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Home My WebLink AboutBlack, Shannon 80035CIvCAMA / ❑ DREDGE & FILL N. O 80035 A B U D ®GENERAL PERMIT Previous permit# GENERAL ❑Modification [-]Complete Reissue OPartial 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 Q /�j1-1 /(—,-y %/attached. Applicant Name A6111 /)Of/ black Project Location: County ( f t P C P Address /� 3 r /L I oC Address/ State Road/ Lot #(s) , -i 4 ff Phone # Authorized Affected $cw AEC(s): O OEA ❑ PWS E-Mail ✓ i _]'EW „I PTA �E9 ❑PTS ❑HHF ❑IH ❑UBA ❑N/A ORW: yes / nd' PNA Type of Project/ Activity _ Pier (dock) length ' ( ` Fixed Platform(s) i< Floating Platform(s) Finger piers) Groin length / number i Bulkhead/ Ramp length avg distance offshore max distance offshore Basin, channel / cubic Boat ramp Boathouse/ Beach Bull ozing Other l Shoreline Length SAV: not sure yes Moratorium: n/a yes I no Photos: Waiver Attached: yes no A building permit may a required by: ( Note Local Planning jurisdiction) ! rJ Agent or Applicant I no r- Subdivision City ZIP Phone # ( ) Rinr Basin ij /', Adj. Wtr. Body Q.- nat' na unkn Closest Maj, Wtr. Body G� f rr i (Scale: ❑ See note on back regarding River Basin rules. '"-�. InAA �r}...r / W� �'� Signature •* Please read compliance statementon backof permit" Application Feels) Check # 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 isinspected 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 Iandowner(s) . The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available information and belief, certifythatthis project is consistent with the North CarolinaCoastal 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 INC 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 howto complywith 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/ 1-888-41RCOAST 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. ncden r.org/web/cm/dcm-home Revised 7/06/17 JYSCAMA / ❑ DREDGE & FILL N. O 80035 A B, c; D GENERAL PERMIT Previous permit# Y]New ❑Modification ❑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 Rules attached. Applicant Name S (�/I ( lZC " Project Location: County j C { E' Address / r i _ I �- = Y l Street Address/ State Road/ Lot #(s) City State/v[. ZIP; J.,2Q Phone # (^ Y' /l.tr)r E-Mail Subdivision Authorized Agent 1CW 2EW __PTA AE9 ❑PTS Affected AEC(s): ❑❑ElOEA ❑HHF IH UBA ❑N/A ❑ PWS: ORW: yes Nn,A PNA yes Y no Type of Project/ Activity 1, Pier City ZIP Phone # (_) River Basin lk/ ' JJ Adj. Wtr. Body tF�/ / I le nat:.2inan unkn ) Closest Maj. Wtr. Body (Scale: MOM M UNIM■■■■■■■■6E1�.■■■��■■ ■■■■■■■■ ® ■■■■■■■ ■■■w��.l��■0 ■■■■■■ ME:■E■■■■:i :■�■::ii�. : ■■■■.l�J■■■■ ■a �� ■■■■ NO number �ME I �■■ ■■■■ ■■■■■III 11121111H avg distance offshore ■MM■■MMM max distance offshore:::..:: ■...■,channel.■� ■■■c MEN IN 0■■j■■■■0�■■ ■■■■■■H■■ MM■;:■�i■■ u�■::�:::::mom n��■::ii:::rum cubic yardsN■■......■®■1■;IN ..�...■■.®■ �... .■N■ ramp■■.■■■...■■ .j....■■ li■ ;/I•: MM �a■ ■■■■ ■■ IN ■�■■■■■■■■�■■■j■■■■■■�■■■■■ ■■ J�H■ ■■■■ ■■■■I■■■■■■■■■■■■■■■■■ ME■■■:■....■■ I■■.■■��ifl■■.■■■...■® ■■■■■■■■!JlJE:!■■C!t"ra:Mw�:f!►r1®■ MEN ■■ �■■■■ ■1■� l�lllli■I■■Ni■I• 1ll�Jmaii m dine Length No FA ►`►VI■►1�■■I■►��I■111l11I1n.�1�111WAN ■■■■■!�■��,r�,r��,,�■i not sure yes n/a s Cn :::::: i�nn�ml�i�i�■ ■: ■■■ �.■E �I■.®UME .:E , ME ON I Fixe Platfor Float Fing Groi Bulkl Basir Boat Boatl Beac OthE Sher SAV Mon Phot Waiv A building permit ma`y'Se required by: ( Note Local Planning Jurisdiction) A v ❑ See note on back regarding River Basin rules. j i Name 1 S' nature "Please read compliance statement on back of permit" Signatyre Application Fee(s) Check# Issujfig Date Expira ion Dale 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 complywith these buffer rules. Division of Coastal Management Offices Morehead City Headquarters 400 Commerce Ave Morehead City, NC 28557 252-808-2808/ 1-8884RCOAST Fax: 252-247-3330 (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) Washington District 943 Washington Square Mall Washington, NC 27889 252-946-6481 Fax: 252-948-0478 (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 fiver Inlet - and Pender Counties) http://portal.ncdenr.org/web/cm/dcm-home Revised 7/06/17 ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to �) �(V�n 0Q s !) �0, r 4v-., 's n //}},,(Na a of Propert gwner) property located at / c5 R (, A , + �or _ l'J q f'e ,< ��/ /�3. R(Address, Lot, Blbck, Road, Op.) � ✓t✓ , in I a ) v 0rt N.C. (Waterbod) (City/Town and/or County) The applicant has described to me, as shown below, the development proposed at the above location. I have no objection to this proposal. I have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (Individual proposing development must fill in description below or attach a site drawing) �t C'T WAIVER SECTION I--1 I understand that a 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. (If you wish to waive the setback, you must initial the appropriate blank below.) to I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Property Owner Informatio) (Adjacent Property Owner Information) Signature Signature* 5%O,v\tncbv�, r�l o �� ! atk 00les6i Print or Tyyppe Name Print or g N md (D ll a{(ling Adrj ress II aili g Address a_ levclo.tiel rAf _0 3 Cit /'s,�--yo state/Zip Cit 3y ate—. P A vi2a-S Telephone Numb/gr/email address Telephone umbe/r'/email address Date 7/� 8 I �� Da F��%�F (Revised Aug. 2014) *Valid for one calendar year after signature* a. ... �. , � r' ;AUfAiwEN"r' F1'�1h11t I?F� it'92"I"w! C)tVNi h i'A tti�€i f hereby certify that I own prapol'y acljacalit ta____ F/ Alt aline of Prota( i�wjerl ioc Cr .. �.. t C�-r',;1 lJ 1.>r:..� /of _ ..._ .. };� �clro 1 cat; t�l(a� � kiea 1 c�tc j :rksb u>r hav:t_Y+ C .r (4 sit:,ce's, (t�'ity/r.kW. rittictCccarrtvS The applicant has described to me, as shown below, the development proposed at the abov ; location. _. .... € have no objection to this proposal. __.._..___. I have obje cdor)s to this protnfsz,l. D ESCRIP KXN rai3€)r f`R ?;RAWIN G CIF PRO ?i°C1,3t ?"1.E i"SPME,NI (tr,t r eictri preypo. hWy, crevcfeaprlrrerrt rrlu f f°ff in description below or attach d site (rraed ri g / WAIVE"A SECTION i Und(!'St=,!?Ct thW c! p:@r: <!::tCl;, mooring pilinc boat snap. bre:z;,?<ru,3ter, hQ�if:i 1C=.€�"r�'...l.11i,. ( f(71n MU ! be SEA baol( Ea Mirfrniinl distance of 'l.'.)' tr�it,i nay tires. of riparian accssz> unless w.1Ivod by n'1�::. Qt 'yr9 CI wi s) i Ii"a `Nli3}V[t tilt': $E?tt?c Ck, yOL: 3'S1.1:,i irdfia€ the apprrpriatc tale7n}; b;a!ovu.i I do wish to waive: the 15' sethrac}: requiresmfesat. I do data wish to waive the 15' set.b ac}i requivenient. (P-op'erty Owner h'Iformattol"I Print or Type Name Ahar(rnr/ Ac dress "4010C'ip ;al rr1 a rllinnh r/c n:rrr�cf)(r/ss �)al "Valid for one calendar year after signature;' (Adjacent Property Owner Its?orana't}c lij Print or Type /Vance tY/.' atolZip ; fepho(nyaNumOvl f-(- oJ. ass (1R8wsall Aug. 201411