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HomeMy WebLinkAboutModular Technologies Inc 80445CAMA / DREDGE &FILL i01 " ` ' NE L PERMIT Previous permit # INew ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued As authorized by the State of North Ctlrolina, Department of Environmental Quality and the Coastal Res urces Commission n a area of nviro ental concern pursuant to 15A NCAC les attached Applicant Name ,,AA oject Location: County Address 4v� 2bdi eet Address/ State Road/ Lotf)e/#(s) City /n� ate ZI %% f Phone # `�l d Mail a `vxsipn Authorized Agent Affected ❑ cDPT ww ❑jP�TA AEC(s): ❑ OEA ElHHF ❑ H PWS: ORW: tes// no PNA yes / Type of Project/ Activity Pier (dock) length �-- Fixed Platform(s) Floating Platform(,s - Finger pier(s) Groin length number �_ Bulkhead/ Riprap length avg distance offshore max distance o fshore Basin, c annel cubic yards Boat ramp Boathouse/ BoatliF. Beach Other Shoreline Length _/ I_ SAV: not sure yes Moratorium: n/a yes Photos: yes Waiver Attached: yes A building permit may be required by: ( Note Local Planning jurisdiction) ❑ ES ❑ PTS ❑ UBA ❑ N/A Zor7�pplitaat'PFinted Name — — Sig ature Please read compliance statement on backof permit" 9 � A' plic io Fee( Check# City Phone # Adj. Wtr. Closest Maj. Wtr. Body ❑ Sqq note on back Permit Basin rules. Si natpre ( -#�— 1'o / xa'- tsl4g Date tExpir4n 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 [)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, certifythatthis project is consistentwith 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/ 1-888ARCOAST 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 AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: 61 � � 1 � ��L C �? � Mailing Address: _� 61-1�Zq971JkAl ' 0&- I L�t-- Phone Number: Email Address: I certify that I have authorized NJCJYI c�►Q� /dPn/UCt`��il't ��/l /'contractor to act on my behalf, for the purpose of applying for and obtaining all LAMA permits necessary for the following proposed development: ,L C % A-e �. A I A at my property located at 2 County. l furthermore certify that 1 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: Signature Print or Type Name Title Z -(-- I � 1- � - Date This certification is valid through l 1, ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to 's (Name of party Ow property located at � a� ' C (Address, Lot, Block Road, etc. on, t' !�� /�!r,✓L in (Waterbody) (City/Town and/or County) The applicant has described to me, as shown below, the development proposed at the above loca 'on. 1 have no objection to this proposal. have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (individuai proposing development mast fill in description below or attach a site drawing) Zo-c i2 _ �oX)ok Z, lS�af ~- tinII WAIVER SECTION 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. (I ou wish to waive the setback, you must initial the appropriate blank below.) 1 do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Property Owner, f ation) (Adjacent Property Owner I formation) ,< S17r,!na i�✓%�j/i�.G/'//�✓/ �YZ7" nuts n, .}fly //�AA/ �1t� Ji%F' s Pint dr Type Name - "` Print or Type Name etlln dre ,v Malling Address f C -2AV o .7) e Cry ^ � ►1 ci il/ e city tatetZlp City/ tate/Zip Telephone umb r1 email address Telephone Numb email address V /a/o7 0AA Date Date* (Revised Aug. 20141) �\I—Ito 6.............I.....In..,......,to-...,.i...,.,a....,* ADJACENT RIPARIAN PROPERTY/OWNER STATEMENT I hereby certify that I own property adjacent to Z -i' z /� C'4 � � f ,s (Name of Property Owner) property located at hlll5/ 0/1 . ('I'� ^-f1rf (Address, Lot, Block Rod e on _ bt L'fl. C O-e/ ..�_ (Waterbody) (City/Town and/or County) The applicant has described to me, as shown below, the development proposed at the above location. f-.� I have no objection to this proposal. I have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT Ond/vidual proposing development must fill In description below or *Hach a she drawing) WAIVER SECTION 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.) r' I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. 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