Stryker, Foster 80039C

trCAMA / I DREDGE & FILL N9 80039 ABCDENER/AL PERMIT Previous permit #
ENew IModification IComplete Reissue EPartial Reissue Date previous permit issued
fu authorized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources Commission in an area of environmental concern pursuant to l5A NCAC
Applicant Prolect Location: County
E Rules attached.
Address Street Address/ State Road/ Lot #(s)
Phone # (_)Subdivision
1
)E-Mail G
Authorized Agent n)1 City zt?
Phone # (-)----------r---AI
River Basin L V,1.o,C<
Adi. Wtr. Body (nat /man /unkq)
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.llcw'ffi trPTA
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oRW: yes / no
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y", / no
nES
tr UBA
tr PTS
trN/A
Closest Maj. Wtr. Body
'(fl 9<t \/P \
kType of ProiecV Activity \
)(Scale:
Pier (dock) lengh
Fixed Platform(s)
Floating Platform(s)
Finger pier(s) -
Groin length
number
Bulkhead/ Riprap length
avg distance offshore_
max distance offshore_
Basin, channel
cubic vards
-
Boat ramo --.
Boathouse/ Boatlift
Beach Bulldozing
Other
Shoreline Length
SAV: not sure
Moratorium: nla
Photos:
Waiver Atached:
A building permit may be required by:
( Note Local Planning Jurisdiction)
yes no
yes no
yes no
yes no
E S"" note on back regarding River Basin rules.
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n a\)A o/1 GNotes/ Special Conditions
Agent or Printed Name Permit Offi cer's Printed Name
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Signature Please read compliance statement on back of permit **Signature
Application Fee(s)Check#lssuing Date ration Date
City_ State ZIP__
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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 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 proiectsite and accessibletothe permit officerwhen the proiect is inspected for compliance. The
aPplicant certifies by signinSthis permitthat l) priorto 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 certified mail return receipt has been obtained from the ad,acent riparian
landowner(s) .
The Sate of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, cenifythatthis proiect is consistentwith the North CarolinaCoastal Management Program.
lf indicated on front of permit, your project is sublect 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 Olftce (252-946-6491) or the
WilminSton Regional Office (9 I 0-796-7215)lor more information on howto comply wiih these bufferrules.
River Basin RulesApplicable To Your Proiect:
I Tar- Pamlico River Basin Buffer Rules
l ] Neuse River Basin Buffer Rules
Division of Coastal Management Ofiices
Morehead City Headquarterc
400 Commerce Ave
Morehead City, NC 28557
2s2-808-2808/ r -888-4RCOAST
Fa><:252-747-3330
(Serves: Carteret, Craven, Onslow -
North of New River lnlet- and Pamlico
Counties)
Elizabeth City 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 other:
http://portal.ncdenr.orglweb/cm/dcm-home
Revised 7/06/ I 7
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-648t
Fax: [phone]I
(Serves: Beaufort, Bertie, Herdord, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
9 t0-796-72t5
Fax: 9 l0-395-3954
(Serves: Brunswick, New Hanover,
Onslow - South of New fuver lnlet-
and Pender Counties)
As authorized by the State of North Carolina, Department of Environmental Quality
andtheCoastalResourcesCommissioninanareaofenvironmentalconcernPursuanttol5ANCAC
Applicant
Address
Project Location: County
Street Address/ State Road/ Lot #(t)__
City State ztP
Phone # (_)E-Mail
trCAMA/ IDREDGE & FILL
ENERAL PERMIT
ENew []Modification EComplete Reissue IPartial Reissue
N980039 A B c D
Previous permit #_
Date previous permit issued_
City ztP
Phone # (_)River Basin
Adl. Wtr. Body (nat /man /unkn)
Closest Maj. Wtr. Body
Subdivision
Authorized Agent
Affected tr cw
AECG): DoEA
tr PWS
ORW: yes / no
EEW
tr HHF
tr PTA
trtH
nES
tr UBA
tr PTS
trN/A
PNA yes / no
Type of ProjecU Activity
(Scale:)
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)____________ -_
Groin length
number
Bulkhead/ Riprap length _
avg distance offshore_
max distance offshore_
Basin, channel
cubic yards
Boat ramp
i-...--+-
Boathouse/ Boatlift-
Beach Bulldozing
Other
T
T
Shoreline Len4h
SAV: not sure yes no -{-
I
Moratorium:
Photos:
Waiver Attached
nla yes no
yes no
i yes no
ltlt:tJ*
A building permit may be required by:
( Note Local Planning Jurisdiction)
E S"" note on back regarding River Basin rules
Notes/ Special Conditions
Agent or Applicant Printed Name
Signature # Please read compliance statement on back of permit **
Permit Offi cer's Printed Name
Signature
Application Fee(s)Check #lssuing Date Expiration Date
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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 sublect the permittee to a fine or criminal or civil action; and may cruse the permit to become
nullandvoid.
This Permit must be on the proiect site and accessibletothe permit officerwhen the proiect is inspected forcompliance. The
applicant certifies by signing this permit that l) prior to undenaking 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 obained 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 certirythatthis project is consistentwith the North CarolinaCoastal Manatement Program.
River Basin Rules Aprplicable To Your Proiect:
Tar- Pamlico River Basin Buffer Rules
Neuse River Basin Buffer Rules
I oth".'
Division of Coastal Management Oflices
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 ar the Washington Regional Office (252-946-6481) or the
Wilmington Regional Office (9 I 0-796-72 I 5) for more information on how to comply wiih these bufferrules.
Morehead City Headquarterc
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
Counties)
Elizabeth Ciw District
401 S. Griffin St.
Ste. 300
Elizabeth City, NC 27909
2s2-264-390t
Fax:[phone]
(Serves: Camden, Chowan, Currituck.
Dare, Gates, Pasquoank and Perquimans
Counties)
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-648t
Fax:252-948-M78
(Serves: Beaufort, Bertie, Henford, Hyde,
Tyrrell and WashinSton Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
9t0-796-7215
Fax: [phone]
(Serves: Brunswick, New Hanover,
Onslow - South of New River lnlet-
ahd Pender Counties)
http://portal.ncdenr.orglweb/cm/dcm-home
Revised 7/06/ I 7
AGENT AUT$.ICIRE'{TION FOR CAMA PERMIT APPL$CATION
Name of Properg Owner Requesting Permit:Fafre A./. Srav*
Mailing Address:
Phone Number:Q t'/.' 6'3 - ooTo
Email Address:trfr *t'*sA F e<'.A4-{.d*t
i certify that I have authorized lhu,, "hvlll /j'ir.,.*J.:r,e
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development tc,t lf ,,1 !e,- o't'. /l
at my property located al I 4"1 €ett0Y H utr OAttr ,
in (AAnE R bT'
Srgnafure
A A
Print or Type Name
6 ut,* ZcL
Title
I furthermore ceftify that t am authoized to grant, and do in fact grant permission to
Division of Coasta/'Management staff, the Lrcat Permit Officer and their agents to enter
on the aforementioned tands in connection with evaluating infarmation related to this
permit application.
Property Owner lnformation :
0"rt /jAl
-L t4( t.4a / i
Date
This certification is valid through
I ,l-l 4a n r7,/ Li tt< s f) lr t tZ
AOJACENT RIPAR|AN eROpERTy OWNER STATEi|ENT
I hereby cert fy that I orn property djacent to FosraL /. 5 rA./ kETL s
{Nanre of Property O*ner}
property located at
on 5 ?,tny"..ty'r... c , ,,-,
l^ ''e1Yjff;*'l*^. ^, - *,(Waterbodyl tCitylTorm andlor County)
The applbant has described to me. as shorn bek)tr. the develrornent proposed at the above
bcafsn
, -lU( I have no obprtrron to this proposat.
i have obpc{rons to this proposd.
DESCRIPTION AND'OR DRAI'YING OF PROPOSED DEVELOPII'IENT
(lndividual orqosing d*elopment must fill in d*criptian lcllaw ar athch a site dnwing)
{ycQ 2'&4itt4^A
t4r{
1/NGPelo txrT/rl fiatu u,fiVL ,ela,4Al 7b
tftc/ f2f*/trtt"l Fllart r*ap1)6:
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breahrater. boathouse, lift, or groin
must be set back a minimum distance of 15' from my area of ripanan access unless waived by
me. (lf you wish to waive the setback, you must initial the appropriate blank below.)
ruL I do wish to waive the 15'setback requirement.
I do not wish to waive the 15' setback requirement.
t ttYr't'6
{Property Owner lnformation)(Adjacent Owner
Print or TypeName
..(y''1.t l*'^5','r't (f ir'c
Mailing Address
li.i*ur,? t{,ti.CA
City/Statef,Zip -/\ rt , og-1,1t
Telephone Nunbr / email address
0"r.t
Signature
E>,5'rr:rL 1 iz^sl ,./txpA
Pint orTyp Name
Mailing AddresstAl .franrrZt H,Eg 01
City/State/Zip
Number / email
!- 4-qa- Lf q
Date F f,TA{tra4.€ €C, A4,,Ce iV
{ftt/t/
'Valid for one calendar year after srgnature'
Date+
7-
(Revised Auq.2014)
ADJACFNT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certifo that I own property adjacent to Fof fdil [, 57A/nr* 's
(Name of Property Owner)
property located at
on faNnv Hvl'f Ctark in
, Lot, Block, Road, etc.)
CnAru/af <aatrv r{ ,N.C
(Gity/Town and/or County)(Waterbody)
The applicant has described to me, as shown below, the developrnent proposed at the above
locatioru,./ I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWNG OF PROPOSED DEVELOPMENT
NEA n
lu rT
/AoVrTa t tl f,rar"*rha pEL,, v / ily1 /aa cuA/ L To
ltau 72 Pru yoaTy FAa44 E Asot,v6 \,
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, brealaarater, boathouse, lift, or groin
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 initial the appropriate blank below.)
I do wish to waive the 15'setback requirement.
v/ I do not wish to waive the 15' setback requirement.
(Propefi Owner lnformation)
Signature
Fa6ren-
*
.,,
' rG.
frzv'n* A <ft tE STilkr(G
Print orType Name
ql-
Telephone / emailaddress
Date
4 /M/ I,t
Address|Ziinn c, r1. At< /€r r7
City/StatetZip
Nunher / email address
Print or Type Name
t7o
7
€toruir
Yalid for one calendar year after signature*
Date+
7
(Revlsed Au7.2014)