HomeMy WebLinkAbout79355A_Rainey, Robert_20210816VCAMA,, DREDGE &FILL
�C4,ENERAL PERMIT
9 /AN B C D
Previow permit
New Modification Complete Reissue Partial
Reissue Date previous permit issued fs-r,,;;L\
As aumortzed by the State of North C_arolina. Department of Environmental Quality I ,Do
and the Coastal Resources Commission to an area of environmental concern pursuant to I SA NCACI :)..--.
iAuie,; attached,
Applicant Name `V.Obar� 'AGE
Project Location: County . ct'ft - 4crX,
Address Itax 01a ?:Kc
Street Address/ State Road/ Lot #(s) 4et It'jst
city StateM ZIP HC06
'I� I Facet
Pnone # . .... E-Mail 14*ta,4yj 9 w�34.AO+
Subdivision
Authorized Agent
City C""-;CG ZIP -?;'l a,3
Cw OEW 'PTA ES FTS
Affected
Phone # f River Basin r.9
OfA HHF lH USA N/A
AEC(s):
Adj, Wtir. Body CC.R tg��,W,Alnkh)
PWSI. . .....
Closest Mai, Wtr. Body Cut ............
ORW Yes PNA yes
Type of Project," Activity &A6_L,) 1(!7'4 4; (Scale:
. . . ............ ..........
Pier filmi,j length
hroger fiferts)
Groin length
,tumber
Wkheadf Rip rap
Ivs distance offshore
nnax distance offshore
Bach, chanpe; e—
cumc yards
3each BUILOTM9 UI&
Other
horeiine Lergrn FL
AV. *t sere yes NIL —
Yes no
no
ivarrer Attached: Oes
A ouilcing permit may be required by: —fL f —I _n' See note on back regarding River Basm rules.
i Note Local F111anning jurisdiction;
Notes; Special Co"tions ..A lqel
4r
n
�awre Please reati romplonce statement on back olpermit
0 4*-
Awr[tCfffi,efr's Fn ted N
Signature
Issuing Date Expiration Date
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit:db
Mailing Address: fu-- a(d
k3J q
Phone Number: P / ' ff'( {a 3 2— 5
Email Address: is IZ,
t j
I certify that I have authorized ik4 itiU�ei( Sty v` aA l nC
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
r /
necessary for the following proposed development: 156 �01 1 l c— i y �
,tS rJ'o {+-Y� t� Ie-tt 0�t� r"t°o-�-
'(lZ.I(lZ.I
at my property located at _ t3 �� U f-,- 4-t `1 ►`
in Uri County,
t furthermore certify that / 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 0 ormation:
Signature
Print or Type Name
Title/
1 � l�—
Date
This certification is valid through /
N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
CERTIFIED MAIL RET;JRN RECEIPT REQUESTED or HAND DELIVERY
{Top po , n to be completed b owner or their agent)
Name of Property Owner. (((( b—Q r' Ci trio L-4
Address of Property: 13 b
Mailing Address of Owner
Owners email: fAca,��ti
L( `„�- Nc 27�2?
t,rt C t'ci i f oo S16
Agent's Name Z ri,►tydsp,�; � , S
`�"� "" �� � Agent �5 Z-
Agents Email. G �A/IU�,War�f, jt>J a✓OJ'�(tSc�T�-LCY-A
4 ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
;Bottom portion to be completed by the Adjacent Pro arty Owner)
I hereby cert.1y that I own property adjacent to the above referenced property. The individual applying for this
permit has described to me, as shown on the attached drawing, the development they are proposing.
dgscnptk>n or gr,
,TAino. with dimersions mus' be provided -with this letter.
I DO NOT have cbjectiors to this proposal. 100 have objections to this proposal.
ff you have objee4ons to what is being proposed, you must notify the N.C. Division of Coasial
Management (DCM) in writing within 10 days of receipt of this notice. Correspondence should be
mailed to 401 S. Griffin St., Ste. 300, Elizabeth City. NC. 27909. DCM representatives can also be
contacted at (252) 264-3901. No response is considered the same as no objection if you have been
notified by Certified bail.
Owner's Phone# -
WAIVER SECTION
i understand that any proposed pier, dock, mooring pilings, boat ramp. breakwater, boathouse, lift. or
groin must be set Hack a minimum distance of 15' from mY area of riparian access unless waived by me
f this does not apply to bulkheads or riprap revetments} (If you wish to waive the setback. You must sign
the appropriate blank below j
100 wish to waive somelall of the 15'
_OR_
*S119---
of Adjacent Riparia roperty Gwrer
I do not wish to waive the 15' setback requirement ;,initial the blank)
Signature of Adjacent Ripanan Property Owner
TYPediPrinted name ofARPO:
Mailing Address of ARPO
ARPO's email:"r_LLes z 2 E; a ARPO's Phone#: i
Date: )" 4 b.`Ci a = `waiver is valid for up to one year from ARPO's Signature'
Revised May 2021
RECEIVED 07/27/2021 11:154
07/27/2021 10:42 2524534823 MATT SLATE PAGE 02/02
N.C. DMSION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIOMWAIVER FORM
GERTIEED MAIL RETURN RECEIPT RECIWESTED or NAND DELIVERY
(TOP pon to be completed by owner or their agent)
Name of Property Owner 1('C} +�� 4- y Q t Z
Address of Property: 13 �i �%IA71 Q�t t k 0 �(1 iJ ,' i�.�� 27123
Mailing Address ofjOwner �� L 0 l d [' (J n-T►'1�
Owner's email: Ore, +�ne`?A 10wne szr Phone#: QL!
3 �S
Agents Name: nZf *4A VtVeU0 :, QAA [it( Agent
Phone* _ a� -
Agents Email: A rI U'el soel 61 ck�-> ."�aL)-Htsb
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom Portion to be Completed by the Adtebettt rr m rty OWner)
t I hereby certify that I own property adjacent to the above referenced property. The individual applying for this
l� permit has described to me, as shown on the attached drawing, the development they are proposing. A
descriptor or drawtro with dimensions. must he provided with this letter.
AID m$� 71 DO NOT have objections to tits proposal DO have objections to this proposal.
if you have objecticina to what is being Proposed, you must notify the M.C. of Coastal
Management (DCAf) in writing within 10 days of reee/pt of this notice. Conrospondence should be
mailed to 401 S. Grfffin St, Ste. 300, Elizabeth City, NC, 27909. DCM rap►vsentatives can also be
contacted at (252) 26b901. No response is considered the same, as no objection 1f yoe have been
notified by Cerdfied Mail.
WAIVER SECTION
I understand that any proposed pier, dock, mooring pilings, boat ramp, breakwater, boathouse, 'ift, or
groin must be set back a minimum distance of 15' from my area of riparian access unless waived by me
(this does not apply to bulkheads or riprap revetmerrtS). (if you wish to waive the seft=k, you
the appropriate blank below.)
I DO wish to waive some/all of the 15' setback
-OR-
Signature of A latent Riparian Propety Owner o�
�I do�to w&jie the 15' � Gr
tback requirement {initial the blank) -
Signature of Adjacent Riparian Property Owner.`
TypedlPrintad name of ARPO: S,�
Malting Address of ARPO: 2 G_ L�li1 tOG� - •�-7 ,44
ARPO's email: 6W&"r.1 iiFx'r-`+7 ARPO's Phone* _75��21= 9iaX�
Date: 7— "waiver is valid for up to one year from ARPO's Signature,
Revised May 2021
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�Rsd: Band_1
�f3rten�rd 2
�Bws: Band_3
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