Outlaw, Dana 80079C

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ENER/AL PERMIT
ENew EModification EComplete Reissue EPartial Reissue
As authorized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources Commission in an area of environmental concern Pursuant
Applicant Name_
Address
c State_ ZIP_
N980079 A B c.o
Previous permit #
Date previous permit issred-
to l5A NCAC
I Rules attached.
Project Location:
Street Address/ State Road/ Lot #(s)
Phone # (_)
Authorized Agent
E-Mail Subdivision
ZIP
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] PWS:
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tr HHF
tr PTA
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trES
tr UBA
tr PTS
trN/A
Phone # (-)
Adl. Wtr
Closest Maj. Wtr. Body
River Basin
Affected
AEC(s):
ORW: yes / no PNA yes / no
Type of ProjecU Activity
(Scale:)
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length '
avg distance offshore_
max distance offshore
Basin, channel
cubic yards_
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
Shoreline Length
SAV: not sure
Moratorium: nla
Photos:
Waiver Attached:
yes no
yes no
yes no
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
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Agent or Applicant Printed Name
Signature x* Please read compliance statement on back of permit **
Permit Offi cer's Printed Name
Signature
Application Fee(s)Check #lssuing Date Expiration Date
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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 line 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 bysiSningthis permit that l) prior to undertaking any activities authorized by this permit, the applicant will
confer with aPProPriate local authorities to confirm that this proiect 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 Coasal 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 Proiect:
Tar - Pamlico River Basin Buffer Rules
I Neuse River Basin Buffer Rules
E othe.,
lf 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 (252-945-6481) or the
Wilmington ReSional Office (910-796-7215) for more information on howto complywith these buffer rules.
Division of Coastal Management Of,ices
Morehead City Headguarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ r -888-4RCOAST
Fax: [phone]
(Serves: Caneret, Craven, Onslow -
North of New River lnlet- and Pamlico
Counties)
Elizabeth Citv District
401 S. Griflin St.
Ste. 300
Elizabeth City, NC 27909
252-764-390t
Fax:[phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquoank and Perquimans
Counties)
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax: [phone]
(Serves: Beaufort, Benie, Henford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-796-7215
Fax: 9 l0-395-3964
(Serves: Brunswick, New Hanover,
Onslow - South of New River lnlet-
and Pender Counties)
http://portal.ncdenr.org/web/cm/dcm-home
Revised 7/06/ I 7
TCAMA / tr DREDGE & FILL
GENER/AL PERMIT
ENew EModification EComplete Reissue EPartial Reissue
As authorized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources COmmission in an area of environmental concern Pursuant
Applicant Name
Address
State ztP
N9 80079 A
Previous oermit #
Date orevious oermit issued
attached
BCD
to l5A NCAC
Phone # (-)- e-Y"it
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision
Authorized Agent _Citv ztP
-CW ,]EW ]PTAAffectedniCirj, oEA HHF - rH
--r PWS:
ORW: yes / no PNA yes / no
trES
N UBA
N PTS
trN/A
Phone # (-)River Basin
Adl. Wtr. Body (nx /man /unkn)
Closest Mai. Wtr. Body I
)c
Type of ProjecU Activity
(Scale:)
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)_
Groin length
number
Bulkhead/ Riprap length_
avg distance offshore _
max distance offshore_
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
Shoreline Length
SAV: not sure
Moratorium: nla
Photos:
Waiver Attached:
yes no
yes no
yes no
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
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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
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Statement of Compliance and Consistency
This Permit is subiect 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 project is inspected for compliance. The
applicant certifies by siSning 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 proiect is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
Tar - Pamlico River Basin Buffer Rules
Neuse River Basin Buffer Rules
Division of Coastal Management Oflices
Morehead City Headqua*ers
400 Commerce Ave
Morehead Ciq/, NC 28557
252-808-2808/ r -888-4RCOAST
Fax:[phone]
(Serves: Carteret, Craven, Onslow -
North of New River lnlet- and Pamlico
Counties)
Elizabeth Cit), District
401 S. Griffin St.
Ste. 300
Elizabeth City, NC 27909
2sz-264-3901
Fax: [phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
E other:
Washington District
943 Washingon Square Mall
Washington, NC 27889
252-946-648t
Fax:752-948-M78
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
YVilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
9t0-796-7215
Fa* 9 l0-395-3964
(Serves: Brunswick, New Hanover,
Onslow - South of New River lnlet-
and Pender Counties)
http://ponal.ncdenr.org/web/cmldcm-home
Revised 7/06/ I 7
lf 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 (252-946-648l) or the
Wilmington Regional Office (910-796-7215) for more information on howto complywith these buffer rules.
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adlacent to €
property located ,t'2'/ 4 2€ ry
(Name rty Owner)
OC
(r-J ,s
on /.r/.
, Lot,Block, Road, etc.
NC
(Waterbody)(Cityffown
The app[cant has described to me, as shown below. the development proposed at the above
location.
I have no obiection to this proposal.
I have o$ections to this proposal.
DESCRIPTION AND'OR DRAWING OF PROPOSED DEVELOPMENT
(tndividual proposing development must fill in description below or attach a site drawing)
e
O -/ KL*aJ *B..-fn'U
watv_E*E gE$Jgt{
I understand that a pier, dock, mooring pilings, breakwater. boathotrse. lifl. or groin must be set
back a minlnrum distance of 15'lrom my area of riparian access unless waived by me, (lf you
wish to waiua Ore setback, you arult lilt0tl the appropriate blank bdory.)
I do wirh to waive the '15'setback requirement.
I ao trt wish lo waive the 15' setback reguiremenl.
(Property Owner lnformation)Property Owner lnformation)
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Maittna Address-
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Mailuo Address(ve.,;G,_6;-; ^/ Q -qs-t,
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certfy thal I own property ad,acent to T)7..n-{ , Oc-,1- L6, *)
property located at 4a )5 (n o ?-'/-a?1 {rJ. of Property Owner)
on [.n,)I<r'--- Cc =<*
s
(Warorbodyl (City/Town and/or County)
has descnbed to me. es shown below. the development proposed al the above
I have no obpction to this proposal.
I have obFctions to this proposal.
DESCRIPTION AND/OR ORAWING OF PROPOSED OEVELOPMENT
(lndividual proposing development must fill in description below or attach a site drewing)
3 B ,- / t< h<,=;€*.--\ e t t+-
w^lvEi_qEqfl9N
I understand thal a pier. dock, mooring pilings, breakwater. boalhouse. lifl. or groin musl be set
back a minimum distance ot 15'lrom my area ol riparian access unless waived by me (lf you
wish to warve the setback. you murt lnltel the appropnate blank below )
I do wrsh to waive the 15' setback requiremenl
I do not wrsh to warve lhe 15' setback requtrement
(Property Owner lnformation)
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Addr ess
Pc-r nt Q 2s16 Mating
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-(Address, Lot, Block, Road, etc.)^
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bulkhead permit
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tonns elong sfi A|G *llXl permn fee payeua ro the NCDEO Then. I n i$ue &e permit on slc and you nl hrve 120 d-ys lo compl€le &le wott H€i,s€ leel h.e to ct! mo al lhe number
boloyr if you have eny Wesfoos h tte inta{trt
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E-nail conexpand*ce to and lmm this address may be sublect to tl,e llorth Carolina Publ,E Records La* znd may be disclased to third pailies-
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