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Home My WebLink AboutRushing, Rodger 80062C®CAMA / ❑ (C " DREDGE & FILL N9 80062 A B D GENERAL PERMIT Previous permit# \� kiew ❑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 I SA NCAC 0 Pt]Rules attached. Applicant Name rq , P (\ i_I ,1A r /) 'I Project Location: County i n S } P � Address i 1 \ n< V i i' ( b( V(" Street Address/ State Road/ Lot #(s) 14 (� City r ��tiopp�� 3k6,y,%tateA/_C_zlP9 Lf--'1 Phone #) /f 0% D�St� E-Mail+ I Subdivision Authorized Agent A n race 11 e i7 b City ZIP Affected AEC(s): UM ❑CW -,M EW APTA ❑OEA ❑HHF ❑IH ❑ PWS: yes / nc PNA yes / no) ❑ES ❑PTS Phone # (_) River Basin V —6_ a ❑UBA ❑N/A Adj. Wtr. Body rk �''/ a'/14 n t man mkn) Closest Maj. Wr. Body P U 0'.:fl.:::'■'■'■'■' ■'.■ :' : ■®. Y■■ ■ ■N ■■■■■■■■� ■■■ ■■ ...�.::.■■■::■■■:■■......® Foom■::■:� �:0::NEMEMEEME:�::�WOM►■a■:::�■® .■■■■ ■ ■■■■■■NN ■■■■■■■ iMENEM■�■■■■■■■■■N®N■■■■■■ ■■■■N�N■■■■�■N .....■■■■■■ .MEN ■■■■■■ N■■NN■■■■■■■N■ ..■■. N■.....N■■■......■■■H■ ■■■:- 1::::: N■■■ ■■■NN■■■■■■�®■■�■■■ N■■■■■■■■■ME • N■N■■■N■NN■■■■■■■■NNN■■�■■■■■N■ N■■■■■■■■ a■■■■■■� sommmm�� ■:.::��. NEE N�� ME ■■■■ ::■■■�iji■i�■ ii:::ii��ii ■■■ MOM■■■ ■■■■■■N■ ■■■.■l�■■■ N■■ ■■■■■ ■Y■■tCti■i■■■� ■■■■■■■■NN Iw��N!■L�■■■■■ ■■■■■■■N! :::t ■::::: Agent or Applicant Pri%ed Name _ Permit Officer's Pit rated Name— Signature "Please read compliance statement on back of permit" Signature I r c/. 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 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 ❑ ❑ 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 howto complywith these buffer rules. Division of Coastal Management Offices Morehead City Headquarters 400 Commerce Ave Morehead City, NC 28557 252-808-2808/ 1-888ARCOAST 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 River Inlet - and Pender Counties) http://portal.ncdenr.org/web/cm/dcm-home Revised 7/06/17 i �CAMA/'❑DREDGE & FILL GENERAL PERMIT VNew ❑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 pursuant to r Applicant Name Address i City Staten ZIP' 'fI Phone # 1, - -) E-Mail rr i Authorized Agent ),( P i `) Affected O CW �m EW rA PTA ❑ ES ❑ PTS AEC(s): L20EA ❑ HHF ❑ IH ❑ UBA ❑N/A ❑ PWS: ORW: yes / no PNA yes /l"J N9 80062 A B c D Previous permit # Date previous permit issued 15A NCAC ' -l-f. / .d Rules attached. Project Location: County Street Address/ State Road/ Lot #(s) i Subdivision City ZIP Phone # (_) River Basin ;7 Adj. Wtr.Body i`' /- I/a� /nac'ma nkn) r Closest Maj. Wtr. Body �"! F v .■■■■■ .■■ ■■■■■■■■�■■■■■■■ENE ■■.Y■ME ■.. .�C '�I�■�..■�.. .■■If. . ■■■■ .. ■■ .. . ..■ ■■■ ■ ■■■■■■ ■■■■ Y. ■ ■■■ ■■■■ ■® ■■.C.�.■■.■■.■�S...i.0..=■■ ..... ■.... ■■.® ■.■�, ...■..® ■■■■ ■■B■NS ■■■61�A�®�■.��.■. B..■■..■■H.p■.■■11111111 .■. ::MEN ::::C:':u. :::: ■■■.IN IN ■il■■■...■■ ■■■■■■■■■■ MEN ■■..■■.■■■N■.■■■■■■..� ®■■■■■ ■■■■■■■■■■0■■■■■■■■■■■■ ��.■■� ri ':ME :� ..� :IN C■'0 0 IN ME 0 IN IN ME ME IN ME momm��ommomomm INN MwEI111I111111I 1EIIIII11IIIII1I �■■■ . C..■.■■■■■■ .�.■■■..B �■.■.■. ■..■.■.r■■.■..�. Ems _■■■■■■■ ■.■r"O■■. IMS mom MEN ME MEN�C 11C'��C ...... .■.�.■ NMI Agenfor Applicant Pri edrName Signarlure '*"Please read compliance statement on back of permi *'r Application Fee(s) Check # 0 //( PermitORicer's Printed Name Signture 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 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 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 ❑ ❑ 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 400 Commerce Ave Morehead City, NC 28557 252-808-2808/1-888ARCOAST 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 River Inlet - and Pender Counties) http://portal.ncdenr.org/web/cm/dcm-home Revised 7/06/17 AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit:/��JJ'�nK 1S�t11� Mailing Address: 122 A, r 6v v A QWe r l ,,Ae I&Mw tI� 56 Vas, Ne 2$5 2 Phone Number: 336-y- V s-g Email Address: brty14Yu5ti1jM(� do covtj I certify that I have authorized Al m W 614 Agent / Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: 6 0 C �y'g b IU Ce %t,ev�4 at my property located at in Cavteve+ 22 Ari rvileto. Ov. VVcs County. / furthermore certify that / am authorized to grant, and do in fact grant permission to Division of Coastal Management staff, the Local Permit Officer and their agents to enter on the aforementioned lands in connection with evaluating information related to this permit application. Property Owner Information: 12. 13c� V2� Signature ISveKA K1A$ .1u5 Print or Type Name HO u%-t O I.0 IteN Title Date This certification is valid through/ / 7V?ZZ— Owner's email: Agent's Name: Agent's Email: N.C. DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY (Top porrttion to be completed by owner or their agent) Name of Property Owner: " cev & Nel�'4 '` �1llns 6 l Address of Property: 122 V 6yyl (ie IN. 1' �L 5, N e Mailing Address of Owner: 2 f-40 bt^�k�ruSk1ia'G@k61-001►% Owner's Phone#: J7-q[055,p 4cAv,. We boo Agent Phone#: 52- 6v`� i� �VQ ?-qqI 1009 Ge6%VV, KJV, $VIA<vsjkllt ►Mu.i 1 . C0 ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION (Bottom portion to be completed by the Adjacent Property Owner) 27291 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. Qy`""' 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.U. viwsion or coasrat Management (DCM) in writing within 10 days of receipt of this notice. Correspondence should be mailed to 400 Commerce Ave., Morehead City, NC 28557. DCM representatives can also be contacted at (252) 808-2808. 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' setbacks 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: QG flIA u Its f rdRg 1n Mailing Address of ARPO: (L � A 4 p/ ✓, } oe D, f,,e hi, Y J41,r,, v( Zirl L ARPO'semail: +Ae bin d eve/-Ico fr o, I. r ARPO's Phone#: l 1 It //�� Date: T .4-0 6 41 waiver is valid for up to one year from ARPO's Signature* Revised May 2021 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:�uS•1II��t�J Address of Property: 122 AAwMif etC �Ib✓• Pk5. A C 29512 Mailing Address of Owner: 1069yc�V�11G t(JV• VeVj122$VStL1�1ittftQ/VCQ 21291 Owner's email 6044 ASS' %94 @ a01•�Odwner's Phone#: 56' `' !� uD5 Agent's Name: /Tvoft l"eb14 �i Agent Phhonne#: 152 - 45-4x W Agent's Email: top 0-Webb G -I kiaA .'mot/ 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 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 400 Commerce Ave., Morehead City, NC 28557. DCM representatives can also be contacted at (252) 808-2808. 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 15from 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' setbac �d , a� - Signature of AdjaceM Riparian Property Owner -OR- I do not wish to waive the 15' setback requirement (injtq the Signature of Adjacent Riparian Typed/Printed name of ARPO: Mailing Address of ARPO: f Z U 0Xj5rfCVf1 N& •-/er//n ARPO's email: BGf7-, G'R/�A'' �U%+ p ARPO's Phone#: FIX- ��d 7 ic Date: G(f, 20 `waiver is valid for up to one year from ARPO's Signature' J Revised May 2021 s mp m� F�� E FEE N>y 011� IA1 (no y pm0 !r1 V 0 • C TC Tgp � I �ss ^1 m 1 I 1 1 I 1 C Z Q z I I I I I I I I I Q Z- z F N m II � m C '� mu omc Fx I O o m m g C '� yZ O+I i0 mo O N Aw N> OfnO mo I I O A -' N.�C1 N CI1 yO�^1 Rp h N g x N Q N Q Z O z 0 N m F F F O O y � i C m C m C z m Jm J J J v zJ mo Mom mo o$ mm F Fa o�+l mo NO _ C oRo mo NO C vlu66 M6 VES'CJJ s CON51, ANM MW 3AI3 OLD Ap'OK'f ROAV Ftw ikJa,1Y 21�i62 252-665-A398 RUSHING 122 ARBORVITAE DRIVE, PINE KNOLL SHORESvlq of/la/mzt vq -t s SITE PLANS 19v f