Body wy lair, ► ( [ SCfc d in • NONE ■■■■■N■■■■■■■■■■��1�■■■■■■!■■■■[�■■■■■■■ ■■■■■■■■■■®■■■:�ii■■■■mod■■■■■L�■■■■■■■■■ ■■■■■■■■■■■■■■■►�■■■■1�■■■■h�F.1i■■■■■■■■ ■�■■■■■■■■■■■■■I�■■■■Ilia■■■'■■ii�■■■■■■■■■ M. • �i■■■■e■■�■C�■�■■�■■■■■■■■i■■■■■ ■�■■■■■■■■■■ ■■■■ ■■■■■■■■■■■ ■■■■ % ) rF-h 1 <:::t r C/C Agent or Ap' icant Printed Name Signature ** ease read comp lance statement on back of permit ** 4: " -,/. 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 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 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/ I-888-4RCOAST 252-946-6481 Fax: 252-247-3 3 30 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 NC Division of Coastal Mgt. Habitat Impact Computer Sheet Applicant: --3 . �1 v, A d Leu �� 5 imgw-, Permit #: Date: Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement found in your Habitat code sheet. Habitat Name DISTURB TYPE Choose One TOTAL Sq. Ft. (Applied for. Disturbance total includes any anticipated restoration or temp impacts) FINAL Sq. Ft. (Anticipated final disturbance. Excludes any restoration and/or temp amount TOTAL Feet (Applied for. Disturbance total includes any anticipated restoration or tempimpacts) FINAL Feet (Anticipated final disturbance. Excludes any restoration and/or temp impact amount i I Dredge ❑ Fill ❑ Both ❑ Other � —impact (� � 1 �� yt- 4 Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ 252-808-2808 :: 1-888-4RCOAST :: www.nccoastalmanagement.net revised: 02/03/10 AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: Mailing Address: _ �v Sa l_ L 7)/2- Phone Number: Email Address: LA I certify that I have authorized Agent / Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: at my property located at in ��M��v County. I 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: M Print or Type Name Title �j Date This certification is valid through I / DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERED Name of Property Owner: J , � I �7 �� Address of Property: Agent's Name #: V/h-t, ry �c� , C4M73> Div ,� Z -71 Z 1 (Lot or Str f-iCV- M`6AL_L Agent's phone #: 'Z5Z - T31 - 3273 Street or Road, City & County) Mailing Address: 163 SL,,AS Zlil , .Ak- Z75 Z i I hereby certify that I own property adjacent to the above referenced property. The individual applying for this permit has described to me as shown on the attached drawing the development they are proposing. A description or drawing, with dimensions, must be provided with this ..: I have no objections to this proposal. I have objections to this proposal. if you have objections to what is being proposed, you must notify the Division of Coastal Management (DCM) in writing within 10 days of receipt of this notice. Correspondence should be mailed to 401 S. Griffin St., Ste 300, Elizabeth City, NC, 27909. DCM representatives can also be contacted at (252) 264- 3901. No response is considered the same as no objection if you have been notified by Certified Mail. 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 sign the appropriate blank below.) I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Prope Ow er Information) Sig ature 1��1'4,j��, �� L Print or Type Name 16)(2 SM,42L .wiz Mailing Address C I L� XC City/StatelZip ZSZ - Zoz - `tZ i --PAVE . S1r>>Sv.� 0 Telephone Number/Email Address Date ''Valid for one calendar year after signature* ( p fo�mation) Signature Print or Type Name <--1S� Ir-20X P-0,L Loh ( �vl Mailing Address City/State/Zip (avr� gaS -/09S Telephone Number / Email Address s j0)9 Date Revised 2017 _� 11 J ,pE7il� 44*1 AV AJ Ono 61. CAMDEN COUNTY Camden County, NC Property Report I Monday, July 22, 2019 n 1 102 106 PIN 028943012637590000 911 Address 104 VALLEY RD Owner Name 1 SIMPSON J. DAVID Owner Name 2 LEAH SIMPSON Owner Address 100 SMALL DRIVE City St Zip ELIZABETH CITY NC 27909 Building Value $165,682.00 Land Value $70,500.00 Assessed Value $237,961.00 Deeded Acres 0.3440 Deed Book 259 Deed Page 828 Plat Book 2 Plat Page 106 Zone Rural Residential Township COURTHOUSE Drainage District Shiloh Tax Maps are not to be used to establish boundaries and/or size. Use for such is soley the reponsibility of the user. DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERED Name of Property Owner: Address of Property: (Lot or Street d, Street or Road, City & County) Agent's Name #: I� / A c-LA L L Mailing Address: I U3 s 1-,e--. Agent's phone #: Z5L _ 331 — 3 Z-7 � (At-,zJz44. A% Z7'7zt I hereby certify that I own property adjacent to the above referenced property. The individual applying for this permit has described to me as shown on the attached drawing_the development they are proposing. A description or drawing, with dimensions, must be provided with Phis letter. I have no objections to this proposal. I have objections to this proposal. if you have objections to what is being proposed, you must notify the Division of Coastal Management (DCM) in writing within 10 days of receipt of this notice. Correspondence should be mailed to 401 S. Griffin St., Ste 300, Elizabeth City, NC, 27909. DCM representatives can also be contacted at (252) 264- 3901. No response is considered the same as no objection if you have been notified by Certified Mail. 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 sign the appropriate blank below.) do wish to waive the 15' setback requirement. x Q >( I do not wish to waive the 15' setback requirement. (Property Owner Information) 'TfViD )7M?s Print or Type Name Mailing Address (A ent Prope Owner Information) Signature * ll ! ) 71o,& / J Print or Type Name g5o j�74 Mailing Address City/State/Zip City/State/Zip Z�L - ZZ,z.- Telephon Number/Email Address Telephone Number/Email Address � Z- ZD.- oho/ Date Date *Valid for one calendar year after signature* Revised 2017 {-nk/�a 1dhn, ILe�ffn @�7metd - -o' I CAMDEN COUNTY r r., enNrgy. nern _. Camden County, NC Property Report Monday, July 22, 2019 102 106 is PIN 028943012637590000 911 Address 104 VALLEY RD Owner Name 1 SIMPSON 1. DAVID Owner Name 2 LEAH SIMPSON Owner Address 100 SMALL DRIVE City St Zip ELIZABETH CITY NC 27909 Building Value $165,682.00 Land Value $70,500.00 Assessed Value $237,961.00 Deeded Acres 0.3440 Deed Book 259 Deed Page 828 Plat Book 2 Plat Page 106 Zone Rural Residential Township COURTHOUSE Drainage District Shiloh Tax Maps are not to be used to establish boundaries and/or size. Use for such is soley the reponsibility of the user. L -Z-1 104J V'�J(e4 7j 0arV-,d'r, Mugu at V, Z-U IV - - - ��h SilhQ3t)A 0 0.0075 0.015 0.03 mi Streets Addresses Streets too SM4<< tif, 0 0.0125 0.025 0.05 km Parcels �1� to b2�h Ci -y 6ommurity Garmn, (o) OpenStreetMap co tl ib« u s, a d he GlS use Main Roads County Boundary a7g0� Source: Esr4 DigitslGlobe,GeoEye, EarthstarGeographi s,,CNES/AirbusDS, 13 N, USDA, USGS, AeioGRID, IGandtheGIS User CormuY 2019 1 .I qx t. �i Ilk AV 144 ° 104rValley Rd J :r r. 3 h l oo rt