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Home My WebLink About78048A_McElroy, Thomas & Amy_20210415'0- V CAMA / � DREDGE & FILL N9 78048 (A-) B C D GENERAL PERMIT Previous permit # ®New ❑Modification ❑Complete Reissue ❑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 15A NCAC i❑ Rules attached. Applicant Name I I VA: + Project Location: County �G , Address �t M ,� ; j�d Q l�r. Street Address/ State Road/ Lot #(s) City J\c,r\afCk�Uk�kc State ''a ZIP (��-7S I 1 o tl�pi. Phone # (AL) ) `(cjt� 'S7 iS� E-Mail ii-„'r.U� = f>1r F I �,•: Oqm, I Subdivision 11\ Tpt, ,h-a a (--Ip l pc.0 V� Authorized Agent l f ct ,J I_ 1 City C c i r' ZIP Z Affected ❑ cW ❑ EW W PTA ❑ ES ❑ PTS Phone # ( ) River Basin ❑ OEA ❑ HHF ❑ IH ❑ URA ❑ WA (� AEC(s): Adj. Wtr. Bod/man /unkn) ❑ PWS: ORW: yes / no PNA yes / no} Closest Maj. Wtr. Body Type of Project/ Activity `for rr Z (Scale: Pier (dock) le Fixed Platforr Floating Platfc Finger pier(s)_ Groin length number Bulkhead/ Rip avg distz max disc Basin, channe cubic ya Boat ramp _ Boathouse/ B, Beach Bulldo; Other Shoreline Len SAV: n Moratorium: Photos: Waiver Attacl A building permit may be required by: t yl 1-CA n (U—i r a ❑ See note on back regarding River Basin rules. ( Note Local Planning Jurisdiction) Notes/ Special Conditions R �,_; ':Jr A-%, n of J uek i Agent or Applicant Printed Name Signature ** Please read compliance statement on back of permit Application Fee(s) Check # t 7l Permit Off ers rinted Name Sign ture , 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 1) 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:Hportal.ncdenr.org/web/cm/dcm-home Revised 7/06/17 AGENT AUTHORIZATION FORM FOR PERMIT APPLICATIONS Name of Property Owner Applying for Permit: M,e-ej f o�j Mailing address: Telephone Number: 5\4-Aox-J,5v�\(c, U aa- -13 �Lldn� I certify that I have authorized _ .TrzzV S L' I I (agent/contractor), to act on my behalf, for the purpose of applying and obtaining all CAMA permits necessary for the proposed development of at my property located at �-Da wlytvt�b4�o Tra,;�{ �JA 21931 This certification is valid through (date). (Property Owner Information) fig/nature Print or Type ame Title, co. owner or trustee for property a d-- Date y3q - q16 Telephone Number Email Address ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to I v vwi It A rc `s Property located at i t ,, 0 L L (Name of Pr4erly Owner) n onWk^^ 1`�y1� (Address, (Waterbody) , in The applicant has described to me, as shown below, location. I have no objection to this proposal. I have objections to this proposal. (City/Town and/or county) N.C. the development proposed at the above DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (lndMdual proposing development must fi// /n description below or attach a site drawing) 12 i}f n e o a ' O o �li4 VV Vf"YAISECTI n N ��"Y 1 "'k 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 you wish to waive the setback, you must initial the appropriate blank below.) I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Property Owner rmation) (Adjacent Property Owner Information) Si Si afore* nt or Type Name 7 F'`'� C L )�s YVI t l k i L -br. , ant or Type Name W!V71ag Adds ss --a "2 ( �;vQ„ i j�� , ✓A a j J Mailing Address Ctty/Stl/State/Zip �ii ilcvwcS e mc�r�`,� J telZip A. Te%phone Numbgr/em it address 1 - 1 n7� n� S 7d- _ Telephone Number/email address Date —'.L - -7 Dare- *Valid for one calendar year after signature* (Revised Aug- 2014) i Waiver Section 1 understand that a pier, dock, mooring pilings boathouse, list, or groin must be set ba ka min rn m di tanOfIS, breakwater, re from my area of riparian access unless waived by me. (if you wish to waive the setback you must initial the appropriate blank below,) • /ZZ) . I do wish to waive the 15 ft setback requirement Ef * I do not wish to waive the iS ft setback requirement AIDJACENT RIPARIAN PROPERTY OWNER STATEMENT_ 1 hereby certify that I own Property adjacent to T� 1 A � K, e l c 0 's sty located UVt {�(Na�ne of Prbperty Owner] 6 0 IYat.i 1 on — r "v faly . n `vim (Address; Lot, Block, Road, etc.) (Wate I`rbody) , inLc,} , N.C. (City/Town and/or County) The applicant has described to me, as shown below, the development proposed at the above location. I have no objection to this proposal. I have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (Individual proposing development must fi// in description below or attach a site drawing) r-rk %l w. WAIVER SECTION 1 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 you wish to waive the setback, you must initial the appropriate blank below.) --Z11— I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Property Owner Information) (Adjacent Property Owner Information) _ 6 )J F4 /rrn Lly/ % r�S7 1i P jyt � r, s�gnv�e* 1 1 Print or Type e -Lai) of t e yi,1 P►7nt or Type Name Mqspng Address L• L� � R r� �j vt l�e I 'VA as 913 Ma6 r gr Address C#ty/p c.rty/state/Lp rD TelepirW►e Number/ mail address Telephone Number/ ema# address Date Dale 'Valid for one calendar year after signature' (Revised Aug. 2014) ANACENT RIPARIAN PROPERTY OYMER STATEME14T ! hereby certify that I own property adjacent to o Yk 4 A&e-el ro s PrOPerty kcned at d ,2 t t/ : �c - -(Nam* of P Owner) a on f �� lqi� (Addres Lot, Block, Foad, (Waterbody) N.C. (City/Town and/or County) The applicant has described to me, as shown below, the development proper at the above location. I have no objection to this proposal. I have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (Individual Proposing development must fi// /n description below or attach a site drawfng) i ,% & ` c> i l Pry � WAIVER SECnON i understand that a pier, dock, mooring pilings, boat ramp, breakwater, A. � ' must be set back a minimum distance of 15' from t"�� or d by me_ if you wish to waive the setback, You must initial the aof rite access unless waived try � ( Y appropriate blank below.) �` I do wish to waive the 15' setback requirement. i do not wish to waive the 15' setback requirement. (Property Owner information) Adjacent Pro (Adjacent Pent Owner nformabon) Td Sr ►�� re �. j'Vt ` ro &re � Print or T e Nan* Print or TypeNe�me Mailing AddressMailing Address Ir -s't�� 1�on�astw►ct;rr clryurp Telephone Number/email e ss /ePhone Number/email address ! a - ao - — 2� DateDw, "Valid for one calendar year after signature' (Revised Aug. 2014) `l� f \\R Lsr 2 2. Sec-t L I R g �YY� ��ey-d fSe�e.H Zp Z � ��o f ��1 b ,�,�' ��' Untitled Map Legend 7� Write a description for your map. 202 Winnebago Trail 14 j. al 144 AF ";e