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Home My WebLink About73895A_Clark, Christina_20191021il All / ❑ DREDGE & FILL NERAL PERMIT ew ❑Modification El Complete Reissue El Partial Reissue No. 73 895 a� 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 I SA NCAC � F Rules attached. Applicant Name C_l r ; s -f 1 A C r a. V- Project Location: County Pe u Address o/.' da y k'.1 c' / / Street Address/ State Road/ Lot #(s) d / $ 3 -R City & State "C ZIP 2-27y y // Y H. A J' i�.� a / Phone # 113 -. 3 �3'ZE-Mail <- c-I cAc- k' 3%6 ® y*iek,/'Subdivision r / Authorized Agent J e • d c LC" City /-% Q f �� ci ZIP Affected ElCW SEW PTA �1ES 7�PTS Phone # ( ) nnZ7 River Basin rti's I ElOEA AEC(s): ❑ HHF ElIH ❑ UBA El WA Adj. Wtr. Body 5---. ,. 4 4,4 nat an ' unkn ❑ PWS: \ I d Closest Maj. Wtr. Body u'J ORW: yes / no PNA yes /not . - ,� ■MEMEM � iOEM■■_ ISAME MEMO�MEIN■�■�ME - - ■■�i!!�■�i■iiiii�riiiii�iliii■ii■'�G■iiliiliiii ■■v■■■■■►.!■■■■■■■■■■■■ram■■■■■■■��v■■■■■ ■■■■■■�I�r�■��■�!�1■1■■!lllr!!�1■Ii1o%�i■■71L7 ■■\■■H�I�Iv■i'�i■■■il■ill■i11f1iJilfiil■!li(YiiiL��/■■9C1l�11:� ONE M. ■■■■■■■■m ■■■■■■®■■■■ NMI o m■■�lmn MUM • ■ME■■■■■► il- --��------1.........�........ . ■■■■■■N■■■■■■■■■■■■ ■■M ■■■■■■ . .. .. I, ■ .. M. ,;� /� i/g/i/C—K Agent or Applicant Printed Name Signature Please read compliance statement on back of permit* z_ Application Fee(s) Check # �r- Per it Officer's Printed Name ice---, Sign re 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 complywith 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 AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: 1-1 r i S%, ►j Mailing Address: Phone Number: Email Address: I certify that I have authorized CL I c rn Agent / Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: JZ,led, e,, h--�(�� `b X qD at my property located at I I `i I -ID I , c� in County. 1 furthermore certify that 1 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: Signature Print or Type Name t .c) Y) e r Title !/ I (0�' /� Date This certification is valid through I I 6av", r�0 UJIM11 ja o / 0-,k-Kol, ti,7-110 L� k-- ADJACENT RIPARIAN PROPERTY" OWNER STATEMENT I hereby certify that I own property adjacent to 1►' -`�`i �'1Q l a s (Nam of Pr erty Owner)r) a property located at �4v 1. da kiJ I -- (Add ess, Lot Block, Road etc.) on �� Uel�lCcJ'�E�v1G� ,in_Iri' rC _, 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) A I be mQ.v I-e- I W� G A- A./ D I ER 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 do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (P perty Owner Infwm yg Print or Tye Name J / .�{1 M' n9 T' ff►'d lei '- of %q S�V- City/State2-+ -- ? 375-30 TelephoA Num er/email address �� Date `Valid for one calendar year after signature* (Adjacent Property Owner nformation) Signature �r`�J%Q iC Zr G, Pnnt or Type Name Mailing Address N V'-YvT�g-z' e, -9 City/State2ip C� 1-2- L - 76 5 3 Telephone Number/email address Date* (Revised Aug. 2014) l7 I hereby certify that I own property adjacent to i I I\ It property located at on (Waterbody) (City/Town and/or County) I 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) A W&'V-s 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 do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (P p rty Owner Infor ation) S' ff tune 1r-I5'+, r_lc C Print r Ty e ryar�e )I "da n-0 �I M ' inrA drTs� C/Statelz* (-� Teleph9peiNumper/email address Date *Valid for one calendar year after signature* Property Owner Inf9rmation) Print or TypwName Mailing Address c4lc �rti vv City/state/Zip XA! -2 i Telephone Number/ email address Date* (Revised Aug. 2014) -Sz) kt-/ V-N0 l4% k � v k'n-)� )-- L. ,ws77�Z� BU,+! A l `�`3+� �«arar8 �RR'+:.wio�ie.1.•::+.a�4„�1,�•„,,�„�..JII.......#►..is,......s.e��...u..�+�.e.._. ,.. _... s pax # c s „ w y, n p „ d t r + M n r p�aID w �` 1 44 s �, f, :..4x. . r"V'�f • .l '.y. FIN '.r• ° ' drV w ..u",e Ir. v. " ••y,;,` +. �, f 14°. * :� a .. N,M+/ +` � � • T p , A ai s w , ✓ I 4 , t.., � iJ" r "` ... xl' ".yx �� r � �r. R,�R y � r Y t s a " , , Y AX IF rt ,..... „,, ,t ,� ♦. ♦ � � �F ��„r � +.'�' +dam �b�'y� «� - ` � « f° _ �.,� n� Cr x i, dam. IL +y« O�' +& r� ;;, � , � 9�d ,;WY,^'h vt�, a,+W ' a}: 4` � ✓yy. key «".W �d:.N " vy C,�, x IR x , n �„TU.i ,,°r .7v :9;z,� �, .., a ,�a�• ^' �F ''1F4 t i +d w W v� J r r r 2019-10-21 2019-10-21 NC Division of Coastal Mgt. Habitat Impact Computer Sheet Applicant: G L-A K /l. Date: / o /•2 r'/ 1 Permit #: 73 F 75 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 impact amount) TOTAL Feet (Applied for. Disturbance total includes any anticipated restoration or temp impacts FINAL Feet (Anticipated final disturbance. Excludes any restoration and/or temp impact amount l�ta��c Dredge ❑ Fill ❑ Both ❑ Other �— I 4fL Dredge ❑ Fill ❑ Both ❑ Other E " Y �� Dredge ❑ Fill 4 Both ❑ Other ❑ w a a Dredge ❑ Fill Both ❑ Other ❑ Dredge ❑ Fill ®. Both ❑ Other ❑ t( l 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.nccoastalmana ment.net revised: 02,103,10