Bickley, Wes 77301C

/ DREDGE & FILL
ERAL PERMIT
Modification i lComplete Reissue L Partial Reissue
As authorized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources Commission inan area olenvironmental concern pursuant to l5A NCAC
N9 77301 A B/C O
Pretious rr:rmX # ( ./
--Date previous permf issued
7l/ t i,
Applicant Name
Address
C ity State ZIP
Phone#( )_ _ E-Mait
Project Location: County
i Rules atrached.
Street Address/ State Road/ Lot #(s)
Authorized Agent
Affected
AEC(s):
aEw
HHF
fES
UBA
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OEA
PWS:
Subdivision
City ztP
L PTS
- N/A
Phone # (_)_ River Basin
lt -,
Adi. Wtr. Body (natlgan /un!4)I
Closest Maj. Wtr. BodyORW: yes / no PNA yes / no
)'c
Type of Proiect/ Activity I
)Pier (dock) lengrh
Fixed Platform(s) _ _
Floating Pladorm(s) _
Fin8er pier(s)
Groin lenSth _
Beach Bulldozint
Other
number
Bulkheed/ Riprap lengrh _
avg distance offshore _
max distance offshore _
Basin. channel
cubic yards
Boat ramp
TWXTTTTIT
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yes
yes
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A buildinS permit may be required by: _.
( Note Local PlanninS Jurisdiction)
f l See note on back regarding River Basin rules
Notes/ Special Conditions t--,a
Ht
ul
&ent or App Priflted Name PermitOffi
Signatrre *i Please read compliance statement on back of permit *
Applica$on Fee(s)
-
Ln".u u
Signature
I
Name
ration Date
(Scale:
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SAV: not sure
l'toratorium:
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lssuinS Date
Statement of Compliance and Consistency
This permit is subiect 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 actioni and may cause the Permit to become
null and void.
This permit must be on the prolectsite and accessible to the permit officer when the Proiect is insPected forcomPliance. The
applicant certifies by signing this permit that l) 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 wriften 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 beliel certifythatthis proiect is consistent with the North CarolinaCoastal Management Program.
River Basin Rules Applicable To Your Proiect:
lf indicated on front of permit, your proiect is subiect to the Environmental ManaSement Commission's Buffer Rules for the
Rjver 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 WashinSton Regional Oflice (252-945-6481) or the
Wilmington Regional Office (91 0-796-721 5) for more information on how to comPlywith these buffer rules.
Tar - Pamlico River Basin Buffer Rules
Neuse RiverBasin Buffer Rules
fl othe.'
Washintton District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax:[phone]
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Warhin6on Counties)
Wilmintton District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
9t0-796-7215
Fax: 9 I 0-395-3954
(Serves: Brunswick, New Hanover,
Onslow - South of New River lnlet-
and Pender Counties)
Division of Coastal Management Ofiices
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ I -888-4RCOAST
Fax: [phone]
(Serves: Carteret, Craven, Onslow -
Nonh of New River lnlet- and Pamlico
Coumies)
Elizabeth Ciw District
401 S. Griflin St.
Ste. 30O
Elizab€th City, NC 27909
252-26,4.-3901
Fax:[phone]
(Serves: Camden, Chowan, Curriock,
Dare, Gates, Pasquoank and Perquimans
Coumies)
http:.//portal. ncdenr.orglweb/cm/dcm-home
Revised 7/06/17
Untitled Map
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AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit:Bt"
Mailing Address:\4s \..
Sat VF^.th, N<- 3?5JQ
Phone Number:Xa -guo - Sls)
Email Address:
I certify that I have authorized o '- Dt^/"
Agent I Confactor
to act on my behalf, for the purpose of applying for
necessary for the following proposed development:
and obtaining all CAMA pe rmits
I \,J 11\ cF
9Y Sh"rt bn *.&. PllL-at my property located at
inlark.f co
! fudhermore certi'fy that I am authoized to grunt, and do in fact grant permission to
Division of Coasta! Management stslff, the Local Permit Oficer and their agents to enter
on the aforementioned lands in connection with evaluating information related to this
permit applicalon.
unty.
Property Owner lnformation :
--,l/<-r.'?-'
Signaturetl Ef 8t c.zc47
Print or Type Name
ftnPE/-:-Y o t^'z''E/?
Title
2{r zD
Date
This certification is valid through ?r0 r U{
CERTIFIED AIL' RETURN RECEIPT OUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner:lAlcs Brc*-t-q
Address of Property:Etut^_ Kf
\.<- OaoY-s nvU.n;#t "t,j8ffi street or Road' citv & countv)
Agent's Name #(xrvt @ Nlailing Address: 1/ l- N
\ruz-nt-A
Agent's p hone #:A3) '?dS '3>a-l M/L+{L,\L a6#7
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 p ing. A description or drawino. with dimensions, must be orovided with this letter.
I have no objections to this proposal. _ I have objections to this proposal
lf you have oblectlons towhat is belng proposed, you must notify lhe Divislon of Coastal Management
(DCM) in wrtting wlthln 10 days of receipt of thls notlce. Contact lnformatlon for DCM ot?lces is
available at or by ca ing 1-E88.1RCOAS7.
No response ,s considerad lhe same as no objectton lf you have been notffted by CetTltled Mail,
WAIVER SECTION
I 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. (lf
you wish to waive the setback, you must inltial the appropriate blank below.)
I do wish to waive the 15' setback requirement
-Pt, I I do not wish to waive the 15' setback requirement.
N'\a!"
(Property Owner lnformation)
Signaure
tleg tstc*-tga
Pdnt or Twe Name
Do 8ox lt3S-
^,r;itingIAdress**\antrrc B ( h r\Y- ZfrtZ
(Riparlan Property Owner lnformation)
Signature
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(Revised Aug. 2014)
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