Clark, Chimer 79585C

- DREOGE E FILLERAL PERRIIIT
'-,lModification',-,CompleteReissue'r-partialReissue
Quatrty
),{? 79i85 cAS D
Previous permit #
Date previor.rs permit issued
l24epuruuantto l5A
Project Location: Counry
Streer Lot
&e.t-
ztP
Affected -gw ,frFHHF ... IH
:-PTS
UBA ,:l'l/AOEAAEC(s):
ORW:PNA yes no
Type of Activity
Pier (dock) tengrh Its----
Fired Plarform(s)
Ftoating pradorm('rjtr;q-C
Finger pier(s)_
h*, :fiu*/
(Scate:r1rV )
C- /1,
Groin length
numb€r
Butkhead/ Riprap lergth
avg disEnce offshore
max disance ofshore
Basin. channel
cubi< yards _,,
Boat rarnp
Boathru4 Boadifr
Beach Bulldoting
Orher __
Stroretine.-"r. --Ta -SAV: notsure -y;
g
Moracorium: n/a yes /iPhoros: yas Ef
WaiyerAnacheO: /es H LIL rue /s- 7t"tn 1
,d buitding permit may be required by:
( Note Local PlanningJunsdiction)
NceV Special Conditions
c
See on baek regarding River Basin rules,
ore f
lll 4
ffil
x
backofpermit6_ atur_
{
or
Fee(s)
Printed '--E-
Check #
4-tQ-
/
by the Srate of North Carolina Department of Environmental
and rhe Coasal Resources in an area
Applicant Name I c
Address___
Phone# ( - _.)-
Adj. Wtr
mrone #p1.
Authorized Agent,_ _ __ *_
Basin
FWS:
Closest M4. Wtr Body .*_.
-l
bs_L_{
Statement of ComplianGe and Consistency
This permit is sublect 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 proiect site and accessible to the permit officer when the proiect is inspected for compliance. The
applicant cenifies by signing this permit that l) priorto undertaking any activities authorized bythis 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 belief, certiry that this proiect is consistent with the North Carolina Coastal Management Program.
River Basin RulesApplicable To Your Project:
E Tar - Pamlico River Basin Buffer Rules
E Neuse River Basin Buffer Rules
lf indicated on front of permit, your project 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 Office (252-945-5481) or the
Wilmington Regional Office (91 0-796-7215) Ior more information on howtocomplywith these buffer rules.
Division of Coastal Management Ofiices
Morehead Ci+Headquarterc
400 Commerce Ave
Morehead City, NC 28557
2s2-808-2808/ | -888-4RCOAST
Fax: [phone]
(Serves: Carteret, Craven, Onslow -
North of New River lnlet- and Pamlico
Counties)
Elizabeth City District
401 S. Griffin St.
Ste. 300
Elizabeth City, NC 27909
252-264-3901
Fax:[phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
! l Other:
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-U8t
Fax:252-948-M78
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Warhington Counties)
Wilmington District
I 27 Cardinal Drive Ext.
Wilmington, NC 28405-3845
9t0-796-7215
Fax: 9 l0-395-3964
(Serves: Brunswick, New Hanover,
Onslow - South of New River lnlet-
and Pender Counties)
http://portal.ncdenr. orglweb/cm/dcm-home
Revised 7/06/ I 7
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting permit;
Mailing Address: -1tt x
Lrtt q- Lth?V-
trir\
u)V(r0a,\.yl_ l1t1n
Phone Number:12?- t-11s
Email Address:
I certify that I have authorized
Agent I
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development r\\C-,rl
[ \\-\
at my property located at il\r ,;LlFtaO\\ k {{Y_ ?b-.rL-{k\
ln iH k County.
I furthermore cerlify that I am authorized to grant, and do in fact grant permission toDivision of Coastat Management staff, the Loiat Permit Officer ana ineiir alents to enteron the aforementioned tands in connection with evaluating information ietated to thispermit application.
il,*n {l<r k{z
Print arType Name
& crl *<f
I ZZ
Title
z.oLl
Date
This certification is valid through t t
-L\
(
Carteret County, N.C.
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nty do€3 nd guamnlee 0ral tro drtaard I
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'm0rled lhd tb ardcntentrffEd p$lb FirEiy lntrmalion
trEp eorvbos wil bo wsilabloto us€fr wtlDd inbrruplbn
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Dwk Live Lo:rd of 62.5 lbsisqfl
Low Prafile lkrk Lrvc Lond 30 lhs/sqft
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Distributr:r Name;
Lltrviri i\ndersn
}Z DulL Sol{tiorr!
llSl) 7?1.0793
rPmjcct N:mel
Dra*'n hy: Dovid.4rdmn
[dg;622.tllXl
f)wG Name; fx)o_,t.13635 111.1 74
EZ Drrck, lnc
878 Etst ltighway 60
Monett, Missouri 65708
l'lhone: I [phone]
Far; (4 I 7) 235-2233
M|TIc'El R&d Llz r)m* Limncd lvarauty mrcfully. Arnng rxher things. lu Dtrk docs nor womnr danrog*.
fiihtrcs w dcl'cds r:aused by uilsutllorlzxl rnrdilicaticn of EZ D<Bk ProdrKq rn(t?or uEuthon?cd drsdtrtLnl lorbf
EZ Dtrk Pftxlucr.
General Notes:
Thrr &nir' &cs rot roet Ntfiir& Qts rllllcimt inffiurin &
wdct{i Prlro*l Xql.d lfir mfirir4 rvqd ral hotum {qlltbfl
b KlBd, elsrin! nrty t! &tllcd.
2, Nol(: I ir rlrc d.EI @Er(ry({br's rr{hBiltiliv s F.r0Na sDd.oilpb.
FlOr rll rppligbl f.d6sl, Sld!. ir{t h.d hs!, odl[ilcH sd
rc8r*[iru) ri $"il rt all is{Bi {, ttsE*tits ml llm*g rolirunr
l*roir[ql io ric imtrllrtkxr. rppli€tih $xl u{ of P7- Do(t p^ldrsb 6
Itc @ns/op.rrlorh lrmiH. EZ Del. lE. asmr m dly or
E$x[aul{y with rpGct tn thc lci.lit, ( @rtrlhBy of atE
wrEr:irrhrt{\ dm iddknlor\ qrr{i(dm c 6c of }.1 Do.l
podnh
3. L€f(@c HZ D(lorffi Muul fsaddiildrll dfrik.
CERTIFIED MAIL. RETURN RECEIPT QUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERW OWNER NOTIFICATION/WAIVER FORM
Name of Prop€rty Owner t_Ar*.- Clo,L
bt6 il./>,,,,
^/c-l 3c< L.u. I *t C 2-8;7+
(Lot or Strset #, Street or Road. City & County)
Mailing Address
lf you have oqections to what is being pmposed, you must notify the Divisjon of Coas/6,l Managcmeot(DCM) in writing within 10 days of receipt of this notice- Contaca intomation lor DCM offices isavailable at ,f orby ca ing 1-8884RCOASI
l!:r9by.."Tfy that l,.orvn prop€rty adjacent to the above reEranced property. The individuatapplying for lhis permft has describ€d to me as shown on the attache<t ctrarvingjthe developmentthey are proposing. A descrio{ion or drawino. with dimensions. must be providA w h this lener.
.lrh_ I hare no objections to this proposal. _ _ t have objcctions ro this proposal.
i,to response is considered the same as no obiection if have been notified b Cenilied Mail.
(Pro ation)(Riparian
Signa(1,.^.- D. (la.L rz-
,*
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laE'tF
Lxlii<F
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I understand thar a pier, dock, r**niii:::;5,"J',3| or""*"r"r, boarhouse, or rifr musrbe set back a minimum distance of 1d frorn-my area ot iipafian access unress waived by me. (lfyou wish to waive the setback. you must initial he appropriate blank betow.)
--
i do wish to waive the 15' setback requirement.
7i a2
->lE- I do not wrsh to waive the 15. setback regutrement.
Prg)erty Owner]pbrmation)
/ <----
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t/t (
or Typo Name
Maihng Addless Add.ess
f/6.u.tf.t*l lc z8s7o v(City/Stete/Zip P.,-..k,t><_e City/State/Zip
77j_K,m"Fl.x.r..lit;r>r>Telephone Num,]trr
Print or Type
lr,7 ,Li I t.' nt ,,ti' o .k e,)
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788 4-7
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2-:2-|zt ?
b- LZ-L I
Number / Emal Addds$
& ?ci' 17.t41a1;'s ('.iA
Dott'
/ Emaif Addres9
/l
(Rews€,d Aug.2O14)
Address of Property:
Agents Name fr
Agent's phone #.
Signature
SENDEH: COMPLETE IH'S SECI'ON COMPLETE IH'S SECT'OA' OA' DELIVERY
r Comploto itoms 1, 2, and 3.
I Print your name and addrcss on tho rsverse
so that w€ can return the card to you.
a Anach thls card lo the back of the mailpioce,
A
x -
>;fsnr
ofc.
or on the front if
1. Article
2.
to:
9sg0 9402 62s7 0265 8751 04
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3.
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tr Csrtifl.d ltLil Rodtict d Ddlvcty
tr Collooton Odiv.ry
tr Collcct on Diliv.ry Rcaufded Oeerory
tt YES, onter dolivry ad&oss below: >En|o-
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trcm item 1?
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R.gbtcrod iihil RGstslc'tod
Doxveryggnrturr Cottfinrstlonil
slgn8tull Confirnation
DellvcryRestricted(fransler
?uL1 0t h0 u00u t??? aa15 tr Blatrlctod Deliv€ry
PS Form 381 1 , July 2O20 PSN 7530-02'000-e053 Domestic Rcturn R€ceht ,