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Home My WebLink AboutAylward, Lee Annd CAMA / N DREDGE & FILL GENERAL PERMIT N° 78926 A B C D Previous permit # 215 New ❑Modification ❑Complete Reissue ❑prtial Reissue Date previous permit issued As authorized by the State of North Carolina, Department of Environmental Quality �- J' / CC). / and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC /7 L L Rdw attached. Applicant Name E /" l 1 / V 11, ' Project Location: County i , N �J Address " t' s �' y,�fI �\ f'� �� Street Address/ State Road/ Lot #(s) City C I r?�( Mate N ZIP Phone # ( �^)�:'-7/%fi E-Mail Subdivision Authorized Agent li '• t V 1 J An l 6 S oll City ZIP Affected LiCW SEW LPTA ❑ES ❑PTS AEC(s): ❑OEA ❑HHF LIH ❑UBA ❑WA ❑ PWS: ORW: yes / no PIMA yes Phone # ( ) j River Basin V & -P Z._f T Adj. Wtr. Body l i ' ('fA )nat rml unkn Closest Mal. Wt.. Body ( ) t a 4 L('t A. N■■■■■■■■■H®■■■■■■■■B■■■■■■■■■■ ■■■■■■■■■�■:■:■■■■■:■■:�■■�■■■■■■■■■ c'.'■■■c'■'■'..■ccC'.'c' :c■■■■::cc:c■ :�c•••■c:•••••• i::::: • a :■�:::::■ mc::c::�i�� ■■■■ ■■■■■■■N■■■■■■/OJ■1��/,7�J�i■T�� ■■■■■■■■■■■■■B■■■■ M O.■ A■■■■■■ ■■ ■ME ■■® ME M oil IN ■■■■■■ No ON wlLi. ■�►�■ 1{�i■■■■■■ ' ::� �ME c:■® OEM ■�■1I■!0..0..01. �111Ri�.. ..■�■ ■■��i1... . I�ISil1■■®■■■� c:c:cE■ ::Bc�+ �:■cc Agent or Applicant Printed Name Signature . "Please read compliance statement on back of permiit" Application Fee(s) Check # rwar PermitORicer s Printed Name /( Signs ure / ) i 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, certifythat this project is consistentwith the North Carolina Coastal Management Program. River Basin Rules Applicable To Your Project: ❑Tar - Pamlico River Basin Buffer Rules [A 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 400 Commerce Ave Morehead City, NC 28557 252-808-2808/1-888-4RCOAST Fax: 252-247-3330 (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) Washington District 943 Washington Square Mall Washington, NC 27889 252-946-6481 Fax: 252-948-0478 (Serves: Beaufort, Bertie, Hertford, Hyde, Tyrrell and Washington Counties) Wilmington District 127 Cardinal Drive Ext. Wilmington, NC 28405-3845 910-796-7215 Fax: 9 10-395-3964 (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: L e. p- l'l rt ✓; n v / via ri Mailing Address: Z�-tQ S4" (fcr I" a+-k (-Zd P n Kno) I S1 ora-S 12 Phone Number: 2 SZ 6,71 - 3 Email Address: LaYA I certify that I have authorized-DIL v ld �O Ce C) n Agen / Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: See - at my property locatedat�-'t(O n �T2r ��,, Rf in Cet' r {' 2. l-?� County. l furthermore certify that l 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: SignatI L,eQ� nn 1� f vj,?x r-� Print or Type Name (2c' �azr4,l Title l I Date This certification is valid through Z / ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to _ �C6? T-Ail) A iU lz_z_V^d s (Nam property located at 2-`f O Sti- (��.!" Pa.'{-j-� J�.� e of Property Owner) c (Address, Lot. Block Road, etc, on P K� �* n"�� , in . f i r\Q, Ky%n l I :> k0 -S N.C. (Waterbody) (City/Town and/or County) The applicant has described to me, as shown below, the development proposed at the above location. _J 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) 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.) X I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Property Owner Information) Q_aVw J l ignatur (22 r� Print or Type Name z'fo s-,(+P-r Mailing A dress. P i r�� , j� r\ o t I of In o rQ.S l \f : 2_3 l L_ Q-A (Adjacent Property Owner Information) a— I�to1 ao (Revised Aug. 2014) *Valid for one calendar year after signature* ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to lie—P. 414 llj- 's property located at (Name of Pro erty Owner) Z`f � S p• � "�Q(. PcAi-, RA (Address, Lot, Block Road etc.) on ids LA,�a. , in F l .,\Z Knoll S or E S N.C. (Waterbody) (City/Town and/or County) The applicant has described to me, as shown below, the development proposed at the above locati 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) 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. (Property Owner Information) (Adjacent Property Owner Information) ,Si vnature or TvDe Name 1 . , _ Print or rvr nuy nv�rwo NC_7-SJ12- /MN kb�// , NC__2_S>IZ address Telephone Number/email address / � r7"ZL� ate (Revised Aug. 2014) *Valid for one calendar year after signature* "x 5c "p P ci - K Tod n Ul 0 V p P p d �l � N d ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to zE ��i� rl�l�c� s Na a of Property Owner) property located at 2_44O Sr^- 1+,r PR {i1 �� (Address, Lot, Block Road etc) on pK� cs�ho{ ,in �'� ',, kho�! 5korys N.C. (Waterbody) (Cityrrown 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) Q� (L,d RECENED va 11 zon DGM-Wit) C; TY 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.) X C Lt) I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Property Owner Information) (Adjacent Property Owner Information) IIIO X0 Da Si at (re j Print or T pe Lame, ee.'� DL)e,41��e uxs(ttlor2 be-c'&� NL a`�Sla- Telephone Number/email address �Iq '�OIY-- Date" I�10(�0 (Revised Aug. 2014) Valid for one calendar year after signature* ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to (f'_Q. 41 i/t f-a �-i' uay- 1 's (Name of Pro erty Owner) property located at �j(' 0 S o. I'{'Q.(' �'a-'{'l-�rZA I (Address, Lot, Block Road f etc.) on �i<5 ca��I ,in �'i.1kc Knv1( Sao N.C. (Waterbody) (City/Town and/or County) The applicant has described to me, as shown below, the development proposed at the above locati9n. 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) RECE.(VEn ,) { h0 FEB 17 DCWMHD t<,t 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. IPronerty Owner Infnrmatinnl C (Adjacent Property Owner Information) (Revised Aug. 2014) *Valid for one calendar year after signature*