HomeMy WebLinkAboutWoodard, Catherine 78997CCAMA / KDREDGE & FILL
G NERAL PERMIT
New ❑Modification El Complete Reissue El Partial Reissue
N9 78997 A B (DD
Previous permit #
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 15A NCAC 0 -% „ f
C��� � Rules attached.
Applicant Name 9 t� Pi � � Project Location: County
Address �� ,,� 1Q 11 Q� V' tye, Street Address/ State Ro Lot #(6 ':;� 5kA Vi
City Statef�ZIP_� � ��
Phone # () E-Mail Subdivision
Authorized Agent
Affected 0 CW " "*S El PTS
AEC(s): ❑ OEA D HHF ❑ IH ❑ USA ❑ WA
CiZIP
Phone # ( ) River Basin Ve—"Ze
Adj. Wtr. Body / V V na an unkn
Closest Maj. Wtr. Body
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GENERAL PERMIT Previous permit#
ORKNew ❑Modification ❑Complete Reissue El 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 15A NCAC ®% , I 1
I�Rules attached.
j
Applicant Name (d1C1 �Pi 1(`�2 ASl Project Location: County Q
Address 3771D, 7TTAIajoQ_V i Street Address/ State RcV';;'V
( c7
City State�ZlP_ �� �QA
c
Phone # () r E-Mail Subdivision
Authorized Agent Cityocclvw ZIP
Affected ❑ CW _4.fW A JES ❑ PTS Phone # ( ) Rive Basin
AEC(s): ❑ OEA ElHHF ❑ IH ❑ UBA [I N/A Adj. Wtr. Body 1fna - an /unkn
El PWS:
ORW: yes PNA yes no Closest Maj. Wtr. Body
Type of Project/ Activity 0
Pier (dock) length
Fixed Platform(s) r
Floating Platform(s)
Finger pier(s)
Groin length r
number '
BulkheRipra length
avg istance offshore
max distance offshore
Basin, channel _ s
s
cubic yards i
Boat ramp i
Boathouse/ Boatlift
Beach Bulldozing
Other
Shoreline Length 0�
SAV: not sure yes / nal
Moratorium: n/a yes no
Photos: yes no
Waiver Attached: yes no
A building permit may be required by:
( Note Local Planning jurisdiction)
Notes/ Special Conditions
Ile
Agent
Sig ture Plqase read compliance statement on back of ermit **
Application Fee(s) Check#
Printed Name
(Scale: I = 01 )
V_See note on back regarding River Basin rules.
r2 G
Permit Officer's Printed f
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, certifythatthis project is consistentwith the North CarolinaCoastal 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 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
N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION (MINOR PERMIT)
CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERED
RECEIVED
OCT 18 2021
Name of Adjacent P
DCM-MHD CITY
City, State Zip
To Whom It May Concern:
�G `�O 21
ate
This correspondence is to notify you as a riparian property owner that I am applying for a CAMA Minor permit to
/ r-s p - r" --r®
TA
on my property at � �-�� 1i z 2 i �� 'i i"l �h i� (CjCl 'ZS
in C County, which is adjacent to your property. A copy of the application and project
drawing is attached/enclosed for your review.
If you have no objections to the proposed activity, please mark the appropriate statement below and return to me as soon
as possible. If no comments are received within 10 days of receipt of this notice, it will be considered that you have no
comments or objections regarding this project.
If you have objections or comments, please mark the appropriate statement below and send your correspondence to:
(LOCAL PERMIT OFFICER, NAME OF LOCAL GOVERNMENT, MAILING ADDRESS CITY, STATE, ZIP CODE)
If you have any questions about the project, please do not hesitate to contact me at my address/number listed below, or
contact (LOCAL PERMIT OFFICER) at (PHONE NUMBER), or by email at: (LPO EMAIL).
Sincerely,
Property
Owner's Name Q
.gIgi n -89C)LQ
telephone Number
Address City State
4f I have no objection to the project described in this correspondence.
I have objection(s) to the project described in this correspondence.
Adjacent Riparian Signature
lYln.r1L l-lr% �V n
Print or Type Name
L 1
I— Date
aS:� -C^�(a-o SI
Telephone Number
Zip
Address City State Zip
Revised July 2021
N.C. DIVISION OF COASTAL MANAGEMENT RECEIVED
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY
OUT 18 2021
(Top portion to be completed by owner or their agent)
Name of Property Owner.
Address of Property: _
Mailing Address of Owner:
Owner's email;L
Agent's Name:
Agent's Email:
`f to 4 Di GJ I ott-,
Agent Phone#:
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adjacent Property Owner)
DCM-MHD CITY
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.
11
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 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' setback
Signature of Adjacent Riparian Property Owner
-O R-
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO:
Mailing Address of ARPO: `�7 (�txs /�i � 5 Vfl
ARPO's email:
ARPO's Phone#: (e. & , C413
Date: )-Va4 *waiver is valid for up to one year from ARPO's Signature*
Revised July 2021
v - r
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit:
Mailing Address:
Phone Number:
Email Address:
I certify that I have authorized
/ Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
at my property located at 12-35
in 0 ra-d cl-1 County.
jn: � ll& 16n 0 c i () -
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.
Property Owner Information:
SigMure
Print or Type Name
cI�J AA --
Title
°Ll IV 1 202 j
Date
This certification is valid through 1'2- 1 V! 1 2 L I
RECEIVED
OCT 18 2021
DCM-MHD CITY
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