HomeMy WebLinkAboutEly, Joseph (1)g1CAMA / ❑ DREDGE & FILL No. 74954
-+ A B 6E—D D
GENERAL PERMIT Previous permit#
New ❑Modification ❑Complete Reissue El 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 , �(_
SaRules attached. (-
Applicant Name Project Location: County °
Address
City StateZIP�
Phone # O �' E-Mail
Authorized Agent i , I u ,or,
Affected D CW JJ EW ! PTA L{] ES ❑ PTS
AEC(s): 00EA ❑HHF ❑IH ❑UBA El NIA
❑ PWS:
ORW: yes ,dno PNA yes / no
Type of Project/ Activity
Pier
Fixe
Float
Fing
Groi
Bulk
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Boat
Boat
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NOMEEME MENEM IN In
A building permit may be required by: See note on back regarding River Basin rules.
( Note Local Planning Jurisdiction)
Notes/ Special Conditions
)f_fr
Agent or Applicant Printed Name
i-
Signitpre,. *Please read compliance statement on back of permit"
i
Application Fee(s) Check #
PermltOffcers Phinte� Name
Signature
71��
Issuing Date 'Expiration Da et
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: -JoPdl C . ACl°Y
Mailing Address: Z.32 Z2rt1(E Z.AWVlA.) G
&)go SEaa) fJC 2 1?-560
Phone Number: (2SZ) I 89
Email Address: a ue. el�` 1) Gd gwtai 1. coat
I certify that I have authorized 130el9l QgI40 A) CorJSg4itr-yiaN, -TaC, ,
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: i1.0A
at my property located at 2S2 NUkC Lpli3DWC ,
in C,eAYCiJ County.
l 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:
O,<-
' 6 Signature
TOS600 C, 'Ck�
Print or Type Na4he
owliep"
Title
10 l oil
Date
This certification is valid through 7l 10 / O O
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
1 hereby certify that I own property adjacent to Joseph Ely g
(Name of Property Owner)
property located at 232 Drake Landino. Neuse Harbour
on _ , in
(Waterbody)
N.C.
The applicant has described to me, as shown below, the development proposed at the above
location.
x I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
Ombilduaf p cposhtg develofMr►entmust HI 1a dsacrilipffon below or attach a sfte draw/nW
Please see drawing.
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 IN setback requirement.
4 1 do not wish to waive the 15' setback requirement.
Pr int or Type Nadia 6
-'Vy�Pdntor
232 Drake Landina
,1- *2 1
Mailing Address
Mailing
New Bem, NC 28560
A119
Cdyl3tate/Zlp
aty&u
252631-4189
sr,
Telephone Numberlemadaddress
Telepht
7-8-19
Date
(Revised Aug. 2014)
'Valid for one calendar year after signature`
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Joseph Ely 's
(Name of Property Owner)
property located at 232 Drake Landing Neuse Harbour
on in
(Waterbody)
N.C.
The applicant has described to me, as shown below, the development proposed at the above
IOCT.,,
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
#ndhd&W proposing development must flit in description below or attach a a(fe drawing)
Please see drawing.
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.
Information) (Adjacent Property Owner InformaM%") /
Mailing Address Malvingg Address
New Bem, NC 28560 ,JfA BERG, /JG 285i+0
City/Sta1a/Z1p C 'Stata(z
a 252-631-4189 0 M (a310 VmeuYatt m�� 9
Telephone Number/email address Telephone Number/small address
7-8-19 'I (i O I -La I `i
Date Date*
(Revised Aug. 2014)
'Valid for one calendar year after signature*
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