Richardson, Nelson 79556C

/ -'DREDGE & FILL
PERMIT
PNA y6
Previous permit #
o r&D
ORW:rc Closest Mai. Wtr. Sody
><i
Sou*,/9n,1,
1 tul
/\/ U \,/
Bech BulHozing _ .*
Fixcd
ff
Orh6
@b/I(y (
,/ tr,,
<wtczrulf1
w--
Jon#/JL
Sodpuld B@tlilt
(utn( fards
Not€s/ Special Condhions
Type of ProiecU Activity
Pier (dod)
Boa rmp
Fb,eg PLtlqin(s)
Fiqg.r pirr(r)
cfohknSdl __ _
Enbs
&lrhl.d, iqr.p bfltth
av3 dBme ollrhore
rudsffie
Barin. chxrd
Shadire Lagth
SAV: nd sre
Hq&im: n/a
PIFGi
WhiGAfthcd:
y6
ys
yel
/es
17x
ctf*rrr'Se note o back regardiq Riw Baln ruls,
Ic)fur;-t.t/
A buildinS pemit may be required by:
( Note Lel Plannint jurisdiction)
t fepcr.) u/l
92
on bxk of mmlt rr
a1q
Perrit Of[ccr'.
Signature
5
l$uint
ikl*ia
Ch€l#
Vr<r-e
_ ES a-PTS
IH - UBA IVA
fuMMsi{rt I t
.* -piiorb";Jjl4 I
Date previous permit
fu authorized
and
Applicant Name
Address
City
Phone
Audrorized ASent
AIIected
AEC(s):
-cw
OEA
Phone # ( )
Adi. Wtr. 8od)r-
l
)
I her@ certify tfat I oem property aqpcant to ,S
propsrty to€ted at
on r-l
The applicant has descr&ed to rne, as shown behw, the dewloprnent propreed at tire above
locatio*s
r ' : ! rr . | !. DESCRITNON AhIT}'GB ORAWT*G OF FROPO$E} DBIELOPNENT
$nevi&d pruposing @g/roynerrt must fill ora&ach asiladraxfngf
I have no objedionb thb proPosal.
'k;,;..i Fro*s'Ytd
+ l'X L6' )o'l'
K 0f C**ta
€ t ?{toc-
I undssbnd that a pier, doch mooring pi[t€$, bdtlilaEr, boetrouse. Iifl sr gmin muS be set
baek a mir*mum distance of 15'from my erBa sf dparian affi trtbss waived by rne. (lf you
wish to wairc ttte se{back, you must ioltial the approfiiate bktk belff .)
W , I do wistr to waive tlx 15' setbact requirBmBnt
Ourpr Inbrmation)
,4,,{.^
ot
1
Num0er?- to-"}, I
Dde
(Rev[eed AlffiBt)
-G.
Dae
b
)t
i
Type of Proiect/ Activity 7tt
(Scale:
Pier (dodr) lmgth
Fixed Phrlom(s)$n,.lr 5oun',/
fbdrgPhthrm(,
Flngerfir)_ _
Croh lcrgdt -_.=_
Mnb6
aldkhad/ Riprap lerEth
avg di5trce ofrshore T tul
ffiddffice
Barir. chunel
(ubic firds
Eodlmp /1/ l,| 4/
E.adbrsd Bortfir( _
Eoch Buidozing. . _ ,_- ,.
Other
Shodire Logth
g
9(v
SAV: nol il.e
H@ckm: n/a
Pttdo!:
Wai€ As.ch.d:
y6
Jo*lA /J/*-yer
yet
yel
lrr
A buildirrg pemit may b. required by:
( Note Lml PlanningJurisdiction)
C Se note on back rcgardi4g River Basln rules.
Notes/ Special Condltions ,l cJ\tiw.t/
T t .!-k-r.!cz\,l ll
4-
Signature
5
r
'statcmmt on bxk of remh "
a1q
cr"*;ikl*i
DREDGE & FILL
PERMIT-Modilication ;Complete Reissue ' Partial Reissue
PNA /s
N? 7955{r AB oPrevious permit
Date previous
Closest Mai. Wtr. BodY
ORW:
)
I
/trDREDGE&FILL
ENER/AL PERMIT
INew EModification ECompleteReissue [] Partial Reissue
of North Carolina, Department of Environmental Quality
N9 79556 o
1?)
A B D
Previous permit #
Date previous Permit issued-
As authorized by the State
and the Coastal Resources in an of
c
ztP
trES DPTS
trUBA NN/A
concern Pursuant to I 5A NCAC
Proiect Location: CountY
Street Address/ State
Applicant
Address
Affected
AEC(s):
Name
ncw
trOEA
Ut
a
Authorized Agent
o C,A, State A./C
Wr<+'r
lL-7
zlP
Basin
trtH
Phone # (-)
Adj. Wtr AU ,"/
)a
UF
PWS
ORW:yes no
Closest Mai. Wtr. Body v
PNA yes no
--l---r-T l+
l--t- t__t-
j
ffi
li-."]T
ll
-t*-i-+-lt-ffiII
I
J-lll
Type of ProjecU ActivitY /lo
(Scale:)
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
Finger
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other J--r-1lT---lij--l*+
Shoreline Length
SAV: not sure
Moratorium: nla
Photos:
Waiver Attached:
yes
yes
yes
yes
A building permit may be required by:
( Note Local Planning Jurisdiction)
C ,*E S"" note on back reg'arding River Basin rules.
ou)\.,rr*-/Notes/ Special Conditions J;"",
I
Agent or Applicant Printed Name PermitOfficer's
Signature"til)i:Ae read comPliance statement on back or Permit H(
Efl*it"e"<o Check #lssuing
ct/
Phone #
,t--J-J
i-r
I
Statement of Compliance and Consistency
This permit is subject to comPliance with this application, site drawint and attached general and specific conditions. Anyviolation of these terms may subject the permittee to a fine or criminaior civil action; ind may cause the permit to becomenulland void.
This permit must be on the Proiect site and accessible to the permit officerwhen the proiect is inspected for compliance. Theapplicant certifies by signing this permit that I ) prior to undenaking any activities auiho;ized by t'his permit, the applicant wtllconfer with appropriate local authorities to confirm that this proiect is consistent with the local land use plan and all localordinances, 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 a ilable
information and beliei certifythatthis proiect is consistentwith the North CarolinaCoastal Management program.
lf indicated on front of Permit, your proiect is subiect 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 (252-946-64g 1) or theWilmington Regional Office (9 I 0-796-72 I 5) for more information on howto coin ply wit-h these buffer rules.
River Basin RulesApplicable To Your Project:
Tar - Pamlico River Basin Buffer Rules
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: Carteret, Craven, Onslow -
North of New River lnlet- and Pamlico
Counties)
Elizabeth Ciw District
401 S. Griflin St.
Ste. 300
Elizabeth City, NC 27909
252-264-3901
Fax: [phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
! othe.:
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-648t
Fax: [phone]I
(Serves: Beaufon, Benie, Herdord, Hyde,
Tyrrell and Washington Counties)
Wilmintton District
I 27 Cardinal Drive Ext.
WilminSton, NC 28405-3845
910-796-72t5
Fax: 9 l0-395-3964
(Sewes: Brunswick, New Hanover,
Onslow - South of New River lnlet-
and Pender Counties)
http://portal.ncdenr.orglweb/cm/dcm-home
Revised 7/06/ l7
AGENT AUTHORTZATTON FgR CAMA pER['ilT APPLICATTON
Name of Property Owner Requesting permir r{e/so^) K,-L- rl ;,u,,
Mailing Address:fr0, Box tog'l
ile 7 3
Phone Number:
EmailAddress:
I certify that I have authorized
t3b - hr4'z >d2-
ql,|,i a-a
Ao lnrpeiloa__
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development z 9* ,J /;J//.
at0l
at my property located at/I lo
in /t/ { county.
t furthennore certify that t am authorized to grant, and do in fact grant permission to
Division of Coastal Management staff, the LoCat Permit Offtcer and lheir agents to enter
on the aforementioned.lands in connection with evaluating informatian ietated to this
permit application
Property Owner lnformation :
,,lr*Qrl*lrT
Signature
Print or Type Name
ou dep
Title
702
Date
RECEIVED
MAY l2 lt\?lThis certification is valid through Lt-l_l_Z*>
DCM.MHD CITY
A*-ho Ft
a 'S
I herebY certifY that
propertY lbcated at
on
I own ProPertY adjaceht to
ress,
in
(Name c Lts! 1
own
The applicant has described to me, as shown below' the development proposed at the above
location. -,'"'"'f I have no objection to this proposal'
DESCRIPTI ON AND/OR DRAWING OF PROPOSED DEVELOPltlENT
mustfill in description or attach a site drawing)
(tndividual ProPosing
$"o[ put /l:r,hJs,,'ft"/ h*orL c.+
€
q
1,tn,...-r-tGtapier,dock,moor,"ffi,boathouse,r,tt,*g6inmustnes"t
uovrr i mlrrrriJm distance of 15'tro* .,iV "!" of riparian 'oot unfuts waived by rne' (lf you
wish to wave the setback, you must iniiiaitne appropriate blankbeio-w')
I do wislr to waive the 15' setback requirement'
I do not wish to waive the 15' setback requirement-
(PropertY Owner I nformation){Adjacent P roPeffY Owner
6
Print or Name
Mailing Address
Oo
1-lr Number
o,2-oz I
Date
lnforrnation)
o1 -,
(Revised 5k 8/201 2)
tL3 1
K.
Print or TYPe Name
teEip
Telephone
o
L
RECEIVED
MAY 1 2 20?1
DCM-MHD CITY
Date
Number
L
rr.l *#
,S
I hereby certify that I own property adjaceht to
(Nime ot Owner)
propertY loeted at
Road,C
on 0wn r Gou
The applicant has described to me, as shown below, the deveiopment proposed at the above
,,-location
-t4-I have no objection to this proposal
DESCRI PTION AND/OR DRAWI NG OF PROPOSED DEVELOPMENT
(tndividualproPosin g develaPment mustfill in below or attach a site drawing)
<-
Atr"o s
7i'
?,
I do wish to waive the 15' setback requirement'
I do not wish to waive the 15' setback requirement-
(Property Cwner I nformatio n ){Adjacent ProPertY Owner lnformation)
._; WAIVER SEGJIQN : - "
I understand that a pier, dock, moo.ng ffiGJ;;;ilte',-boathouse' lift' or groin must be set
back a minimum distance of 15' from my area of riparian 'oot unless waived by rne' (lf you
wish to wairre tt * ,"toact<, you must initial the appropriate blankbelow.)
tn
S;
or Name
o
Telep
cr Type
Telephone
3(
z
^J
t \)
Date
hone Number
2-o7-
Number
fRevised 5n8/2012)
I
(
/
RECENEb
MAY 1 2 Zl,Z|
DCM.MHD CITY
-?Y"rl
NC Division of Coastal Management
Cashier's Officiat ne"eiii'''-'14002 a n @n
il,o z&Date:
Received From:
Permit No.:
Applicant,s Name:
$QO o-
Check No.:
Project Address:
Signature of Agent or Appticant:
Signature of Field Representative:
County:
Please retain receipt for your records as proof of payment for permit issued.
Date:
Date:C-auL
I