Chandler, Scott 76702C

I;I}fiEOGEIFILL
PERNAIT
ft"lod,flcdion i-]Complate&lgu6 iiPartid*eisrue
Proiect Location: CoultI
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Subdiv-ision
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Prerrious pcrmit #
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Phone #
tu*horhed.Agent
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AEC{s):
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Type of Progrctr Ac$ylty
f,er {dd*}
Groir kr6dr
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Sufi*rred ltirrap la,tgrrt
a€d;rfr&eo&ftors
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A butldirs permit rnry h€by:
( I'lcte Local Ptanning Jurbdicilorr)
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/ ar DREDGE e FILL
NERAL PERMIT
EModification ECompleteReissue IPartialReissue
As authorized by the State of Nonh Carolina, Department of Environmental Qual ity
and the Coastal Resources area of ronmental
N9 76702 6
at/ Da)
-7-----EIUesattached.-(- <'rlenz-
A B D
Previous permit #
Date previous permit issued .
PUrSUant to l5A NCAC
Applicant Name
Address
Phone #
Authorized Agent
)P.',a
er'-Project Location: County
L sr^r.NC-zrrgUf
Street Address/ State Road/ Lot #(s)"'''='^"rfix*"r;Jffi'tt
E-Mail
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Subdivision
City
Phone # ( )
Adl. Wtr
Closest Maj. Wtr. Body
ztP
nES
tr UBA
tr PTS
NN/A
RiverAffected
AEC(s):
ORW:
OEA
n PWS,-
no PNA yes /
)c
770Type of ProjecU Activity
(Scale:)
Pier (dock) lengh
$osFixed Platform(s)lia Iitll--.,i--t-
:
I+.-
:Floating o
Finger
Groin length
number -t-.
Bulkhead/ Riprap length_
avg distance offshore
max distance offshore
Basin, channel tl IT*N
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
Shoreline Length
:lr
SAV: not sure
Moratorium: nla
Photos:
Waiver Attached:
yes
yes
yes
yes
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A building permit may be required by:
( Note Local Planning Jurisdiction)
l/a€rc E S"" note on back regarding River Basin rules
Notes/ Specia! Conditions t7'4
X
Agent or Applicant Printed Name
compliance statement on backof pe r%
Fee(s)
t =7Check #Date
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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 subiect the permiftee to a fine or criminal or civil action; and 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 prolect 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 certilied mail return receipt has been obtained {rom 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 beliel certifythatthis project is consistentwith the North CarolinaCoastal Management Program.
River Basin RulesApplicable To Your Project:
Tar- Pamlico River Basin Buffer Rules
Neuse River Basin Buffer Rules
lf 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 Olfice (252-946-6481) or the
Wilmington RegionalOffice (910-795-72 l5) for more information on howto complywith these buffer rules.
Division of Coastal Management Ofiices
Morehead City Headquarters
400 Commerce Ave
Morehead C!ty, NC 28557
252-808-2808/ r -888-4RCOAST
Fax: [phone]
(Serves: Carteret, Craven, Onslow -
North of New River lnlet- and Pamlico
Counties)
Elizabeth Citv District
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)
E oth.r,
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax:252-948-M78
(Serves: Beaufon, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
I 27 Cardinal Drive Ext.
Wilmington, NC 28405-3845
9 to-796-72t5
Fax: 9 l0-395-3954
(Serves: Brunswick, New Hanover,
Onslow - South of New River lnlet-
and Pender Counties)
http://portal.ncdenr.org/web/cm/dcm-home
Revised 7/05/ I 7
t\
AGENT AUTHoRlZanon ron cruun perulr lpputcanol
{r
Name of Ptoperty Owner Requesting permit:re 6co-r< C*xJeue{
Mailing Address:LfrLte v?
Phone Number:
Enrail Address:
lcertifithat I have authorized fu,fiD eod&bS , cakS( ?.CoM( 't.J\RulJL ,
Agenl / Conkactor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:bcv_
atmypropertylocated al 6@2 <o!,Jp t,L. , €M|-{ikLo llLg .
in C*({9(€t County.
I fudhermorc ceftify that I am authoized to gnnt, and do in fact gnnt permission to
Divr'sion of Coasfal Management stafr, the Local Permit Offper and their agents to enter
on the aforementioned lands in connection with evaluafuq information -rclafed fo fhr.s
pemit application.
Property Owner lnformation :ac-!L
Signature
ke,e 5c--< C,ti*r"lzrfC
Pint or Type Name
-l-,-{L,-bbOate
Trtle
)
This certification is valid through
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WA'VER SECTION
_ade€taic:.a: a per Oock. -oorinitffil6-wat6r, boathous€ lift' or groin nrusl be set
3eci a rrn,rJ,1.! drsran@ ii'lii"r'iv aiea ol riganan access unless warved by me \ll yo.
*-*l ro *r r" t,:e setback you murt initle! the appropriale blank below )
I do w,sn to waue ths 15'$tback rBquiGntenl
I do nolwsh !o wa,ve the '15 setback rsguiromen(.
(Adjacant P
iignaturc.
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I hereby cer:,ly I
lAddresB.Lot qlock,Road, otc.)
o"lD qeLho N,C
IwrterbodYl (City/Town rnd/o. County)
lhe appl,cenl ha! descl bed lc n.e as shown below. the development propoged at the above
lt't Aly"
r have no obrearro. ro rh,s p(oposal
l',r',' l,' I s"l'-;riasJ
OESCRIPTION AND'OR DRAWING OF PROPOSEO DEVELOPMEI{T
lndtvtdunt Nopos/rg dovelopnEnt ust ltll ln descdp ion b.low ot atlach a slle dnwing)
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WAIVER SECTION
' !rJe.s'..rd t.el a o.er oock. moorinffifrilG6iii6r, boathous€ l(t' or groin must be set
tr"^ " ^.,",--- o,itance of 15' kom my area of riparian access unless waived by mo' (lf you
,.r'sh l. lrdve I'e selback. you must initial the appropriate blank belo"Y')
dSC I oo w,sr, towaNe the '15'selback reqLirerrent
I do not wlsh to waive the 15' setback requirement
- z ).p< Lttt,,.lglr.a--
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Signaure <4<-kk\)D&)
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Mailing A&Ess (A+gtt * tJ-. ZTas
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