HomeMy WebLinkAbout78764A_Horne, Stephen & Jennifer_20201014-o XCAMA / DREDGE & FILL ; ' + "' (`'►
GENERAL PERMIT Previous permit #_ 0 B C D
YNew Modification 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
ies attacfted. —
Applicant Name 6 �--QpV14% + TCtrtVli �W H PYyLow, Project Location: County
Address 134 5 410i V% 1 r;{ 0" �J'�-r a4- Street Addrres,,s/�S,.tate Road/ Lot #(s) j L4 0 e) W Firs. ).-
City �"l�"t{i h1; Dv% ) State VA- Z1P 2,Z2b4 rJ� Ir�t i Lo' 4P q14
Phone # (463 131 -0015 E-Mail 6kOYN,92 rvS�ubdivision � wrt q (�-- woojeo
Authorized Agent 90i4vi '+' c%vi to Eyrr aJ i rtl� t � " GitY 144k (�'eV �i %t It C,;, ZIP 2" J{ Z
Affected XCW )(EW XPTA ES PITS J Phone # ( — )--~""~^ River Basin ?" bvw-
OEA HHP IH UBA N/A AEC(s): Adj. Wtr. Body �s6U"+ VV (Wiman /Unkn)
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PWS: �✓�CI.�i' C _
OW: yes /V PNA yes / i�o Closest Maj. Wcr, Body �'� iQ GW1 GW I.L rJota
Type of Project/ Activity zq �L r�.?' Ley �1,+A I-i1-M- 31i2.kcd✓ttin��
Q1tl��► PiPa����t�t(�.C`[3a41n1 tnlf �-t�, (Scale:
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Pier (dock) Length
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Fixed Pladorm(st PZr ��1�Vii'Tj
Floating Pixtform(y)
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Grain length
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number
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Bulkheidi RgxW length
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ma distanttance offshore
max distance offshore
Basin. channel
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cubic yards
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Mat ramp
Boathouse! Boatidt
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Beach Bulldozing (
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SAY: not sure
Maratorium: era no
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yes
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Waiver Attached: ya4 (
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A building permit may be required by:�.L
See note on back regarding River Basin rules.
( Note Local Planning, Jurisdiction)
.
Notes/ Special Conditions j�r
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Signaturn Please r dcompliancestatementonbackofpermitSignature
10900.00
4rJbJq' i0! 11412.0f2a 2-i I'Lfj Z021
AppticaGtm Fee(R)
Ctxck Issuing [Satz 1 Expiration Dace
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Skew_
Mailing Address: 134 S Abingdon Street
Arlington, Virginia 22204
Phone Number: 703-731-0015
Email Address: 6 , �Y-Mi \I om
certify that I have authorized an6 S C
Agent / Contractor i�j��,j'
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: '9 jey 5 CX cj } ��JJA�j
o >v, % L`c V A1'lrA . `�t� � ►1� I CPC r � ��D n r� .A Ail -A.-
at my property located at
i n \,y e, County.
I 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:
Signature Received
Stephen M. Horne �,-� 14
Print or Type Name
oINGn DCM-EC
Title
8 / 31 / 2020
Date
This certification is valid through
■. Complete items 1, 2, and 3. «e r
■ 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:
Ave -
el 11 1R-ev11 WWS, W V q4 8
A. SlQuaUle
by
C. DAte of Deliver
D. Is delivery address diffdrent from Item V des
If YES, enter delivery address below: ` O
Received
S_?14i.�
II I'lllll IIII II i IIIIII IIII IIIII I I (I I I) I III 3. Service Type ❑ Priority Mail Express®
❑ Adult Signature 's, � tp Registered MaI1T"'
❑ Adult Signature Re+vy�ea I IF (5 Registered Mail Restrict
9590 9402 4821 9032 5388 34 Certified Mail® IV �J Retivery
urn
❑ Certified Mail Restricted Dell v ❑Return Receipt for
?. Article Number (transfer fr(
7015 3430
❑ Collect on Delivery
Merchandise
service label) ❑Collect on Delivery Restricted Delivery ❑ Signature ConfirmationT
- -- —1 ❑ Signature Confirmation
0000 2890 9087 1 Restricted Delivery Restricted Delivery
United States
Postal Service
First -Class Mail
Postage & Fees Paid
USPS
Permit No. G-10
• Sender: Please print your name, address, and ZIP+4® in this box*
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l,f $ �a,✓ �
Luc Z 793 `3
lirlll��,lllIII I till „11111111111111411111111A
9/15/2020 d ' `
USPS Tracking°
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Tracking Number: 70153430000028909087
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Complete items 1, 2, and 3.
1 Nint•your name and address on the reverse
so that we can return the card to you.
0 Attach this card to the back of the mailpiece,
or in the front if space permits.
I. Article Addressed to:
V00+*-ROUI& f7-1, a,
2 k 17 5, (6V6Ul
ve 'o' o)c z 7 qC5 O)
A. Signature
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❑ Agent
❑ Addre
D. is delivery ad.V*JlWw"* W6m item 1? ❑ Ye:
If YES, enter delivery address below: ❑ No
Sc? 1 4
DMEC
3. Service Type
❑ Priority Mail Express®
I I
IIIIII
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III
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❑ Adult Signature
❑Registered Mail*"'
❑ Adult Signature Restricted Delivery
❑ Re olstered Mall Restrict
9590 9402 4821 9032 5388 41
❑ Certified Mail®
Delivery
El Certified Mail Restricted Delivery
❑ Return Reoeipt for
❑ Collect on Delivery
Merchandise
2. Article Number ffransfer fmm servira lah,all
El Collect on Delivery Restricted Delivery
❑ Signature Confirmation*
El Signature Confirmation
7 015 3430 0000 2890
ail
9094 )ll Restricted Delivery
Restricted Delivery
USPWA
9590 9402 4821 9032 5388 41
United States
Postal Service
First -Class Mail
Postage & Fees Paid
USPS
Permit No. G-10
• Sender: Please print your name, address, and ZIP+4® in this box•
6vaO(A) c 27139
Iill'Il�iil'Il'11"'I�li��lll�lll,�Ill'tliil�Ii'I�liiiillll�l'II'
CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner:
Address of Property:�p1 l�\�\�� 'Z7�1Yo
` (Lot or Street #, Street or Road, City & County)
Agent's Name #: 5`�Q� ����iiiini�} Mailing Address:
Agent's phone #: " 0� 1 �j b�C
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
thiwI
posing. A description or drawing with dimensions must be provided with this letter.
they
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. Contact information for DCM offices is
available at http://www.nccoastalmana_qement netlweblcmistaff listing or by calling 1-888-4RCOAST.
No response is considered the same as no objection if you have been notified by Certified Mail
WAIVER SECTION
1 understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift 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.)
ScP it 4
o wish to waive the 15' setback requirement. pq
I do not wish to waive the 15' setback requirement. D M`E G
(Prope w r Information)
5�5�-,.
Signature
Print or Type Name
134 S. Abingdon Street
Mailing Address
Arlington, Virginia 22204
City/State2ip
703-731-0015
Telephone Number/Email Address
8/31 /2020
Date
e _1
M.
W I p�
16V
Print or Type Name �-
2� �, S C 1 5s
Mailing Address
�KVI(fl N a �Y- Lcr—i 5
ity/ telzip
Zsz-x" - L83o
Telephone Numberl Email Address
µ to2o
Date
(Revised Aug. 2014)
Received
D C MI-E C
r,-i) op-l"i N-ll15
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OCT 14 IM
DMEC
This map is prepared
from data used for the
inventory of the real
property for tax
purposes. Primary