The URL can be used to link to this page

Home My WebLink AboutDellasega, Mark 78331C❑CAMA / ❑ DREDGE & FILL N9 78331 A B D GENERAL PERMIT Previous permit# LaNew ❑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 inpn area of environmental concern pursuant to 15A NCAC / J Rules hached. Applicant Name V (` )E' �/� i"" Project Location: County��✓I J �i� 11 Address V(" 'I t !Ur (U� City StatO//(- ZIP % -7 Phone#PO) /q/6' / i lE-Mail Authorized Agent ��' "( t�L ✓`'�/ 1 Affected 0CW LJEW ❑PTA )'E3 ❑PTS AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A _❑ PWS: ORW: (yes) no PNA yes (nq Street Address/ Statt Road/ Lot #(s) 1), fPn;A/, I( /'".-✓'-e '- Subdivision City n S- ZIP 2 0 Phone # O '�r Basin Adj. Wtr. Body kr Closest Mal. Wtr Body W■■■■■■■■ �I11■�!1J12 ME ME No ■■ Ali■ ■■�W M��■�i� ii�iii� IWE ME �G'..� • 1IMMEMIX�i��i■ii ■WiiiiSNo W W ■■■■ 1■W�■�II■■■■■■W W■■.■■C■■ 0 in MEN NEE ME ■W■■l..NEE A■■. ■■.■...1C ■■.�... W. MEN :!W■.■■■....... ■■. ■■■ W■�I■ MEMEN is mom MEN ■W■■■WM III ■■�E..�CW ME ■■®,■■■■■■ ME C..�... �.�■I.��C.. LIEMOM LIE.ii■■■i ME .�■.. ■. W■■!■■■■.■■OI■■■■w 111...0.. �" �ii iii■�°I, 1 MEN �ili■■i■� ®■■�I��■ •�. IIaW No Agent Agent or Applicant Printed Name ' Sign)Sign)-e��Please ead compliance statement on backof permit•*ead compliance statement on backof permit sa Ap .lnation ee(s) Check# Permit B, ,./�n Expiration 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, certifythatthis 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 how to comply with these buffer rules. Division of Coastal Management Offices Morehead City Headquarters 400 Commerce Ave Morehead City, NC 28557 252-808-2808/ 1-888-41RCOAST 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:910-395-3964 (Serves: Brunswick, New Hanover, Onslow - South of New River Inlet - and Ponder Counties) http://portal.ncdenr.org/web/cm/dcm-home Revised 7/06/ 17 �a5 CERTIFIED MAIL • RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM Name of Property Owner: Address of Property: (Lot or Street #, Agent's Name #F;enn.wr� Agent's phone#: 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 drawin the development ""� . F 3hL R, ':iP^t� .P':'�'R'65@. F'Mµ` Tgr they are proposing. Afffcsir fio o� d awmo i'h irRgK � ns,rnusf be pC timid . vith hlsle t r+. ✓ I have no objections to this proposal. I have objections to this proposal. if you have objections to what is being proposed, you must notifythe Division of Coastal Management (DCM) in writing within 10 days of receipt of this notice. Correspondence should be mailed to 400 Commerce Ave., Morehead City, NC, 28557. DCM representatives can also be contacted at (252) 808- 2808. No response is considered the same as no objection If you have been notified by Certified Mail. 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) RECEIVED V/ I do wish to waive the 15' setback requirement. ' JAN 25 2021 I do not wish to waive the 15' setback requirement. DCM-MHD CITY (Propertyl Owner Information) Signatkre 1 Print sorr Type Name MailinAddress City/State/Lip aka.- 0\ fit, Telephone Number l-°� - aoal Date (Adjacent P perty Owner Information) tgnature Xllf-!rllr'd Print or Type Name Mailing A ress City State2ip Telephone Number x Date Revised 611812012 l f 1 �c� ueps�.�crS AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: JYl► P K r u.n3an Mailing Address: b2lUE �ntzt✓ v✓�L A/ C 'AML Phone Number: g2 Email Address: Mk--bF-1- &,6Fig@&AAlL-.CAM 1 certify that I have authorized �� f r' 4 V-�' Quv\a Q S Agent / Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: k�.Pi,�4 Ag 2ca at my property located at ;i a,$ PEVnt C5444 /h9d10/Z , in 6IA L.O 0 County. I 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. Property Owner Information: Signature,' t'►' A'k)�- &WgSEFl8 Print or Type Name Title � 1 oft a0 2 Date This certification is valid through 0 S l 0/ l aoal ..9 CERTIFIED MAIL • RETURN RECEIPT REQUESTED DIVISION OIF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM Name of Property Owner: Address of Property: (Lot or U Agent's Name #: _ Mailing Address: _ 1d� Agent's phone #:= 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 they are proposing. A'Rs£i Yioia bsi of f i h, Hr:en0onxs �r �stM pro`uitled�N 1offi tet�e . I have 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. Correspondence should be mailed to 400 Commerce Ave., Morehead City, NC, 28557. DCM representatives can also be contacted at (252) 808- 2808. No response is considered the same as no objection if you have been notified by Certified Mail. 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. I do not wish to waive the 15' setback requirement. (Prop ty Owner Information) Si nature \V\Qr"\y1 � L-I Print or Type Name Mailing Address CifylStatemp Telephone Number Date (Adjacent P perty Owner Information) Sign re DoNlrl � d F;J `.C/ Print or Type Name \)\ � v . (J6 / 1,3& �/ Mailing Address -)� -7 Te�,rJz•stlju l(�—, VG Z Sd y City/StatelZip Telephone Number X Z2 8 A1a Date Revised 611812012 14