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79424A_Staley, Richard_20210920
(W- ✓ ❑ CAMA / ❑ DREDGE & FILL O ,. N . 79424 'JA B c D GENERAL PERMIT Previous permit # ❑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 I SA NCAC O Rules attached. Applicant Name - A ' Project Location: County Address f<�-e \1 C Uf Street Address/ State Road/ Lot #(s) CityState W ZIP t: t Phone # '�3` kt� E-Mail Subdivision Authorized Agent • ct.t , 1,�� ,tiE, AC' City ZIP Affected ❑ Cw ❑ EW D9 PTA ❑ ES M PTS Phone # ( ) River Basin AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ WA Adj. Wtr. Body (nat /man /unkn) ❑ PWS: v, ORW: yes / no PNA yes / nd Closest Maj. Wtr. Body yy i { K ivf'V 71 NONNI was 11M No amomomms 10, IMMUNE W21101p,211ME nil MMM!!!! MR PENIS !MPH MEN MFAUMML�4plmm ME i Agent or Applicant Printed Name Permit Officer's Printed Name Signature ** Please read compliance statement on back of permit ** Application Fee(s) Signature '/C0/1.( I/ZO/-tZ Check # 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 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 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 Name of Property Owner Reques" Perrnit I cwW that 1 have authortwd L.-agdee7 - t77CIr; lle --T A9W I C to act on my behalf, %r the purpose of applying for and obtaining all CAMA permits necessary fir. the Mowing proposed developmem&,X 35 i el I LI r I (D' Pl a ,� c.1 xab S�PP��n 3 j< 3� ' cut""al k at my ply loc ab3d at `-{ -5 in T� County. I fur#wmore certify that I am authorized to grant; and do in fact grant permission to Division of Coastal IKanagaement staff, the Local Permit Officer and then agents to enter on the akwemenboned lands in connection wifh evaluafing information nested to this permit app. ichavd 344 Print or Type Name ?ro per+Y Ow✓1 e+-- This cx"fication is "M tnrougn l herd cry tgd i own property t ID property located at�Sn RONA u) on � � w . N_C_ (MYakboxdy) (dawn a&94 County) The applicant has described to me, as shown below, the development proposed at the above iocafion_ _ l have no ob CUM fo ffft FgXWal. ! have objedwns to this proposal. ' ION ANDIOR ORAIiM OF PROPOSED ©EVEIAPNIEW _ Pf 14- c d 3 w x sc� L- CaI44 VINYL 601*10KAD sEcnoN i understand ftwd a pier, dock, mooring pilings, boat rarnp, breakwater, boathxm-,- fit or groin must be set bade a rrrsanum die of 19 tun my area of riparian mess unless waiaed by me. (If you wish to waive the sebadc, you must initial the appropriate bku* bebw_) l do wish to waive the 19 suck requeernent t do not wish to waWSOM 19 wdAck mq* ernent t Petit 4 Win? Ra>t ? T PMW or type Name i5h br . q S 3 PQ VI STA d A r' �G xt .2 t" ,a 6 T,'`l. �, 27? a9 ys3 3l(r �S�-33• -.214 2ANLA Ie4jf t address t Mumbsrlem� addkw �// Spa ,oz/ Date Duke* ADJACENT RIPARIAN PROPEM OWNER GTAT lff I hereby certify tify that I own property adj mt IQ JZ & w 's property located at LIS Cos^ �/` i�5rf G.� on L,,-,LVA in , — . P (Wal arbody) tCri Town akfarCow The applicant has described to me, as shown below. the moment proposed at the above location_ I have no objection th this prgwsal. I have objections to this proposal. ONION ANDIOR DRAWING OF PROPOSED DEVELOPMENT . - --- �.. _ . _.._ _- og dev�elopme>ti must fib in iw or attach a sf j _A4. ; 0" I U Co rs4"`--NW114 I&,/— F , G �- 5�i e dam. I ���o/'.-►-t �d 3 w .r 3� L- L ufwW, WAMM SEC-1XM I understand tW a pies, dock. mom % pNr+gs, boat ramp, bredwsWer. boathouse;- It or Wm must be set back a adrdmmndial P i g of 15' from rrry area of riparian access unim waived by nta-(f you wish to waive the sedxw k. You must IrdW the appropriate black below_) I do wish to waive the 19 seffiac3c requi emerft- 1 do not wish to waive the IT selimc k re*+ement. (Property Owner lrtormation),,- (Aommt Property Owner Information) 16- 7,4 «fZh 51 L%A= CNC;jIda �3i� T�ejohov�e Mnnbw/ ad�ss �—/'3—Z02-1 ar Type Mame I '3 wig"Oo©v /�7 ✓d �� 77 << V� z z0/.) `4 �, .3 .. Yy6 2-L» - Telephome Number/emei address Ei3- Z-0y M o � Su c_ L, ✓� 0�1 a /o V v) 6) Af ,adofc � Yo t/Ut5,11 ' y aa�v� a 1 •, A ,L Lit March 29, 2021 fvY OL r \rti. 54- a 2'1�10CA Paoli intnnk C�ni inty N('. W55 V' ', D{' 1:1,128 0 0.01 0.02 0.04 mi 0 0.02 0.04 0.07 km NC CGA OwEye, Maxor, MlcrowN o?� ���� .� .ran �1 le Earth 200 ft AML. 'FA'w N