HomeMy WebLinkAbout78049A_Chesson, Steven & Tammu_20210311®C:AMA / DREDGE & FILL lr9 78049 A: B P� D
-� GENERAL PERMIT Previous permit #
❑New ❑Modification El Complete Reissue El Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC
❑ Rules attached.
Applicant Named v f n Project Location: County
1
Address ) Cxck k'c� Street Address/ State Road/ Lot #(s)
City State ll--Y ZIP'
Phone # 2 `�$` (E-Mail "> %-" P ;mot°;� i3C • ' !- .c, Subdivision
Authorized Agent Tr CA Ls j J City
ZIP I `j
Affected ❑ CW ❑ EW ® PTA ❑ ES ❑ PTS Phone # ( ) River Basin V� '.I. n.
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body (Qaatt /man /unkn)
❑ PWS:
ORW: yes / no PNA yes / no) Closest Maj. Wtr. Body
Type of Project/ Activity
X
Pier (dock) length
�'X r
Fixed Platform(s) tic•
Floating Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore -
max distance offshore
Basin, channel
cubic yards
Boat ramp
r I
BoathousR/ Boatlift
I
Beach Bulldozing
Other
I
Shoreline Length
SAV: not sure yes
Moratorium: n/a yes no
Photos: no._..__i ...
.........._..
Waiver Attached: tes 1
A building permit may be required by: l yip _>ct r\ ` ovk
( Note Local Planning jurisdiction)
Notes/ Special Conditions
c. �r L A'0
Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit
Application Fee(s) Check #
,E Scale:
I
❑ See note on back regarding River Basin rules.
AA4k 0"-: i\ �Y-e e
Permk icer's Printed Name
(' 1 tr y �.
Signatur
�/tl/zt ail! lzi •
Issuing Date Expiration Date
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 officer when the project 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 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 available
information and belief, certify that this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
Tar - Pamlico River Basin Buffer Rules Other:
Neuse River Basin Buffer Rules
If 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 Office (252-946-6481) or the
Wilmington Regional Office (910-796-7215) for more information on how to comply with these buffer rules.
Division of Coastal Management Offices
Morehead City Headquarters Washington District
400 Commerce Ave 943 Washington Square Mall
Morehead City, NC 28557 Washington, NC 27889
252-808-2808/ I-888-4RCOAST 252-946-6481
Fax: 252-247-3330 Fax: 252-948-0478
(Serves: Carteret, Craven, Onslow -
North of New River Inlet- and Pamlico
Counties)
Elizabeth City District
401 S. Griffin St.
Ste. 300
Elizabeth City, NC 27909
252-264-3901
Fax: 252-264-3723
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-796-7215
Fax: 910-395-3964
(Serves: Brunswick, New Hanover,
Onslow - South of New River Inlet -
and Pender Counties)
http://portal.ncdenr.org/web/cm/dcm-home
Revised 7/06/ 17
*I -
AGENT AUTHORIZATION FORM FOR PERMIT APPLICATIONS
Name of Property Owner Applying for Permit: xv
Mailing address:
Telephone Number:
I certify that I have authorized _ �ru v1 1 I (,.
(agent/contractor),
to act on my behalf, for the purpose of applying and obtaining all CAMA permits
necessary for the proposed development of
,a" d
at my property located at 95
This certification is valid through
(Property Owner Information)
Signature
iyt°✓) Af
Print or Type Name
Title, co. own _ or rustee�forpr�operty��
D2 23 2l
Dat
Telephone Number
Email Address
_; /
(date).
AD.IACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
S
property located at�lJ�yame of Property Owner)
on (Address, tot, BlocA Road etc-)
_�� �✓
M►aterbody) in �"/ , N.C.
(City/Town and/or Co nty)
The applicant has described to me, as shown below, the development proposed at the above
lj�
� I have no objection to this ro p posal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
E:3 0 � A, � "- I\(" 12-)( *�'b
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin
must be set back a minimum distance of 15' from my area of riparian access unless waived by
me. (If yo%u wish to waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement. q irement.
I do not wish to waive the 15' setback requirement.
(Property er Information
(Adjace perry Owner Information)
7 ""��
=41ew
LV Signature
Pnnt T <pe aVl► / % Fl r` 5 , .. t ILL
(Yyf
f J nr or ! ype NanW
J L((
Ma#C'
N2,� J ��? 7�'�Z Mailing Address
City/State/Lpy V C
ram,,. Z
3/,Z- y ,SAC' •"�yrorate�,Up
Te%phone Nu er/ ma!l address
Date Te%phone Number/email address
Date
*Valid for one calendar year after signature* (Revised Aug. 2o94)
I hereby certify that I own property adjacent to ,t,C`/ (?X - Is
Property located at 9S5 of (Name of Property owner)
on 117 0 "k7 �i✓ter (Address. Lot, BI k, Road, etc-)
in
(Cit(city/Townand/or County) N.C.
The applicant has described to me as shown below, the development proposed at the above
location.
V _ I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
WAIVER SN
! understand that a pier, dock, mooring pilings,
must be set back a minimum distance of 1159from omy area of at ramp, r riparian access unless'w ft,ry groin b
me. (if you wish to waive the setback, you must initial the appropriate blank below.) y
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Props or Inform o) (Adjacent Property Owner Information)
Si
ZVO '�?SS0
Print or Type �_ � 1'�i �•` `� 1 r,,, n � —
9 ll d f e.-61 -;N ant or Type Name
Date
C, 27f �Z
s%2 8384//-tr✓ssa7dac�/,(►e,�l
v* Nb /email address
0/1�2L .Z /•
*Valid for one calendar year after signature*
Mailing Add1ss
r�.1 �� 2��3 Z
/St-teOD
s �) sc, - lbZ2 S.de�1;,�k-G
Tehor►e Number/email address
fit- -n 1
Date' .---
(Revised Aug_ 2o14)
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