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Home My WebLink About75672A_Carawan, Betty M_20191112A] CAMA / X DREDGE & FILL NO. 75672 Q GENERAL PERMIT Previous permit# ONew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued f (�L L ,,. B C D As authorized by the State of North Carolina, Department of Environmental Quality ry` and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC X Rules attached. Applicant Name �Q r"� . ��a (G WG Y` Address I!] (o d n eg �&� J Ed - Ci f7a.r V4 State W_ ZIP (o Phone # E-Mail Authorized Agent 5� wo . ; �) a vP:n oor Affected ❑ CW ❑ EW ❑ PTA ki ES X PTS AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A ❑ PWS: ORW: yes /;!no PNA yes / `° ) Project Location: County C � n Street Address/ State Road/ Lot #(s) [p4 27 1 U � lN,1:611 -C.ch Vd Subdivision N, k cin City C dentt�n ZIP Phone # (— ) River Basin I (S f u 0G 0 C Adj. Wtr. BodSOu,d Hari/man /unkn) Closest Maj. Wtr. Body bP W"' /P 57o12 ncy • ■■ice■■l',Zi■■■■i�'�■lq■■■■■ ■■A■■■■w�l No r�i1G�■rRi■i■Cd■■■■■Itl`I��■■■�!"■l#I�■�■■■■ON ■i ii/.ir■■■■if■iii■It1■'ij■!!■iRi1Ml1111■i■ii00 ■■1■�■■■■■■■■t■�U■!�Itl■ �I E'i■�ili�ll■■■�■■■■■■ ■■■■■■■■�■■■■■fit■■■�1■ ■■I r■■i■■[�■■®■■■■■■ ■■■■■■■■■■■■■■■�■1■■L■�.� ��!■■fie\■■N�■■■■■■ ■■■■■iii■■i■■■il■■i!1■�li9i■i■i�t■■�i■■ ■■i ■■■■■■■■■�■■■ ■►■I�r■ice■ID�H■■■■■■■■■■■■ M. ■■■■■■■■■■■■■■IGI■Iri■lL:■■■■■■■■�■►�■■■■i ■■■i■■■■i■n■■■1■I■■■■�il�ii■■i■ilC9iii■■■ME M. NEE MEMO Is mmommmommor, MIMME NEON ■■■■■■■■ME■■MERAIN ■■■1■■■■■�iii■■l��l■■II®■■■■■■■ MOM am • 111000F. ■MM■M1 ONE E■■-n1 EM■►liM■■IMMI■■■�O■M�� ME��■■ . . .. .. ■T. Agent or Applicant Pri_ntteed_N_a�me Signature ' Please read compliance statement on back of permit 1400 Application Fee(s) Check # Permit Office s Prioted Name Signature 11 /r ll9 3�i _z /oZ0 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 Washington District 400 Commerce Ave 943 Washington Square Mall Morehead City, NC 28557 Washington, NC 27889 252-808-2808/ 1-888-4RCOAST 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 ■ Complete items 1, 2, and 3. Also complete item 4 if Restrict6d Delivery is desired. ■ Print your'name and address on the reverse so that we can return the card to you. ■ Attach this card to the back of the mailpiece, or on the front if space permits. 1. Article Addressed to: a iafin ►a, ��a�h, VA 2. Article Number (transfer from service A. Signature ❑ Agent X 1. MIA 416,(Az Addressee B. Received by (Printed Name) C. Da of/D,eWeeA D. Is delivery address different from item 19 ❑ Yes If YES, enter delivery address below: ❑ No 3. Service Type ❑ Certified Mail ❑ Express Mail ❑ Registered ❑ Return Receipt for ❑ Insured Mail ❑ C.O.D. 4. Restricted Delivery? (Extra Fee) 7003 0500 0000 8817 5172 PC Fnrm 3R11 Fahn iary 2nn4 Domestic Return Receipt 6E UNITED STATE$•�S�F First -Class Mail Postage & Fees Paid USPS Permit No. G-10 • Sender: Please print your name, address, and ZIP+4 in this box • M . Ceh a w a,k. Kyl_'� 2d. Authorized Agent Consent Agreement I 5z /1'%• a /Z a 4 , hereby authorize Leis bto act on (Property Owner) (Authorized Agent) my behalf in obtaining CAMA permits for the location listed below. This agency authorization is limited to the specific activities described above. Property Address: r-J Property Owner's Mailing Address: 77,,l 4 � j1j,o..4s lam. � , 7ez 4 Property Owner's Signature: J, ff - Authorized Agent Signature: -Sbr_ Date: /y - 19 - ,2o /I? Form: Authorized Agent Agreement as developed by NCDCM revised 9/25/06 ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to , J1-- A/1's ( ame of Property Owner) property located at F (Address, Lot, Block, Road, etc.) on in CtowA.0 C�...�� 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. 1 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) ,�� ,� , Albe•�A-tfe— Soe,rJcQ 1, z U-, e o G o f '*VT aW , tom�� n i 1 l'o bu i d, WAIVER SECTION I understand that a pier, dock, mooring pilings, 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.) C�#L— I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Property Owner Information) Signature Print or T e Name ire +-:t b/1 • Mailing Address 7 7ey Cityate1z,,q 1SFarrW,eid .27C�2- � Telephone Number Asa - 9,:�-6-- t -qC? Date (Adjacent Property Owner Information) � Ete e Name / z Mailing Address ;� 1,3 Ail I'olu Bic City/State/Zip At a79 3 a, TelephoneNumber -Asa- 333- 6Y'-/.- Date (Revised 611812012) ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to / 2/- /�/' ' - 's ( ame of Property Owner) property located at `OS AA xo•J Aferxe-k /4Ale- 9"'3 (Address, Lot, Block, Road, etc.) on _�i%%eµ��.t�� So�� in C'AowA.,,) t �j 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) At A-Qe- -Fit 10 . is- -A'z>'o :5 k a WAIVER SECTION I understand that a pier, dock, mooring pilings, 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. (Property Owner Information) Signature J,9 7t4 Print or Type Name +4 v M. ci ro w a nl Mailing Addre s, '77�o ti'nl eco WOO- -- RC1 City/State/Zip Fct i ri e lcl . A/0- a%F2 Telephone Number 5.2- ?.:2 - i-,/17 Date (Adjacent Property Owner Information) Signature Print or Type Name /-/M7,C- 1 r tfA�" Mailing Address /.�sZS [TneliC L�oyc� City/State/Zip Tele one Number 7Sr7- Al Q 1- SQ 14 Date /o - l g- ,tor q (Revised 611812012) z J 4 r jjj P r I i y r m aF M r a r � e I � r � M u to » r ti ' �;c�- sill ]�'' Qz- 4- �hn, UJ5GS,1jl ce m-aP,1NC � ,-]VIEU�'?'J") :1\1RC n, �d �Ja?an, VNI7E ] 1, dci ! ng" G��1�, 'Est r soc -a, Esc - fla � ,, NGC�, (c) G S Usc (Community, mil, 55am n� (Q OpenStw, cc cfai ila- p cone u m s, annul *It c G05 use T coc =In]',; C cue w(n6`. P-O. Legend Untitled Map Write a description for your map. $� ..� N t .,, .� � .r` .ram `�,• 4 F`,.. J'a•'': � • 4, ..0. .�•• ` �. •.' to '♦ 105 N'xons Beach Rd t` { n a , =,' y .. t de. `+IC �'� r,. �► . 'x` I y '�` #.ski '�R x;^�c ',yii r+� i w t.A •, f '� T " * .• .'. !w . /M 10, • r Googl h I 100 ft A N ib .�_ � t;T