Yadlowsky, Matt 77307C

.CAMA/ L DREDGE I FILL
GENERAL PERMIT
New Modillcation Complete Reissue Panial Reissue
As authorized by the State of North Carolina, Depanment of Environmenlal Quality
and the Coastal Resources Commission in an area of environmental concern pursuant to
'tO
*tOt , . fl;i;; i ;n;.
Applicant Name
AUdress
Proiect Location: CountY
Previous permit #-
Date Drevious oermit issued
BCD
Clty_
Authorized Agent
-ORW: yes / no PNA Yes / no
State ZIP
Phone#( .)_ E-Mail Subdivision
City
---
Phone # ( )
Adi. Wtr. Body
Closest Maj. Wtr. Body
zlP
River BasinCW lEW . PTA -ES PTSAf]1ted oEA HHF rH uBA N/a
AtL(s):' PWS:
nat man unkn )
>O
Type of Proiecv Activity
)
Pier (dock) length
Fixed Platform(s)
-
FloatanS Plattorm(s)
I
I
Finger pier(s).
Groin length -u-.
Bulkh€ed/ RiF-ap len8dl_.
ev8 distance ofbhore
max dhtance ofilhore
Besin. dlann€l
cubic fards
Boat ramp __
Bodloosc/ Bodift
H
I
Shoreline Len8th
SAV: not sure Yes
Moratorium: nla yes
Photos: yes
WnverAttached: yes
A buildinS permit may be required by:
( Note Local Planning Jurisdiction)
See note on back reSarding River Basin rules
Notey Special Conditions
Agent or Applicant Pnnted Name
Signanrre
Application Fee(s)lssuing Date
N9 77307
Street Address/ State Road/ Lot #(s)_
(Scale:
il'lr-rf ia
I
Beach BulldozinS I
Other
iEl
I
l!--+
Signature ** Please read compliance statement on backofpermit **
Pe.mit Oflicer's Prinred Name
Check #Expiration Date
Statement of Compliance and Consistrincy
This Permit is subiect to comPliance with this application, site drawing and attached general and specific conditions. Anyviolation of these terms may subiect the Permittee to a fine or criminal or civil action; ind may cause the permit to become
null and void.
This permit must be on the proiect 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 proiect 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 adiacent 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 proiect is consistent with the North Carolina Coastal Management program.
lf indicated on front of permit, your proiect is subject to the Environmen6l Management Commission's Buffer Rules for the
River Basin checked above due to is location within that River Basin. These buffer rules are enforced by the NC Division of
Water Resources. Contact the Dlvision of Water Resources at the Washington Regional Olfice (252-946-6481) or the
Wilmington Regional Oflice (9 I0-796-72 I 5) for more information on how to comply wtih these bufferrules.
River Basin RulesApplicable To Your Project:
Ij Tar - Pamlico River Basin BufferRules
I Neuse River Basin Buffer Rules
Division of Coastal Management Offices
Morehead City Headquarters
400 Commerce Ave
Morehead Ciq/, NC 28557
252-808-2808/ r -888-4RCOAST
Fax: [phone]
(Serves: Caneret, Craven, Onslow -
North of New River lnlet- and Pamlico
Counties)
Elizebeth City Di3trict
401 S. Griftin St.
Ste. 300
Elizabeth City, NC 27909
252-26r'.-390t
Fax:[phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquoank and PerquirEns
Coumics)
! other:
Washington District
943 Washington Square Mall
Washington, NC 27889
2s2-946-648t
Fax:252-948-M78
(Serves: Beaufon, Beftie, Hertford, Hyde,
Tyrrell and Washington Counties)
WilminSton District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
9t0-796-7215
Fax: 9 l0-395-3964
(Serves: Brunswick, New Hanover,
Onslow - South of New River lnlet-
and Pender Counties)
http://portal. ncden r. orglweb/cm/dcm- home
Revis€d 7/06/ l7
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit:Morft dqd Lorlr sk{
Mailing Address:-21688 Brady Lake Blvd
Morley, Ml 49336
Phone Number:616-256-4556
Email Address;[e-mail]
I certify that I have authorized oetc. ooc/hYan/ tt6*tY^, ol€)/e.
Agent / CoYtractor
to act on my behalf, for the purpose of applying br and obtaining all CAMA permits
necessary for the following proposed development:n e,W a-c'rn ere
o li++s
at my property located at z!+ a andrr.wE ianr.
in OnSl Cou nty.
I fufthemorc ertify that I am authorEed to gnnl and do in fad- grant pmission to
Division of Coaslal Management sffi, the Local Permit ff7@.r and their agenB to enter
on the aforcntendoned lands in annectbn wih evaluatirg informalion rclated to this
permit application.
Property Owner lnbmation:
Print or Type Name
ne/r
Title
2020
Date
o
26t
This certification is valid thaugn '12 t 31 t 2020
tvlatt A Yadlowsky
8
No. 76319 AB o D
rlHodllkadon trCompletcReisse nPartialtieissue
A. a!6oriz.d by dtr State
and tha Coastal R€.o.rr€c.
of North C.tounr, DGPartmlrlt of EMrotrnBntil OBlity
Pr€vio6 permlt #
Dato pret/lous permit issued
concem Puriuant to l5A NCAC
Proj€ct Location: County
Sre€t Address/ State Road/ Lot #(s)
Subdivision
zlP
an of lt dr/cL
t'i.
z
fuplicant Name
Addrasr
?
ztP
Phone #
Authoriz€d Agsnt _City
I I Rl,lr Basin'4tr-crr',Ed tr Prs
OUBA OIVA
Phone # ( _
.kdl.riman lunkn)Adl. Wtr.C;-
Clooest Maj.ORW: yes PNA yex I
ot 1.ITypa of Proiect/ Actlvlty (,(,,
I (s..b:/l/TU )
Plc. (do.k) hr{!n
Fixld Pb.m(!)
d
Floaiine Phtfo.rn{.)
Fln86.
Croh htgdr
rtrdo.lc.ofih6.. ,/,
B3:in, drann€l
q.tic
gda nnp
B.rdt SddodE
Odrr
St'ordt'l€ t-5gdr
SA\r: tlottt t
i4or&orltrn: .U.
Pi6
\ryh,YrAtnd.d
F
yLr
,s (y
A bu dng porrnh may bc rcqdred b)4
( Notc l-.o.al Phhnlig lur8dictioo)
OL D
a-+
5€6
L,
rEte on back rugardlnS R vcr Easin .ules,
ilot.d Spcdd Clndtlo.rt <tlSt rt I
t\
I
I t
!I
I
i-
I g E
II
I
I
.__.1
I
L I
i
L
I
I
I .t
I
!I It ('
(
.\t)3 (itr
IIITIIIIIIII
rrr
a
t
t\
I ar,at
IIIIIITI
st,
11
q
I
A8ent or Appfl<.r't Printod l.{a.rr.Permir Ofi.€r'!
(4
I FILL
PERMIT
E-ftrl--------
ffi 3*, E5^
\tl
-T-n-r
I
F_
r=rTrTrtT-
+