HomeMy WebLinkAbout75505A_Hepburn, David & Teresa_20200123V 9 v-
-. . CAMA / ;DREDGE & FILL No. 75505 CN B C D
GENERAL PERMIT Previous permit#
iXNew -'Modification El Complete Reissue ❑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
0 Rules attached.
Applicant Name lin Q , d d _ff"5G j e J0 kA r ��
Address IIU1J FrUnSky-e,,pt
City ��er (�orei State_( ZIP 279 c/`l
Phone # 95�) 36 Z 1(04 E-Mail
Authorized Agent ir,�3 k
Affected ❑ CW Z EW ® PTA Z ES ® PITS
AEC(s): ElOEA ❑ HHF El IH ❑ USA ❑ N/A
❑ PWS:
ORW: yes / ,no PNA yes / no)
Project Location: County
Street Address/ State Road/ Lot#(s)
1 `4
I I i 1I ,nj
Subdivision
city i-�r Ifurd ZIP �27cyq
Phone # ( — ) River Basin VC, SG t, n1'0 A k
Adj. Wtr. Body / F'r u u rn c b, I let semi (at man /unkn)
Closest Maj. Wtr. Body I_l l :„ .' ( r /e '5ok., r_(t
Type of Project/ Activity i i r W-
_- r" el d U r wl (Scale: I~'
Pier
x
Fixes
Float
Fingc
Groi
Bulk
Basir
Boat
Boat
Beac
Oth(
Shor
SAV
Mor
Phot
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number
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avg distance offshore— C
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max distance offshore 6
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cubic yards
ramp
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tii���rtlo3d�C.Zii:�'���ca�yr��►i.�iii�:�Eay(a,��l�+.'t�:"
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-.line Length X 06
not sure •
ENOMEE1r1■�■■
yes
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MENEEMEMW
no
EMENEWE
no
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EMEREMEMENEMENEEMEENNEEM
A building permit may be required by: er G u rm. a n S a( (x i ❑ See note on back regarding River Basin rules.
( Note Local Planning jurisdiction) •
Notes/ Special Conditions RnCr k 5 k c' II
i�,,►�hv Wk4A_ _
Agent or Applicant Prin�tee { amee
Q� V�
Signature * ease read compliance statement on back of permit
sCoo. -
Application Fee(s) Check #
A (� }
PermitOffl 7'A
nted Name
.
Signature jV
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/ 1-888-4RCOAST 252-946-6481
Fax: 252-247-33 30 Fax: 252-948-0478
(Serves: Carteret, Craven, Onslow - (Serves: Beaufort, Bertie, Hertford, Hyde,
North of New River Inlet- and Pamlico Tyrrell and Washington Counties)
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)
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
N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date o 2 O
Name of Property Owner Applying for Permit:
V b u2tJ
Mailing Address:
HjaZ-j -JP70 �� , c�c 2--7
I certify that I have authorized (agent) �O �S�`i VV ore to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) fR>iAL_ V.
at (my property located at) ((Q Q �ko �� �T -T2�Fa��1744+4-
This certification is valid thru (date)
Property Owner,S"ignature Date
CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
c
Name of Property Owner: u I T�Cf S�—
Address of Property: w 6Fr.�- ti+ S�— qer1 44 �Jc 2 7 9 I I
(Lot or Street #, Street or Road, City & County)
Agent's Name #: &oII 6/ W Mailing Address: o7 Cy
Agent's phone #: d )IJC--
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 letter.
1 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 1367 US
17 South, 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, 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
-Davl� � Teresrn—
Print or Type N me
U b N5-�-
Mailing Address
N C- `f Y
City/State/Zip
Telephone umb
1�720
Zo
Date
(Adjacent Property Owner Information)
Sig ure
X07M e- -5 L?
Print or Type Name
Mailing Address A n
City/State/Zip
aP-t - �,ez -lea iY-2
Telephone Number -
Date
Revised 611812012
,�)Yjs 1 Ql , r0'd1l7' �01
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CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: Da o� ,e►'\
Address of Property: Fca"+ 5�rw + � e (+41 N L A7 �1 Y
(Lot or}}Street #, Street or Road, City & County)
Agent's Name #: Mailing Address: D PrQSS
Agent's phone #: oS,�, 33 7 500
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 letter.
C� 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 1367 US
17 South, 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, 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
�yicl 7e-re5a P60�►�
Print or Type Name
Mailing Address
City/State2ip
Telephone um7,,�uo
�9
Date
L(A,* ent Property Owner formation)
I--
,
Signatu
G
Prin orp Name
Mailing Address
City/State/Zip
Telephone Number
i /Q o1a 0 ,�2 o
Date
Revised 611812012
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Address Points perquimans _nc_ lot perquimans_nc_ acres
perquimans_nc_misc perquimans_nc_easement ® Imagery2016
perquimans_nc_dims
1-564
0 0 0.01 0.01 mi
0 0.01 0.01 0.02 km
Esn. HERE, Oanmr, fci OpenStreetMap conttib,ltors, and the G;S
community
For tax purposes only. Not a legal document or survey. Perquimans nor State of NC assume any liability resulting from use of this I I
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