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Home My WebLink AboutWhite, Marie 76795Cf ;-<CAMA / DREDGE & FILL A B t'C) D GENERAL PERMIT Previous permit # _ �`�' �' __ _ IVew Modification Complete Reissue Partial Reissue Date previous permit issued --_«—.. As authorized by the State of North Carolina, Department of Environmental Quality j / %+ and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC 07 t ' Rules attached. Applicant Name ( J Project Location: County Address } k .r r Ave. Street Address/ State Road/ Lot #(s) City Sa. _State ;� %� ZIP /-_ .._.. Phone # �, V J. _ _ E-Ma Subdivision _ f Authorized Agent i fYj City ZIP - Authorized SEW River Basin Affected .-�-t;rA .�=E5 Pis Phone # ( ) 11_� . OEA HHF IH UBA N/A ,i�'�t AEC(s): Adj, Wtr. Body 14� Cl > %marl !unkn) PWS L i� — T Closest Maj. Wtr. Body Lift { l C t . ORW PNA yes 1Z nb Type of Project/ Activity/" ,'� Y1ii ( t`--tE� ��✓'' c Pier dockjlength s Fixed Platforms) .,.. - Floating Platforrtt(s) Finger pier(s)_- Groin length , Aber (Bulkhe/adl�Riprap length —" avg distance offshore, max distance offshore :t Basin, channel r! cubic yards r Boat ramp Boathouse' Baadift aJ Beach Bufldoz+ng 1-11 ache' 11 Shoreline Length SAV, not sure yes Moratorium: rda yes j photos: Yes (}�� Waiver Attached: l 1- no ` A building permit may be required by:rl i Note Local Planning Jurisdiction f.fotes/ Sp ` ecial Conditions C .li AppD'nt�ptl N__.... € "Please read corftpliane s ttzrntrrt on beck of )St nnnrt i rr i (Scale: ) rl K See note on back regarding River Basin rules. / 1 r, r__ PertnrtOfiieer's P Nana+ ii Sigtat e � 1SSt ng D* .. t . w.. _ 'P)dZ-1.' stir y.:ti4t;4,,'i--1•,�i� _ ><. '17 i., r�. 7ij,' 'iie"��'s J + "'F-' ` 7 +� �•_ yi,Tik ,'� ^ tX,J ie r ..yJ,il+r„ ,Y' , Ig 1.%lk ' a.. "rf� �',i.?r.3�..vrrr'c.. '•s __r ,':�4 r�'i' !' S i Y`r,�, _f�'"% -A", ' ,� .' i I� , ai .}'{,(} �+°� M i'+i t'� ? � I `<i •�_ fir' s'�' :w •r , 1 • I IS �'Y�yJ b 1 't 4 �� - i�' R{s "i1 't"`+ �tilr{ r ACT -,i. r �r '�" ,,�;' 's^1�gr�.-hFiWitzbvaA�tnlc •.. ...��...,�:: rd0 t � l .. ;i i .. i {,4� �. �3. Jl _ _ � � b.• � _ + r. l . to .L7' ' 'h -'t .ir �:kl�`k F '<rrr.l h y 4ri ,' lry I�.-},,y'�{+��I�eee�d Ir'I �.. ` , �r'Is �iY_„ 'r_- �+�4,�',ey�'��',,, , - ��,,�r •r �,�, S',. , ,. } �" �'_��. '�;F •- 1 tj.4 1 - , u .�� .Altr .f•I I ,{y.`^,t t, __� - ti�3G '' '�� +, .. Y.� l,' _ -;I�li� � ;�, n.,i +ui ' - 'rtitd'"1'R`•�7•+eF�-: �m � ._I• �}-,'•eM�l,�i�}�: � I I �'r; .- I " e - . _ r E4;elf •:, rf1 r J � i '� col r. ' -•.I , I fit .-'—'^ - ' i •�. ;��. � d $. !,. :, . .� � „ ,I.�.,. "�� •�' y' •.W r '[ .I.' ram• �' ;� .' ..'r':^�-.+ wyA- R - • 4 Jc,+ N a1E •' t yy �I us NP. ,..,, ! lri�,. rro'a -.: u—,� » _ � w ; ,�' � F rk * i d , � fp•. lr ' � � �' '•: � � - �.: !.4 i- _ . _ Y. � - 'b'�'�1�� Ili P I - - � >a�a' 4�,'rwf �+ ri �• t�1"'�, . m �.5nr--.--.,vi:i>v �-�t+i7r�-'u�•-' -.w,—. + I ' ' ` l•.-• 3 12,E �? .r... '. 4]F _ -• .:. • ,_ - • u , l XCAMA / ❑ DREDGE & FILL 7 6i A B C D GENERAL PERMIT Previous permit# ,ew ❑Modification ❑Complete Reissue El 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/ 7 / Rules attached. Applicant Name (,��' I O-j A Project Location: County&(�,y en Address_ City Phone # (1 Authorized Agent Affected AEC(s): ORW: ❑ CW ❑ OEA ❑ PWS: yes %n ew 4TA !❑ HHP ❑ IH ,L�ES ❑ PTS ❑ UBA ❑ N/A PNA yes <�D Type of Project/ Activity Pier (dock) length Fixed Platform(s) Floating Platform(s) Finger pier(s) Groin length / 0kheaber Rip rap length avg distance offshore max distance offshore Basin. channel i cubic yards Boat ramp Boathouse/ Boatlift� Beach Bulldozing Other Shoreline Length SAV: not sure yesOr ....... -- Moratorium: n/a yes Photos: yes Waiver Attached: (ge no A building permit may be required by: ( Note Local Planning jurisdiction) , Notes/ Special Conditions 111�/F"f _ r , I i lir Agen r Applicant Printed Name Street Address/ State Road/ Lot #(s) Subdivision City �' ZIP Phone # ( ) River Basin Px-; (' Adj. Wtr. Body V nr man /unkn) Closest Maj. Wtr. Body Set,( -Ad 4 (Scale: / , .2.o ) See note on back regarding River Basin rules. Permit Officer's Pripted Name ,/' gqmldw--- ature ** Please read compliance statement on back of permit + '7 Application Fee(s) Check # 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 ❑ 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 howto complywith 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/ 1-888ARCOAST 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 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 SAMPLE AGENT AUTHORIZATION FORM PROPERTY LEGAL DESCRIPTION: LOT NO. l PLAN NO. PARCEL ID: STREET ADDRESS: Please print: / Property Owner: Property Owner: The undersigned, registered property owners of the above noted property, do hereby authorize of (Contractor / Agent) (Name of consulting firm) .)r6G✓k(-AAlt/S to act on my behalf and take all actions necessary for the processing, issuance and acceptance of this permit or certification and any and all standard and special conditions attached. Property Owner's Address (if different than property above): Telephone: � 5-9 - % 3 E- 9- We hereby certify the above information submitted in this application is true and accurate to the best of our knowledge. Authorized Signature Date: Authorized Signature Date:�P�-'�d RECEIVED JUN 10 20,0 ,. �: r z�;�+��,�� , f"r 1_ } � _ �, ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to D / %t'. v1 i1 0.or %Ycr�Q y'�%� ��y. S (Name of Property Owner) property located at - (Address, Lot, Block, Road, etc.) on %� -// < �- in Lr/a zN , N.C. (Waterbody) (City/Town and/or County) - e applicant has described to me, as shown below, the development proposed at the above tion. 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) yoeg', 9 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 rf e..-(If u wish to waive the setback, you must initial the appropriate blank below.) V"" I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Property Owner Information) (Ad' c nt Property caner Information) Si nature 1//,7 Signature * , ,,�- 0/ &U� I � Pri;011 -4 !M. %�`2��-� ;G 1 Ube /sue nt or Ty�e� Name Print or Type ame 7 v C4 t ZZ) , A�D U -e- Mailing Address A/mod' -�, 'L l° . 1"a City/State/Zip 5--l�- Telephone Number/email address 4'- / Cam- ,w' Date *Valid for one calendar year after signature* Mail 6ddrlp City/s telzip � ✓�✓��/ %� L Telephorj a Number/email address 3l ��, k 3 Date*` y RECEIVED (Revised Aug. 2014) JUN 10 2020 DCM-MHD CITY ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to Y &` W] ItA 's (Name of Property Owner) property located at �Y%`Z 5111 Di 6;2v� 7 3 `y � (Address, Lot, Block, Road, etc.) on?�. -O l /�y/� , in t V �,'� �✓Y�/ i 4-Y� N.C. (Waterbody) (City/Town and/or County) The applicant has described to me, as shown below, the development proposed at the above locatpn. ti 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) tiet /45 iv,r1w i1141yL W1144- 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.) L n I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Property Owner Information) Signature Print or Type Name + n i , Mailing Address vV; cy l>a �ti% l�✓ �"'a �o City/State/Zip Telephone Number/email address Date *Valid for one calendar year after signature* (Adjacent Property Owner Information) Signature * , Print or Type Name / )r �7 �uE Mail'g Addre s �--6u G City/State/Zip Telephone Number/email address S- a� ;La Date* RECEIVED (Revised Aug. 2014) JUN 10 2020 DCM-MHD CITY I