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Home My WebLink AboutSchultz, Gwendolyn 80092CN9 80092 AB D Previous permit # Date previous permit issued_ cENIT EModification ECompleteReissue EPartialReissue As authorized by the State of North Carolina, Department of Environmental and the Coastal Resources Commission in an area of environmental concern Qualiry PUrSUant l@ Applicant Address Phone # Authorized Agent trcw trOEA State ZIP to l5A NCAC Project Location: Counry Street Address/ State Road/ Lot #(s) Subdivision Phone # (_) Adl. Wtr. E-Mail ilEW tr PTA t] HHF D IH nES tr PTS !UBA trN/A ztP River Basin )C Affected AEC(s): ORW:PNA yes Closest Maj. Wtr. Body I rp-p /)fPr-rrF-l1 l--: I I )t t t- I I I L i I nIrEt/l I n r-t c 2 t \)n n I I )l r )\ ( t lA I no no no Type of ProiecV Activity .- (Scale:) Pier (dock) length Fixed Platform(s) Floating Platform(s) Finger Groin length length avs distance offshore max distance offshore Basin, channel cubic Boat ramp Boathouse/ Boatlift_ Beach Other Shoreline Length SAV: not sure Moratorium: nla Photos: Waiver Attached: yes yes yes yes A building permit may be by:I s"" note on back regarding River Basin rules. ( Note Local Notes/ Special Conditions/ PermitOfficer's Printed Name W 4l4 ** Please read compliance ca llt Check # Agent Fee(s)Date :CAMA/[DREDGE&FILL E Rules attached. J 1,1I t* --+-+* ..t..-,._t-. # F r--r'-l l-il-T-l *t -+- -1 | lr, itti + r-1-t F---1_---l '1---t +-l-]--r- -t -,:---'-i.*j -r+t=]-#- L.t_"1. I I--+ I fi ET-H 1t 1 f, --1-+- ..1......-....1.-.........1 :il,,,1,,,, ,, t-11Irffi# lili. L L_J -FL ilff F-_ --.i___l-_-i-_-+-{ L+ t-t- Signature lssuing 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 nullandvoid. 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 prolect is consistent with the North Carolina Coastal Management Program. River Basin Rules Applicable To Your Proiect: L] t"r - Pamlico River Basin Buffer Rules I Neuse River Basin Buffer Rules [-l other: 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 (252-946-6481) or the Wilmington Regional Office (910-796-721 5) for more information on how to comply with these buffer rules. Morehead City Headquarters 400 Commerce Ave Morehead City, NC 28557 252-808-2808/ I -888-4RCOAST Fax 252-247-3330 (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: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 910-796-72t5 Fax: 9 I 0-395-3964 (Serves: Brunswick, New Hanover, Onslow - South of New River lnlet- and Pender Counties) http://portal. ncden r.orglweb/cm/dcm-home Revised 206/17 Division of Coastal Management Offices Applicant Name Address -CAMA/:DREDGE&FILL GENER/AL PERMIT ,New -Modification Complete Reissue -Partial Reissue As authorized by the State of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pu rsuant to l5A NCAC N980092 A B c D Previous permit # _ Date previous permit issued_ D Rules attached. Project Location: County_ Street Address/ State Road/ Lot #(s) Subdivision City ztP Phone # (_)River Basin Adj. Wtr /man /unkn) Closest Mal. Wtr. Body State ztP Phone # (_) Authorized Agent E-Mail Affected ncw trEw DPTA nES LPTS AEC(s): troEA trHHF nlH truBA trNiA L] PWS: oRW: yes / no -r*o *, i no >C Type of ProjecV Activity (Scale:) Pier (dock) length Fixed Platform(s) I t _i*r -'t--ffiilFloating 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 I I l + + +---r--t--ffi,- i1 ilr--r -,'.- !.- --1 + Beach Bulldozing Shoreline Length SAV: not sure Moratorium: nla Photos: Waiver Attached: yes no yes no yes tro ,. yes no iiti--l Ilit it A building permit may be required by' . ( Note Local Planning Jurisdiction) [I S"" note on back regarding River Basin rules. Notes/ Special Conditions !"'..- Agent or Applicant Printed Name Signature ** Please read compliance statement on back of permit ** Permit Officer's Printed Name Signature Application Fee(s)Check #lssuing Date Expiration Date ffi L_--,1_-l_r.fi I I Other I -]- li-Y:il-i__li1-r; -H"t-ffi + I r*i i---l--l- 1.-t+jri#if + ltt"t t l J--Jt i .i---l rl I !.-+-n -t _:--1 .iJ+i[lfl{+ 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 nulland 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 l) 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, certiry that this proiect is consistent with the North Carolina Coastal Management Program. River Basin Rules Applicable To Your Project: I tar - Pamlico River Basin Buffer Rules E Neuse River Basin Buffer Rules E other: 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 (257-946-6481) or the Wilmin6on Regional Office (910-796-721 5) for more information on how to comply with these buffer rules. Division of Coastal Management Offices Morehead City Headquarters 400 Commerce Ave Morehead City, NC 28557 252-808-2808/ | -888-4RCOAST Fax:252-247-3330 (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 252-264-390t 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 Washin$on Counties) Wilmington District 127 Cardinal Drive Ext. Wilmington, NC 28405-3845 910-796-7215 Fax: 9 I 0-395-3964 (Serves: Brunswick, New Hanover, Onslow - South of New River lnlet- and Pender Counties) http://portal.ncdenr.org/web/cm/dcm-home Revised 7/05/ I 7 AGENT AUTHORIZATION FORM FOR PERMIT APPLICATIONS NAME OF PROPERTY OWNER APPLYING FOR PERMIT Gyendobuschultz MAILING ADDRESS 105 Lakeside Dr. Havelock NC 28532 TELEPHONE NUMBER 2s2-658-20ss I certifr that I have authorized Dan Folev , to act on my behalf, for the purpose of applying and obtaining all CAMA permits necessary for the proposed development o at my properly located at This certification is valid through (l) Year (date). @roperty Owner Information) Signature Print or Type Name Title, co. owner or trustee for property Date Telephone Number Email Address ADJACENT RIPARIAN PROPERTY OWNER STATENENT I hereby certify that properly tbcateO at I own property adjacent to of (CityfTown andlor GountY) The applicant has described to me, as shown below, the dewlopment proposed at the above ,S t inon location. I have no obiection to this proposal. DESCRIPTTON ANDTOR DRAUIING OF PROPOSED DEYELOPiiENT (tnfividual proposing &vdopmenf must fitl in descriptfonbelow oratbch asite dnwing) trct oqF 4bz,t o?Io{I 7 WAIVER SEGTION _:-: tunderstandthata.[ier,docr,moorin@,boathouse,m"oigroinmustbeset back a minirnum distance of 15' from my area of riparian access unless waived by me. (lf you wish to waive the setbac-k, you must initial the appropriate blank Uetow.) Oa or I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requtrement. Snrner or Olrner lnformation) Date Telephone (Revrsed 6/1WO12) (Addrcss, c {+<) 8n5ln21 IMG_1807jps i1 It 'r. r' dgt b.ar, l,t d&f rcPdadstt*&!'o i It r..5oq.frnio0* 9t!!'6J. Orrrr I I https J/mail. google.com/maiUr.r/0/ff nbox?projector= 1 1t1 lo I fud. lo{tarqdei)Q r|rh loxffi6UtGratht*, i*-Je- I do wrrh b ryrrlt k6 l.$ tdArct rrqrorrrnt, - t do notx,rrb !D *trlrt t\6 !S sctb*k mQ[hFtIL