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Home My WebLink About79382A_Mattingly, Sue Lynn_202108131"L_ V ❑CAMA / ❑ DREDGE & FILL N9 79382 ',A B C D GENERAL PERMIT Previous permit # ❑New ❑Modification El Complete Reissue ❑Partial Reissue Date previous permit issued As authorized by the State of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC 1 p Rules attached. Applicant Name S ,t t L ti n n /VI a 4 �' , � �� Project Location: County � G r-- - Address ?. � 6 o x rt Street Address/ State Road/ Lot #(s) 5 / y 2 (o City " 7< A--. ^ State N c ZIP 2-� `/ 2 J S -�> I -a � v b C_+; Phone # 4S-) 7 %% � ° y2 Z E-Mail < r St %,Q r Q a— c-''' Subdivision r i C6 f 2 Q� q Authorized Agent AA'i City F r 5 — _ ZIP Z 13 �D I ❑ Cw EW M PTA t~}ES [$PTS Phone # River Basin Affected ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A AEC(s): Adj. Wtr. Body C c� n ( (nat /manunkn) El PWS: ORW: yes / no PNA yes / 'no Closest Maj. Wtr. Body ��'�' k ` S ° ^ �I =MEE ■ . Elm Mmilmilill ME MEMNON Wi MM11 OEM M MOMINEMMEM MMENOMMEMEMOMME ME MMMMMME��MMEAMMMMEMEMSENIMMMMMMMEME mmmmmm��mmmmmmmmm�.Emmmmmmmo� l M. M. Ion pagligm-laomAMME-simmm , a a MMM min M. W MON!"Knom as' wa M MMMMMMMMMMI1IIIO01l M nommommmmwmmmmmmmmpm-mm-UM MMMMMMM MEN �mnmmmml�'mmomammmm�MMMMMMMMMM"k MMEMMMM mumoso In Sh f an C (fie-T Agent or Applicant Printed Name Permipbfficer's Printed Name Signature ** Please read compliance statement on back of permit e L( Application Fee(s) Check # Signature 12 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 1) 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/ 1-888-4RCOAST 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 N.C. DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY (Top portion to be completed by owner or their agent) Name of Property Owner: Address of Property: Mailing Address of Owner: Pe, eux m 3ry d uit, . , d , C • ,� 7y2s Owner's email: Gra /,5 Kul Ub(. , Unt Owner's Phone#: Agent's Name: ,ItI hae lfoogoer Agent Phone#: Agent's Email: ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION (Bottom portion to be completed by the Adjacent Property Owner) I hereby certify 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. A description or drawing, with dimensions, must be provided with this letter. wl!'J I DO NOT have objections to this proposal. I DO have objections to this proposal. If you have objections to what is being proposed, you must notify the N.C. Division of Coastal Management (DCM) in writing within 10 days of receipt of this notice. Correspondence should be mailed to 943 Washington Square Mall, Washington, NC 27889. DCM representatives can also be contacted at (252) 946-6481. No response is considered the same as no objection if you have been notified by Certified Mail. WAIVER SECTION I understand that any proposed pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, 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 revetments). (If you wish to waive the setback, you must sign the appropriate blank below.) I DO wish to waive some/all of the 15' setback Signature of Adjacent Riparian Property Owner -OR- I do not wish to waive the 15' setback requirement (initial the blank) wQr% Signature of Adjacent Riparian Property Owner: Typed/Printed name of ARPO: VA s'- 1Ar-% K• t, KI I Mailing Address ofARPO: Pam- Q 7`iS J7:zj._,zAt3.zs►t ��T� NC '-701 ARPO's email: ARPO's Phone#: 25s 435 --5042- Date: 7/1 /'-"-1 'waiver is valid for up to one year from ARPO's Signature" Revised July 2021 N.C. DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY (Top portion to be (completed by owner or their agent) Name of Property Owner: - UV L . "LIBt 6 q6z Address of Property: �d �� / 1��hOON t�� F%/.SCG, Mailing Address of Owner: 1 /i, 4X Ili 151' l JlF&Lz Owner's email.Cf� jde.,gn 0 ae COrr) Owner's Phone#: v�,7r� %�O � � oZ Agent's Name: Agent Phone#: Agent's Email: S�yC� v� 7�� 7�m �� t% -W y ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION (Bottom portion to be completed by the Adiacent Property Owner) I hereby certify 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. A I DO NOT have objections to this proposal. I DO have objections to this proposal. If you have objections to what is being proposed, you must notify the N.C. Division of Coastal Management (DCM) in writing within 10 days of receipt of this notice. Correspondence should be mailed to 943 Washington Square Mall, Washington, NC 27889. DCM representatives can also be contacted at (252) 946-6481. No response is considered the same as no objection if you have been notified by Certified Mail. WAIVER SECTION I understand that any proposed pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, 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 revetments). (If you wish to waive the setback, you must sign the appropriate blank below.) I DO wish to waive some/all of the 15' setback Signature of Adjacent Riparian Property Owner -OR- I do not wish to waive the 15' setback requirement (initial the blank) Signature of Adjacent Riparian Property Owner: Typed/Printed name of ARPO: LOVL ; S C, Mailing Address of ARPO: PO 136 X � e.`) GU /V C 27 0 6 ARPO's emaid" "trtP � ARPO's Phone#: �D Y' �Z? -�7 �J7 Date: ; -a - "waiver is valid for up to one year from ARPO's Signature" Revised July 2021 7] �� Rilqcoyte� �u(KW Re P[aLenl6nT 09C K ,co,X,3. w ovl�d u