Hardin Family Trust 76673C

ICAMA/XDREDGE&FILL
GENERAL PERMIT
INew lModification - lComplete Reissue EPartial Reissue
N9 76673
Prwious permit #
Date previous permit issued-
Street Address/ State Road/ Lot fG) -
Subdivision
ci zlP
Phone # (-)River Basin
A B/ Ct o
Applicant Name
Address
Project Location: County
City ztP
Phone#(. )--e-Mait
Authorized Agent
Affected ncw
AEC(s); n oEA., ll Pws
ORTJY: yes / no
IEW
f HHF
f PTA
ftH
trES
f UBA
tr P/rs
tr N/A Adj. Wtr. Body _. (nat /mal luoko)
Closest Maj. Wtr BodyPNA yes / no
>C
(Scale:)
Type of Proiecv Activity
Pier (dock) length__
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)
Groin length
Bulkhead/ Riprap length
Boat ramp
Boathouse/ Boatlift
avt distance offshore
max distance ofshore
Basin, channel
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I-1 i1 -_i 1+IIl
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lll Ir!.t-i +
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lBeach Bulldozing
Other
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t --;---.1Shoreline Length
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A buildinS permit may be required by
( Note Local Planning lurisdiction)
NoteY Special Conditions
il
ASent or Applicant Printed Name PermitOf,lcer's Printed Name
SiBnature
Check#lssuing Date Expiration Date
As authorized by the State of North Carolina, DePartment of Environmental Quality
and the Coastal Resources Commissaon in an area of environmental concern Pursuant to ,tO **a , i;; i a[;a.
State
{
cubic Frds
SAV: not surc
Moratorium: nla
Photos:
fl See note on back regardint River Basin rules.
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Signature # Please read compliance statementon back ofpermit #
Application Fee(s)
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 officerwhen the project is inspected for compliance. The
applicant certifies bysigningthis permitthat l) priorto undertaking any activities authorized bythis permit, the applicant will
confer with appropriate local authorities to conlirm 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 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.
River Basin RulesApplicable ToYour Proiect:
E Tar- PamlicoRiver Basin Buffer Rules
E Neuse River Basin BufferRules
E oth"r,
lf indicated on front of permit, your proiect 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 RegionalOffice (910-796-7215) for more information on howtocomplywith these buffer rules.
Division of Coastal Management Ofiices
Morehead City Headquarters
400 Commerce Ave
Morehead Clty, NC 28557
2s2-808-2808i | -888-4RCOAST
Fax: [phone]
(Serves: Carteret, Craven, Onslow -
North of New River lnlet- and Pamlico
Counties)
Elizabeth CityDistntt
401 S. Griffin St.
Ste.300
Elizabeth City, NC 27909
252-264-3901
Fax: [phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-796-7215
Fax: 9 l0-395-3964
(Serves: Brunswick, New Hanover,
Onslow - South of New River lnlet-
and Pender Counties)
http://portal.ncdenr.orglweb/cm/dcm-home
Revised 7/06/ l7
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax:[phone]
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Warhington Counties)
AOJACEIIT RIPARIAX PROPERITT OWilER STATEilEIIT
I henby cedf fut I om prop€rv adiacqnt to 's
of Ormer)
propro locat d 8t
(Addrt!r,Lot, Block rtc.
on rJh,L oJ. Ru.r in N.C.
f,W!t rtody)(c .ndror County)
The appllcant has dacrlbd to m€, a! shiln bclou,, the devdopmcnt prop$cd at thc sbove
locatlon.x I hrw no obFcffon to ttrL propold.
I tr.rr. obl.cilmr !o thb propo€al.
(lmlMthtd ptop'/l,A .fi,n/0P/,/utt m,,[,t tfr 0dovo',ra,ch. Ctclrt ut g)
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rirAfi,ER SECT|O|{
I undcrstsnd that e pier, dock, moodng pilirqs, boat ramp, brsd(vak, boafiouse, lifr, or groin
must bG 3r* back 8 minimum diltancs of 15' fom my arre of rlpatian acc€a Lnhoc rrah€d by
ma. (lf you wlrh to walrr€ thc ac(bsd(, you mu.t lr t l thc .pprop|lat blrnk b€low.)
_ ldo wish to wEh,c UE 1S 3dd( llguir€|lrglt
-
I do not wbh to weat s thr l$ gatbad(
Owner lnlormatlon )
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Date
ryalH lbr on6 celcndlr yer afur d0maE,]!'
(RavigfdAw.2011)
DESCRIPTIOI{ ATID'OR DRAW|IIG OF PROPOSED DEVELOPi'ENT
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AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Mailing Address:lL+2-l s *t {-- B\ o.^c-c- Dri{c-
il."Cr.
Phone Number:
Email Address:Z@ lt4 eo
I certify that I have authorized J,.rr$ lo. Cte.rr. I Pole- Coclrr:^n
Ag6nt /contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
-Q56r
Li
at my property Iocated at \a,
in C-^o.kr.:f-County.
I fufthermore certify that I am authoized to gnnt, and do in fact grant permission to
Division of Coastal Management staff, the Local Permit Officer and their agents to enter
on the aforcmentioned lands in connection with evaluating information related to this
permit application.
Propedy Ormer lnfomation:
(
Signature
D-r', ) \{*t }'.^J
or Typ Name
ft a)r
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This certification is valid through / /
Name of Property Owner Requesting Permit:
ADJACENT RIPARIAN PROPERW OWilER STATEMEIIT
I hereby cedi$ that I own property adjacentto S
of Property Owner)
property located at
(Addrscs, Lot, Bloch , etc,
on tJhrL o.,1" R!.rc.r .tn N.C.
own andror County)
The applicant has described to me, as shoryn below, the development proposed at the above
locatigfi.
I have no obiection to this pioposal.
I have objec{ions to this proposal.
DESCRIPTIO]I AND/OR DRAYYII{G OF PROPOSED DEVELOPUENT
(lndMcluat proposing d€,,dopm?,7rt mustflrl l\des,crrptlon bCow ot al',lch a Cte dnwing)! .r -- =-_ _:J
i Er rs't 'JG eo--I- I
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a Er'rrlir.: rJood
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I do wish to wEive the 15' setback requirement.
_ I do not wish to waive the '15' setback requirement.
lnfo
Signature ,-.Mrttd //ord,n
WAIVERSECNON
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boahouse, lift, or groin
must be set back a minimum distance of 15'from my arBa of riparian acoess unless waived by
me. (lf you wish to waive the setback, you must lnttlal the appropriate blank belovr,.)
)Property lnfomation)
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or or
€
Telephono
{t n/u at5g7
/ email adchess?-zD address
Z-o
Date
a/a$d br one celefldar year ener signafurB.
o
(Rev,s€,d AW. 2014)
(Waterbody)
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Date.