Truog, Paul 80053C

Eceua/nDREDGEIFILL
GENERAL PERMIT.ENew EModification EComplete Reissue trPartial Reissue Date previous permit issued
Prolect Location: Coungl
Street Address/ State Road/ Lot #(s)
Subdivision
ztP
Phone # (-)-- River Basin
Adl. Wtr (nat /man /unkn)
Closest Maj. Wtr. Body
N9 80053
Previous perm
ABCDit#
As authorized by the State of North Carolina, Department of Environmental Quality
andtheCoastalResourcesCommissioninanareaofenvironmentalconcernPUrsuanttol5ANCAC
Applicant Name _
Address
c
Phone # (_)E-Mail
Authorized Agent
Affected tr cw
AEC(s): !o*L] PWS:
!EW
D HHF
! PTA
nrH
nES
UBA
t] PTS
:N/A
ORW: yes / no PNA yes / no
>C
Type of ProjecU Activity
(Scale:)
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)_
f
1Groin length
number
Bulkhead/ Riprap length _
avg distance offshore_
max distance offshore_
Basin, channel T
cubic yards
t
I
I
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other HffiffiShoreline Length
SAV:not sure yes no
Moratorium:
Photos:
Waiver Attached
nla yes no
yes no
I yes no
A building permit may be required by, .
( Note Local Planning Jurisdiction)
E S"" note on back regarding River Basin rules.
Notes/ Special Conditions
-t
-+---F
-+*-l---]..--+-
I
I
Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit **
PermitOfficer's Printed Name
Signature
Application Fee(s)Check #lssuing Date Expiration Date
State Z.IP
-l_-*
.t-l--+
iiti---i-*i-
Statement of Compliance and Consistency
This permit is subiect to compliance with this application, site drawint 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
nulland void.
This permit must be on the project site and accBsibletothe permit oflicerwhen the proiect is inspected forcompliance. The
applicant certilies bysigninSthis permitthat l) priorto undertaking any activities authorized bythis permit, the applicant will
confer with appropriate local authorities to confirm that this pro,ect is consistent with the local land use plan and all local
ordinances, and 2) a written statement or certified mail retum receipt has be€n obtained from the adlacent riparian
landowner(s) .
The State of North Carolina and the DMsion of Coastal Management, in issuing this permit under the best available
information and belief, ceftirythatthis proiect is consistent with the North Carolina Coastal Management Program.
River Basin RulesApplicable To Your Proiect:
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 Olfice (252-946-6481) or the
Wilmington RegionalOffice (910-796-7215) for more information on howto complywith these buffer rules.
Tar- Pamlico River Basin Buffer Rules
Neuse River Basin Buffer Rules
I other:
Washin6on Distric
943 Washington Square Mall
Washington, NC 27889
252-946-U8t
Fax:252-948-M78
(Serves: Beaufort, Benie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-796-7215
Fax: 9 I 0-395-3964
(Serves: Brunswick, New Hanover,
Onslow - South of New River lnlet-
and Pender Counties)
Morehead City Headquarters
400 Commerce Ave
Morehead Ciq/, NC 28557
252-808-2808/ r -888-4RCOAST
Fax: [phone]
(Serves: Caneret, Craven, Onslow -
North of New River lnlet- and Pamlico
Counties)
Elizabeth CitY District
401 S. Griflin St.
Ste. 300
Elizabeth City, NC 27909
252-26r'.-3901
Fax:[phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
http://portal.ncdenr.orglweb/cm/dcm-home
Revised 7/06/ I 7
Division of Coastal Management Oflices
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Pedue, Governor James H. Gregson, Director Dee Freeman, Secretary
Date
P-"1 I Drr.X^.=-.\ \,. r.,rd.af
Mailing Address:
l\q Sh.,"-v\cu, D".
tlr a
I certify that I have authorized (agent),f/Y t+
to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity)Doc t<
lt0l 4 @rulzbut D r' f/** by ./<'h
I
< l-l "n
Property Owner Signature Date
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: [phone]\FAX: [phone]\ lntemet: www.nccoastalmanagement.net
An Equal Opportunity \ Affirmative Action Employer - 50% Recyded \ 1 0% Post Consumer Paper
Name of Property Owner Applying for Permit:
at (my property located at)
This certification is valid thru (date)
N.C. DIVISION OF COASTAL MANAGEiIE NTADJACENT Rl PARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORiIIL.
(Top portion to be completed by owner or their agent)
Name of Property Orner:
Address of Property:
Mailing Address of Owner:r[1 s
ownels emait: / ^ lrv o n..-.'l Lilot tLSo\.\€-l Ownefs Phone#:
Agents Narne:
Agents Email:
Agent Phone#:
lf you have objecllons to what is being prcposed,you must now AE N.C,Division of C@s/F/lManagement (DCN)in wrlting withln 10 days of ref:elpt of this notice.Corres|,o'ndence srrourd bemaildtotWCommerce Ave.,MorehdCity,NC 28557. DCU represenhtives can also be con'ac@at (252) 8052808. No ,esporrse is consider€d lhe same as no obJecAon if you havre 0nen notfrerc byCefffid t ail.
ATUAGE]IIT RIPARI.AT{ PRoPERTY owNER,s GERTIFICATIoN@tteerlcrl9percso},
I hercby certify tha o^rn property adjacent b the above rcfurenced property. The individuar applying for thispermit has d*cfibed b rne, as sho' n on the. attached q".r,in!-, ur" a*.kcpment they are proposing. Adescdotion or drawino. with dimensions. must be provided with iiis letter.
)<- t oo Nor have objec'tions to this proposar.
-
| Do have obiections to this proposar.
I unde*tand that any proposed p]er:.qock, ffir?ffSt ramp, breah,ater, boarhouse, tift, orgrcin must be set back a minimum dis.tance of .r 5' trom riy area ot riiarian acc"s" ;;i;;;iulJ Ly ."(this does not apprv b burkheads or riprap ra/efnenE). 1ti you wsn b wail tn" iar""r, v*i'il&shEthe appro$iate blank betor.)
I DO wish to waive sorne/all ot the 1 5' setback
-oR-
Signature ot Adjacent
I do not wish to waive the 15, setback requirement (initial the blank)
llailang Addr€ss of ARFO: _
ARPO's email:
Dato:
ARPO'S Phone#:
p to ono year from ARPO'S Sign.ture.'waiver is valid ior u
Revi*d May 2021
L-.<-y+
Signature of Adjacent Riparian property Owner _
Ty podrPrintcd namc of ARPO:
N.C. Dtvrstotit OF COASTAL
ADJACENT RIPARIA]T PROPERW OVUT{ER
TANAGEIEI{T
NOTIFICATIOil,WA]VER FORiI
(Iop portion to be completed by owner or their agent)
Name of Property Oxnen P*.^ L oCt-la^,
r(q (L LcJ
I hereby ceffry that I ofln property adjacent to the above refErenced property. The ind ividual applying turthis
they arc proposing. A
permit has described to me, as shown on the attached drawing , the development
-Z oO NOT have objections to this proposat. _ I DO have objections to this proposal.
lf you have objections to what ls b€,ing prop6ed,you must notify the N.C.Division of CoastalManagementGrCn) in wrtting wtthin 10 days of of this no ce. Conaryndence should berecetptmailedto$n @ntmerceAve.,tlordtecl City,NC 28557.DC U rc,p res€/,,'ati v es ca n a ls o be c{,n,,lc1,€dat (252)80&2808. No response is Gonsidered lhe same as no obiecnon il you havc bean nottfid byCertifid ait.
.-AOJACETiIT RIPARIAN PROPERTY OWNER'A CERTIFICATION
I understand that any proposed pi"rj.-dfr, HY"Tf,ffJffit ramp, break\irater, boathouse, tift, orgroin must be set back a minimum cristance ot t s'iom ,iv
"*,-oi ,ip"ri"n access unress waived by me(this does not apprv to burkheads or riprap revetmensj. tii vo, *i"n to ,""rr" tt " ..o""r, vlr-nGsr*the appopriate blank below.)
Agents Narne
Agents Email:
I DO wish to waive sorn€/all ot the 15, setback
oR-Signaturc Acljacent
Mailing Address of Ownen
OwneCs ernail:"^|
Signature of Adjacent Riparian property Owner
Typ.d/Print d namo of ARPO:
vt Lt)
Mailing Address of ARPO:
ARPO'S cmaal:
Date:
ARPO'S Phono#:
ARPO'S Sign.ture.'waiver .Eli tor up to ono year
Revised May 2021
Address of Property:
o/nersphone# qlo ZIL TCql
Agent phone#:_
I do not wish b waive the lS,setback requirernent (initial the blank) _