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Home My WebLink AboutBelanger, Paul 79607CiC AMA / ❑ DREDGE & FILL NI? 79607 A B C D ' ENERAL PERMIT Previous permit# New ❑Modification ❑Complete Reissue ❑Partial Reissue Date pre vio s permit issued As autho zed by the State of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in rea lenvironmental concern pursuant to 15A NCAC MPutt ?ed. Applicant Na Project Location: County Address Street Udress/ State Road/ LQt #(s) I n City Pho Autl Affected ❑ OEA ❑ HHF ❑ IH AEC(s): ❑ PWS: ORW: yes / (o 1 PNA yes / Type of Project/ Activity Pier (dock) length Fixed Platform(s) Floating Platform(s)- Finger pier(s) `----� Groin length number — --------1 Bulkhead/ Riprap length avg distance offshore j� f max distance offshor Basin, channel cubic yards Boat ramp Boathouse/ Boatlifi Beach Bulldozing Other Shoreline Length SAV: not sure yes o ...--- Moratorium: n/a yes Photos: yes no j Waiver Attached: yes o -- A building permit may be required by: ( Note Local Planning jurisdiction) Notes/ Special Conditiy�ns Printed 6 6A ❑ N/A Subdivision City Phone # Adj. Wtr. Body_ Closest Maj. Wtr. Body 0 � I River Baas'pin (Scale: / ) ing River Basin rules. Sig ature *Ipwease read compliance statement n backof permit ** App 'cation Fee(s) Check # 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 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/ 1-888ARCOAST 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: 'PA U i r- L A -A)� Mailing Address: Phone Number: Email Address: I certify that I have authorized �r4 v&Z eE0, Re. cefW I Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: EUf;�/ 5b GJ /7 74- 57-L--P.5 at my property located at -1,25 in County. 1 furthermore certify that I 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 Omw Information: ' j i � q 0 Signature TAL) -aa. Print or Type Name Q)A)E)' Title �l , Dot, l Date Ck1�51054 RECEIVED LIAR 012021 This certification is valid through 1" 7 l151-5 l 2 bZ / DCM-MR D Cf>Yyf ANIA3 #WHA AC� -Al >. d �! ' ' - , I , - , I. W40 R� OW(PU iJiT k fil ,to qo M A4. vrq ne y.�� - c AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: -PA U �,L'� Mailing Address: -lam ALY 49L5-,�l Phone Number: Email Address: I certify that I have authorized 2!2 L—. Agent / Contractor ST74em Qr1Z) to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: fU��/5c4 at my property located atD� W(7 in 4 5 County. I furthermore certify that I 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. Signature ?AQ L �aAj�� Print or Type Name �! � A)E Title Date This certification is valid through ") lei l 2 b2 irm ivlis TOO Dvy4gqs ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to4ti• � ` (Na a of Prop e Owne property located at _J� _7_73c /_ � ) ---7 — (Address, LotBloc , oadd etc.) on c'fu%r'�%Gl: .`r in ✓� r�r%/�'.� _ N.C. (Waterbody) (City/Town and/or County) The applicant has described to me, as shown below, the development proposed at the above loc ti n. 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) r i 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.) I do wish to waive the 15' setback requirement. — I do not wish to waive the 15' setback requirement. (Property Owwne��r Information) (Adjacent Property Owner Information) qn�_J_ 66 / Si<Tncrtrrrr 5i�� r IIT ` Print or Type N men . Print oType-lame (, 1 Mail*n Address , 7� Mail' Ad resA (?— L_�, L I City State/Zi ,. , Cityl`State2ip Telephone Number; -email address _ Telephone Number/ email address 1 9 —2co t (Revised Aug. 2014) 'Valid for one calendar year after signature' ' r' f , ADJACENT RIPARIAN PROPERTY OWNER S TATEMEN� ,.e.. hereby certify, that. i own ppropertya:�iac:errt to � ( a @ Of prope vrope. ty #ocated { r aterbsadyj (Cityr1'own andlor County, . 'rhe applicant has described to me, as shown below. the development proposed at the above locatio 1 have no Objection to this proposal. h!` 1 have objections to this proposal. _.w..� DESCRIPTION ANDIOR DRAWING OF PROPOSED DEVELOPMENT ' •hr)dividuai proposing development must fill in description below or attach a site drawing) ra-.v WAIVER SECTION 1 understand that a flier, dock, mooring pilings, boat ramp, breakwater, boathouse. lift, or groin trust 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.) 1 do wish to waive the 15' setback requirement. A i do not wish to waive the 15` setback requirement. Property Owner Infon—nation) (Adjacent Property Owner Informati-or;i s t �•dt"��ht�ri�� J;��€r;�E+r: � *� 3r.= <�*�c?r�a�,; Math Addr4ps� ! t• 'Revised Aurg. 2014 'Valid for ane calendar year after signature?' - - - - - - . . . . . -W, tW "gig, am '57 12 .�p M w I po- gp. t cr O m Al. 4.� r>- _ � , s;; �; �,