HomeMy WebLinkAbout75502A_Forever Moore, LLC_20200113f J4- L_—
CAMA / '— DREDGE & FILL
GENERAL PERMIT
IXNew ❑Modification ❑Complete Reissue El Partial Reissue
No. 75502
3 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 10 1 d Gy
[Z Rules attached.
Applicant Name �O'-e-ve-✓ k
Address 39,ZQ (y OC eG n Qf . No . a08
City State FL ZIP 3 3 `./oLl
Phone # (2.5 L) , uy ' 37301 E-Mail Cc, m r I Q5 t a' 1. rom
Authorized Agent a K E _De y ckome ny
Affected w CW ® EW ® PTA ❑ ES ❑ PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
ORW: yes /0 PNA yes /<o
Project Location: County ►"a re—
Street Address/ State Road/ Lot #(s)
Subdivision
City h-0 L�'-e U,l 4 yI1S ZIP all 1qP
Phone # ( ) — River Basin f_�1"d aiC n
Adj. Wtr. Body ,) �L�n Co-mi, (nat)/mom)
Closest Maj. Wtr. Body ( be mar � e, Sou n d
MEN MEN
MEN
NNW
aid
iin length
number
MEMEE
avg distance offshore
max distance offshore
cubic yards
ramp
OEM
.-
ireline Length
MEN
V: not sure yes
ratorium: n/2 yes no
/ •
A
Cu4tN'C'
■■■■■■■■R.'.�?,�ii�■■i■■■■■■■■■■■■■■■■■■■�:■■■ice
■�■■■■■■■■■���■■■■�■���/;%%ice%�%��■■■■■
■�■■G■i�:��:
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Agent or Ap cant Printed Name
Signature Please readcompliance statement on back of permit
$ C� w
Application Fee(s) Check #
r� Cf(�n_TY eF
Permi� rimed Name
Signature
/ij/o1C� '5,I j /aZ0
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 71 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 - (Serves: Beaufort, Bertie, Hertford, Hyde,
North of New River Inlet- and Pamlico Tyrrell and Washington Counties)
Counties)
Elizabeth City District Wilmington District
401 S. Griffin St. 127 Cardinal Drive Ext.
Ste. 300 Wilmington, NC 28405-3845
Elizabeth City, NC 27909 910-796-7215
252-264-3901 Fax:910-395-3964
Fax: 252-264-3723 (Serves: Brunswick, New Hanover,
(Serves: Camden, Chowan, Currituck, Onslow - South of New River Inlet -
Dare, Gates, Pasquotank and Perquimans and Pender Counties)
Counties)
http://portal.ncdenr.org/web/cm/dcm-home
Revised 7/06/ 17
It
AGENT AUTHORIZATION FORM FOR PERMIT APPLICATIONS
Name of Property Owner Applying for Permit
Mailing address:
A
i5jct)a r^G( A�DdY'e-
39olo /), DcPcr�-L 17r1v� 0?08
SlG n� 33 4zd
Telephone Number: c2S-a - ,262 -333�'
I certify that I have authorized jrg a., (agent/contractor),
to act on my behalf, for the purpose of applying and obtaining all CAMA permits
necessary for the proposed development of d (,,� Ikwuy � d oc-k, —,ID <'wn,�i,/
at my property located at
This certification is valid through
(Property Owner Information)
Sig ature(
l-!dwuf-A- MOlX
Print or Type Name
C-A1 ry C-
Title, co. owner or trustee for property
,-�tv / q
Date
a5a -ova-3339
Telephone Number
4?0-rnrr- Cont_
mail Address
-� #1e
ea A,,- /
(date).
Complete items 1, 2, and 3.
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.
Article Addressed to:
H-Vitjx ,
(o D
Ny
9590 9402 4940 9063 8612 19
—„ — (Transfer from service label)
7019 0160 0000 7951 6387
A. Signature �
" �f ' hl ", / 41-1 [3 Agent
X r> i ❑Addresser
B. Received by (Printed Name) C. Date of Deliver)
D. Is delivery address different from item 11 ❑ Yes
If YES, enter delivery address below: p No
3. Service Type
❑ Priority Mail Expresso
❑ Adult Signature
❑ Reglstered MailT"
❑ Adult Signature Restricted Delivery
❑ Registered Mail Restrict,
❑ Certified MailO
Delivery
El Certified Mail. Restricted Delivery
❑ Return Receipt for
❑ Collect on Delivery
Merchandise
Collect on Delivery Restricted Delivery
El Signature ConfirmationT'
U Insured Mal
❑ Signature Confirmation
Mail Restricted Delivery
Restricted Delivery
00)
:)C r:- gR11 _li.Iv oniF vcni 7FZn_r»_nnn_onrq
nnmpctic Ratiirn Rprpini
USP4 TMCKING#. .
First -Class Mail
Postage & Fees Paid
USPS
Permit No. G-10
9590 9402 4940 9063 8612 19
United States
Aai Service
• Sender: Please print your name, address,
6-�- e:- I t YY"P'•.'f
P o '� CK 11S
iiM,11illili 11HIIilI'l'klIIi
■ Complete items 1, 2, and-3.
■ Print your name and address Oh 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.
I. Article Addressed to:
9590 9402 4940 9063 8612 33
—a irn label)
7019 0160 0000 7951 6394
A.
B. _R#eiveo by
❑ Agent
C. Date of Dellvery
Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: 0 No
3. Service Type
❑ Priority Mail Express®
❑ Adult Signature
❑ Registered Mail*M
❑ Adult Signature Restricted Delivery
❑ Reeggistered Mail Restricts
❑ Certified Mall®
Deivery
❑ Certified Mail Restricted Delivery
❑ Return Receipt for
❑ Collect on Delivery
Merchandise
Ol
❑ Collect on Delivery Restricted Delivery
❑ Signature Confirmation*"
^ + .,fail
❑ Signature Confirmation
flail Restricted Delivery
Restricted Delivery
0)
USPS TRACKING #
First -Class Mail
Postage & Fees Paid
USPS
Permit No. G-10
9590 9402 4140 `1063 8612 33
United States
Postal Service
• Sender: Please print your name, address, and ZIP+4® in this box*
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This map is prepared
from data used for the
inventory of the real
property for tax
purposes. Primary
information sources such
as recorded deeds, plats,
wills, and other primary
public records should be
consulted for verification
of the information
112 Ridge LN Owners: Forever Moore Llc -Primary
Kill Devil Hills NC, 27948 Owner
Parcel: 008096001
Pin: 988305184906 Building Value: $62,800
3� 2 0 N . Ocea^ �'r_ Naha Land Value: $67,500
,5� IFL Misc Value: $0
5`� 3�A0Total Value: $130,300
�
Tax District: Kill Devil Hills Out
Subdivision: Subdivision - None
Lot BLK-Sec: Lot: Lot 1 Blk: Sec:
Property Use: Residential
Building Type: Traditional
Year Built: 2018
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This map is prepared
from data used for the
inventory of the real
property for tax
purposes. Primary
information sources such
as recorded deeds, plats.
wills, and other primary
public records should be
consulted for verification
of the information
112 Ridge LN
Kill Devil Hills NC, 27948
Parcel: 008096001
Pin: 988305184906
Owners: Forever Moore Llc -Primary
Owner
Building Value: $62,800
Land Value: $67,500
Misc Value: $0
Total Value: $130,300
Tax District: Kill Devil Hills Out �•
Subdivision: Subdivision - None
Lot BLK-Sec: Lot: Lot 1 Blk: Sec:
Property Use: Residential
Building Type: Traditional
Year Built: 2018
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