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Home My WebLink About78157A_Look, Chad & toni_20210331pp tZ�L ❑CAMA / ❑ DREDGE & FILL N9 78157 CA 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 t7 / / and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC / !� i -' //'' �l Rules attached. Applicant Name C- � a M �,� , ✓i, L ' K Project Location: County Y o. ( s- Address S 2 Street Address/ State Road/ Lot #(s) City c r. �� State N� ZIP 2 7 % S j S Z <_'//� c.c 1S ��.,, fir, ✓c PI w r^4lSubdivision _ e o CQ ^r V, / ✓'rk Authorized Agent 9(an a /yI; . / ( 7-rZ City %� a ys �% n ZIP 2 % / -?" / Affected ❑ CW � }PTA ❑ ES y ❑ PTS Phone # (� ) _ River Basin 4 S u a k� K O ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ WA I y cr ct G AEC s : Ad'. Wtr. Bod c' S i � nat an unkn ❑ PWS: \ � G � J �Q ORW: yes / no PNA yes / no Closest Maj. Wtr. Body —/ d �■■�■■_■■■ice_ ®■■{ice/��■ Now" ■■■■�=�om■■■■■■■■` —aP► ■■■■■■■ ��, ,�EM ME I 1111111100mmo �■112110 Om -�_ � ■■� ■' I■ ■� NEII�N■■■ �■ ®■■!9!�■ifs®■IIC■iEill�li■I■I■■■■■■1�■■■■■■■� ■oilM. ■■■■■ ■■■■ ■ ■WW ■■gen • ■I■■■■■■■■�■■■■■■■ r■OVI ■■■■INNER Agent or Applicant Printed Name Signature ** Please read compliance statement on back of permit 2 Application Fee(s) Check # (✓v n ^ Q C. �-_C✓Ar- Permit Officers Printed Name Signature 121 7�3i/Z/ 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 AGENT AUTHORIZATION F0OR CAM, A PERMIT APPLICATION Name of Property Owner Requesting Permit: LLO-ok-- Mailing Address: Phone Number: _Qy�,�� s------------- Email Address: _ �E f 727J ai-q ------- I certify that I have authorized'��2_j#��_ 9 to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: �.�.A.-LQ.t��__ _ rr' at my property located at _ �� ---------------------- in ---9�� ------ I furthermore certify that I am authorized to grant, and do in fact grant permission to Division of Coastal Management staff, the Local Permit Officer and their agents to enter on the aforementioned lands in connection with evaluating information related to this permit application. Property Owner Information: --r--- ---------- ----- Signature _ ----------------- Print or Type Name ----�� - ----------------- Title Date This certification is valid through -7)9 AWACENT RIPARIAN PROPERTY Q1�I UC0 STATEMEKT I hereby certify that I own property adjacent toW" property located at 75Z_ ffu'Y Pvq�ert4—.&L74?0 �`� �^ (Address, Lo lock asH ewo on XJl:.i1.L_- -, _ __. In _ _}N.C. (Wa%rbedy) (Cityfrown sad/vr Comity) 7 he applicant has described to me, as shown below, the development proposed at the above -T(2 location I have no objection to this proposal. -------- I have objections to this proposal. DESCRIPi1QN ANQPOR DRAWING OF PROPOSED DEVELOPUM (ktdk~ Or+sPOW09 dawbP+t'►+M mast f ff bn dso&40000 iako Or ate# a sft lrar N RECEIVE® MAR 2 9 2021 DCM—EC WAIVElit SECTION I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse. Ilk or groin must be set back a minimum distance of 15` from my area of ripariA access unless waived by me. (If you wish to waive the setback, you must initial the appropriate blank below.) T� I do wish to waive the 15' setback requirement. do not wish to waive the 15"setback requirement (Property Owner infofmaidon) (Adjocant PrrapeM Owow lydoamuMM) Look -- ------------ Print or Type N me or Type Name exy ar t� AIA - Aev':4 AlK 2--W'19 Telephone Number, / ernag address Telephone Number / email address Z,,2 - 1 3/26/2021 (Revised Aug. 2074) *valid for one calendar year after signature* ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own prop,"adjacent to _ -s !' - 1 (N a of Property owner) t property located at .__ X �S_`g -_� _�_L?p- (Address, Lot Siocik, Rr4ad, ) on In In . NGj S------------ N.C. (Walerbody) - ,1 (CitylTown and/or County) I'he apMicant has described to me, as shown below, the development proposed at the above tocati I have no objection to this proposal - I have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (indt Wtw1 proposing doyWopmant must Oil in d4swfp0m blow or aftimb a siiriit *awJ* RECE/ V ED MAR 1 g 20z, DCNj_EC WAIVER SECTION I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boa#Kmse, lift, or groin must be set back a minimum distance of 15' from my area of riparian access unless waived by me� 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 Information) (Adjacent Property Owner Information) �'--------------- _G nac�r�w _---------- Print or Type Name PZorT eN M 'n Ad ess Rte1zp-- --�0�5Q_3� Sl2-51 -'7a7�t �Ir`��t%I�Jt� TeJepho ee umb leJ tl address I erepno e I r/ ernaa addres3/16s lk8e Date* *Valid for one calendar year after signature* (Revrsed Aug. 2014) --�, °� "'� '`��; ,-� ,�,, ,J � �_� ... a� -...:. an�. ,n.: �, Q . �t {ny) 3 �t� t''',f; :t..� .,�' •`a� �' ,{'.'wf;�.�.'.;' .,•i .. 1 +i1 1. 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