Rouse, Franklin & Kelly 79605C (needs signature)

DGE & FILL
N PERMIT
New EModification EComplete Reissue IPartial Reissue
As by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources tn an of concern Pursuant to I 5A N
N9 79605
Previous permit #,
Date
AB D
permit
Appl Location:
Phone #
Adl. Wtr.
Closest Maj. Wtr.
Add
Phone
Authorized Agent
ncwAffected
PTA ES
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AEC(s):tr OEA HHF H
ORW:no PNA yes /
or Applicant Printed Name
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River Basin rules.note
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Type of ProiecV Activity
Other
no
cubic yards
Basin,.
-
channel
Floating Platform(s)
yes
yes
yes
@
F--Bul ldoziBeach
length
Fingerpier(s)[_
Groin length €
Boat ramp
Shoreline Length
Notes/
Pier (dock) length
Fixed Platform(s)
SAV: not sure
Moratorium: nla
Photos:
Waiver Attached:
A building permit may be required
( Note Local Planning Jurisdiction)
Fee(s)
read compliance statement on ,.*
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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 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) 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 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 certify that this project is consistent with the North Carolina Coastal Management Program.
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
Wif mington RegionalOffice (91 0-796-7215)lor more information on howto complywith these buffer rules.
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax: [phone]
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
9t0-796-72t5
Fax: [phone]
(Serves: Brunswick, New Hanover,
Onslow - South of New River lnlet-
and Pender Counties)
Division of Coastal Management Oflices
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ r -888-4RCOAST
Fz><: 252-247-3330
(Serves: Carteret, Craven, Onslow -
North of New River lnlet- and Pamlico
Counties)
Elizabeth Cit!, District
401 S. Griffin St.
Ste.300
Elizabeth City, NC 27909
252-2U-3901
Fax: [phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
http://ponal.ncdenr.orglweb/cm/dcm-home
Revised 7/06/ I 7
River Basin RulesApplicable To Your Proiect:
! Tar- PamlicoRiver Basin Buffer Rules
E Neuse River Basin Buffer Rules
] o,h".,-
AGENT AUTHORIZATION FOR CATA PERUIT APPLICATIOI{
Name ol Property Oflner Reguesting Pennit:ftanlVlt--'l4t Rrus<-
Mailing Address:+4% Uradl'l2oaL
J tJC.'')6
Phone Number:6","") X>-SbqoBS ftaltasbooLbq
Email Address:rwqqpil,t-,
I certify that I have authorized /o.,/"// c/"r',.2t f y'en1/.1,
AgBnt / Conkaclor
to act on my behaif, forthe purpose of applying for and obtaining all CAMA permits
necessary icr the folloring proposed developrnent:{nl /^t/
6'-/ k H"^,/a,/ ZOaf* ?ir. *n/ : Eaal /.'{+J
Su
).,
at my property located at Shorr Nf Rq4
in bt*Iqe?County.
I fufthermore cortry thal I am authorized to grant, and do in fact grant permission to
Division of Coastal Management staff, the Lrcal Permit Officer and their agents to enter
on the abrementioned lands in connecirrrn with evaluating information rclated to this
pemit application.
Property Orms I nlonnrtio n :
Srgnature
r* 4 14)lq Panrc
PnilotTyb Nadle
0uazr
Tiile
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Date
This certification is valid through --l-L LAL)-b4
ido,^d..cnrn
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certi! that I own property adj ac.enrofri",.L[,. { lalQ Ruvw
ffi2"6o.;";t
s
Na
property located at
(AddIes.'lJhflb++ry?x+p^_z-*,tn , N.C
(Waterbody)rTciffi own r ndror County)
DESCRIPTION AND/OR DRAWNG OF PROPOSED OEVELOPMENT
(lndivldual prcporlng devoloptnent murt frll ln darcddon below orcltch a ttlo drtvlnd
Dr*,y ),++^,J^.A
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lifl, or groin
must be set back a minimum distance of 15'from nry area of riparian access unless waivod by
me. (lf you wish to waive the setback, you mu3t initial the appropriate blank below )
I do wish to waive the 15' setback requirement.
er lnformation)(Adjacent Pro rty Owner !nformetion)
141!
K/ lt DuV-
Signan
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(1116)oxsttor^c.Ctw-
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Telep,1,',ne Numbef / email addess
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/ email addess
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'Valid for one calendar year after signatute'
Date'
3-,,t -2 I
(Reised Aus. 2014)
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on
The applicant has dascribod to m€, as shown b6low, tha d6velopm6nl proposed at lhe ebove
locelbn-\." I hav6 no oliection to this proposal.
I have o$eclions to this proposal.
m'
I do not wish to weive the 15' setback requiGment.
I hereby cerlify that I own property adjacent lo tz.hn WI Roue
locaredar l+1 fu\fu Shr"ts$fli,ff,"r".Owner)
property
Block,d,
LO N 0onn , N.C
(Waterbody)(City/T andror County)
The applicant has described lo me, as shov,n b€low, the development proposed at lhe above
location',./ I have no objection to this proposal.
I have objections to this proposal
OESCRIPTION AND'OR DRAVVING OF PROPOSED DEVELOPMENT
(tndlvldual prcpor.lng dewloryn.nt must f,ll ln d.sctlofJon bcrov ot ,lt,ch e tit drsving)
DrantirtS L#Ld4A
Prope rty Owner lntormstion (Adjace P rty Owner lnformation)
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Wqo I RearL Pitlt
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addess
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Number / email s
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'Valid for one calendar year after signature'
Dale'
s
(Rey,sad Aug. 2014)
AOJACENT RIPARIAN PROPERTY OWNER STATEMENT
,s
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, broakwater, boathouse, lifi, or groin
must be set back a minimum distance of '15'from my arBa of riparian accass unless waived by
me. (lf you wish lo waive the setback, you mu3t initial the appropriate blank bslow.)
/fioowish to waive the 15'setback rtquiroment.
I do not wish to weive the 15' setback raquirement.
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