HomeMy WebLinkAbout74555D - CrisafulliCAMA / DREDGE & FILL NO. 74555 A B C h D
GENERAL PERMIT Previous permit #
XNew ❑Modification ElComplete 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 I SA NCAC C)1 j .2- 0
-� NCO
❑ Rules attached.
Applicant Name I JAV 110 CR I SA F V L , I Project Location: County /V E to A AN OV E R
Addres11s''I10(o EVr-/VTIof- BLVD
City W IUtA wW-row/ StategC-ZIP 2 941 I
Phone # (" 1 ) $( T-3 FO0 E-Mail N/,A
Street Address/ State Road/ Lot #(s) ;?- 0 Z 1
_ R-1,/ITy AVl`Nu,E
Subdivision
Authorized Agent CNASIE 15%-AtA City ZIP 2g411
Affected ❑ Cw XEW XPTA ❑ ES ❑ PTS A CwAIT Phone # (9 q-) 819 - 47 IS River Basin WA 1T£ Oft.
AEC(s): ❑ OEA ❑ HHF IH ❑ UBA ❑ N/A Adj. Wtr. Body CRf-E K pFF M1011>1_1-1' cSou�an /unkn)
❑ PWS: ZIT
ORW: ye / no PNA yes / no Closest Maj. Wtr. Body A I W W
Type of Project/ Activity C O/JST R I^ C "i N£vi r L O A-T 1.V C-7 D O c I< w IT14
IZAmp L Aqp2i-A-rr-nPtA (Scale:
oating • /L!��0■lil�i'iiiiiili�■■tom■■■■\1�■II■�1■■iIN■L%
iea Riprap length_
avg tance offshore
max disliance offshore
Basin. channel
cubic yards_
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing \
h r �! A�/DINCi
4� x to �
Shoreline Length t 9 I
SAV: not sure yes no
Moratorium: yes no
Photos: yes
Waiver Attached: yes o
1011-1
A building permit maybe required by: ,AtEW AAAiOyE R CotA,/Ty ❑ See note on back regarding River Basin rules.
( Note Local Planning jurisdiction)
Notes/ Special Conditions A Lt— C o yy m I oA/S cat 1211H . 1200 K A U. 07-9r R F F_ D lE R ^t ,
STA1t'_ L�OCAk-- 1ZrGiA�LATIoMS APrLy, VDCK-InJf, FAciL.1Ty SNAt-L NA%lr- A
LA At I M u IkA n C .2- BoATS!_ I PS 96 S v A L1- A/ i'r E At r P. o A c A i ti To E l l a r' 2
1 5' fZ I PAR I A/ Sr- T0AcK NoK-
Agent or Applicant ri^// Printed Name
Signature ** Please read compliance statement on back of permit **
200 # I4IO
Application Fee(s) Check #
I=Xc8CD TN IF— 1/4 WIDiN uF 1-0t_ wA-lc-1LP�V'Yl
I yLF-- 9- M C Cilkl RE Ar-C
Permit Officer's Printed ,Name 14f-AVi lA
Signature
12 AS 2019 IS 2020
Issuing ate Exp tion l5ate
•_. � �,r=.`k=3��T... . =tee„
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit:
Mailing Address: �� ��'•4` -)�Y rO ,
Phone Number:
Email Address:
i certify that I have authorized
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: LVIV\&)
.al0G_
at my property located at -1-6--L \ �-r-c 1 -J
in N t,,.a 1A0m—o4 c, l County.
1 furthermore certify that I 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.
Pro Owner Informati n:
Signature
�J �. Cyr' � � � �—►1 ;
Print or Type Name
Title
/ 1� / '
Date
This certification is valid through 1 I
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to bO,,A—
.k%M; I
(Name of Property Owner)
property located at �1-` ��'�'� Y Avg- -
(Address, Lot, Block, Road, etc.)
on �+��r.co•��+-� , in i\I t�l.✓ (,wae-V y , N.C.
(Waterbody) (City/Town and/or County)
T;4 applicant has described to me, as shown below, the development proposed at the above location,
VAJ-�k 1 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)
�V,ck-t,1
Ivi� tyc� i"'
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.
do not wish to waive the 15' setback requirement.
(Property Owner Information)
Signature
Print or Type Name
107,1 Y Owe,
Mailing Address
*—+\�wdf", N L-
)
City/State/Zip
vt%� _ A(- 3Vvb
Telephone Number
Date
(A 1111cent Property Owner Information)
(h
4jb�;V--c C9L &Z
Sign ure
(7G� 1
Print or Type Na
Mailing Address
City/StatelZip
5(o ^ 3-P6 -6 36
Telephone Number ,
Date
(Revised 6/18/2012)
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Vr'� Cr'� 4,-11 ' 's
� � � (Name of Property Owner)
property located at L�Z � � � �Y`• G`y
(Address, Lot, Block, Road, etc.)
on in 6--'—V Y , N.C.
(Waterbody) (City/Town and/or County)
`I The applicant has described to me, as shown below, the development proposed at the above location.
I have no objection o this proposal.
,• �_t
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must rill in description below or attach a site drawing)
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathousf., 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
�ic-•V C., (its+ j4 -�yi V
Print or Type Name
102"l Y cy�
Mailing Address
City/State2ip
n -- xcy- 3 �vy
Telephone Number
Dale
(Adjacent Prop y Owner Information)
Si nature
Print or Type Narne
Mailing Address
City/State2ip
Telephone Number
Date
0
(Revised 6/18/2012)
0
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L-OCATICDN MAF'
NOT TO SCALE
NOTES:
1. THIS PROPERTY IS LOCATED IN ZONES "AE"(14),
"X"(SHADED), & "X" ACCORDING TO THE FEDERAL
EMERGENCY MANAGEMENT AGENCY'S FLOOD INSURANCE
RATE MAP, COMMUNITY -PANEL
NUMBER 3720316800 K, DATED 8/28/2018.
2. SITE AREA = 0.61 AC.t
v�
PID: R04518-002-005-000
ALEX HARGROVE &
wife NORA HARGROVE
LOT 2017-A HARGROVE LANDINGS
BK 6042, PG 2824
M.B. 60, PG. 71
N
0
EXISTING IRON
O
MAG NAIL
•
SANITARY SEWER CLEANOUT
(9
WATER METER
m
WATER VALVE
Is
GAS VALVE
EUC o
ELECTRIC PEDESTAL
C-)
POWER POLE
— —
CENTER LINE
----
R/W LINE
— — —
ADJACENT PROPERTY LINE
CANq
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F
x
suL H� p
(APPROXIA4A
76.9,3 MEAN HIGH W�
S54'47'25'W 3i
90.97' (Total)
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I 56 � REAR SETBACK ' -,�
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1
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