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Home My WebLink AboutPerkins, Berkeley 80550C^ ❑CAMA / ❑ DREDGE & FILL N9 80550 A 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 X �� and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC ❑ Ryes attached. Applicant Name Pro j County Project Location: Coun Address �- C�c �! (� i t+1 / Street Address/ State Road(/ Lot #(s) State /V( ZIP' City c. Phone # O3E-Mail Subdivision G� Authorized Agent City 1 -i ZIP ..2 ElCW ❑ EW El PTA [I ES ElPTS Phone # O River Basin Affected ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A . / .t y, fiats man unkn AEC(s): Adj. Wtr. Body , ❑ PWS: Closest Maj. Wtr. Body co)) 1/1 no. r) ORW: yes / no PNA yes / M `' >.s Type of Project/ Activity Shoreline Length SAV: notsure yes �no�..._..... ._......... i.... —`_.-- 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 (i o , � k-- I (c- A-'4 (Scale: r (' ❑ See note on back regarding River Basin rules. ��/? C' Z" Agent or Applicant Printed Name Permit Officer's Printed Name Signature ** Please read compliance statement on back of permit ** Signature Application Fee(s) Check # Issuing 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, certifythat 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 howto 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/ I-888-4RCOAST 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 ❑CAMA / ❑ DREDGE & FILL N9 80550 A 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 15A NCAC ❑ Rules attached. Applicant Name ! 1` J` Project Location: County Address jr l ! Street Address/ State Road/ Lot #(s) r f ,- . City17- / �""`�'" ' State �J ZIP Phone # ( ) E-Mail Subdivision Authorized Agent City ZIP Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Phone # O River Basin AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body i' ` ' (nat /man /unkn) ❑ PWS: Closest Maj. Wtr. Body ORW: yes / no PNA yes / no � 1 ` � i Type of Project/ Activity (Scale: Pier (dock) length Fixed Platform(s) _- I Floating Platform(s) _ _ _.... •• - - - _ Finger pier(s) �v Groin length - - -- - - ..: r - 1 _........ : - number Bulkhead/ Riprap length _ �-............_.__..— —.— ........ ._..... _ avg distance offshore Ii�- max distance offshore Basin, channel I ' s E 1 I cubic yards I 1 Boat ramp , Boathouse/ Boatlift - ..... - - - - - - - - - I -j--- - - -- -- - --i..... i--..._... - - -- --- - - - - - - -- - .i - - -- . - — Beach Bulldozing — -- Other i I ' Shoreline Length I , I I i SAV not sure yes no . - --- ; - Moratorium: n/ a yes no I I _ � Photos: yes no - ( - - i i --� i - Waiver Attached: yes no -- A building permit may be required by: r '' ❑ See note on back regarding River Basin rules. ( Note Local Planning jurisdiction) Notes/ Special Conditions Agent or Applicant Printed Name Permit Officer's Printed Name Signature ** Please read compliance statement on back of permit" Signature ApplicationFee(s) 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 howto 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/ 1-888-4RCOAST 252-946-6481 Fax: 252-247-3330 Fax: 252-948-0478 (Serves: Carteret, Craven, Onslow - (Serves: Beaufort, Bertie, Hertford, Hyde, North of New River Inlet- and Pamlico Tyrrell and Washington Counties) 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) 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. DMSION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM CERTIFIED MAIL; RETURN RECEIPT REQUESTED or HAND ULM (Top portion to be moetlad by owner or their agent) Name of Property Orm r i �9ftUll A I / A , Aftm of Property: - -5 L of owner: r%/ owners etrtaii: & rk a er k Aeenrs Name: Agent's &Mlle &I Phmem I/-9- aL—Ai Agent phone*: A�C Nc,�gs9� iI hereby certify that t awn property a4anard tithe above referenced property. The kUdM Aeduing farthls permit has described to me, as shown an the attached draiwtrg, the development they are Rmpo ft. A desai bon or draw m. with dimensions. must be orovided with this,. I DO NOT have objeciorm to this proposal. I DO have objediorrs fa this proposal. ff you haw otyeW" to what is briny proposes you must no fy the N.C. Muftlon of Comm Manayrment (DCH) in wrift within 10 days of receipt of this notice. Comsspondlrnco shark► bo maned to 400 Commerce Ave., Yoreheaii Chy, NC 28W. DCU repiresentNiws can also bo conbmtrd at (252) 808-280L Mo response Is considwW the same as no obj ctiarr ffyou haw bare, tvtdlid by cartlttrdt Jut 1 understand that any proposed pier, dock, m wig pWngs, boat ramp, breakwater, boathouse, Mt. or groin must be set back a mkrlmum distance of 15 from my area of riparian mess unless waived by me (this does not apply to bulkhasds or riprep mvetrneritay. (N you wish to waive the setback, you MUM elan the appropriate blank below.) I DO wish b valve somWall of the 19 eatbacc Slgmfure ofAoowd Pm" owner -OR- I do not nidi b wahre the 19 w0mc k requir rnerd (Initial the blank) Q• r eonalf r Bosun Head of School for Business mw Ffturrq Ravenscroft School, lrm 7409 Fags of Nme Rd. Raleigh, NC 27615 Signature of Adjacent Riperlm ("roperty Owner 7.Oom • 4otummOnivanscrorl.org Typo&Pditd name of ARM `--� IMaiting Addrwm of ARM ARPO's ema8: ARPO's Phon4& Dab: 'waiver Is valid for up to one year from ARPO's Signatures• RM"d J* 2021 x: N.C. DIVISION OF COASTAL. MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM CERTIFIED MAIL • RETURN RECEIPT REQU9910 or HAND DEUV R (Top portion to be completed by owner or their agent) Name of Property Owner. r � �C' f Address of Property e SD u o 'r ' �'� Mailing Address of Owner. ��% e S o v►/ L rr►e-fr-Id s/e Owners email: De_ rk et k t h 1 a Ya uA-cbwner's Phone#: "t I "/ 02 �' I4 g Agent's Name: Agent Phone#: Agent's Email: ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION (Bottom portion to be completed by the Adjacent Property Owner) 1 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 descriDtion or drawing, with dimensions must beprovided-with this left r. 1 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 W you have been notitsed 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.) 1 DO wish to waive some/all of the 15' setback -OR- Signature of Adjacent Riparian Property Owner _ i do not wish to waive the 16 setback requirement (initial the blank) Signature of Adjacent Riparian Property Owner Typed/Printed name of ARPO: Mailing Address of ARPO: Q po' ARPO's email: a CA d �� Iva O t, rn fn AWO■s Phone#: i Q (— 56 3_ 'RR 3 g Date: A a 'waiver Is valid for up to one year from ARPO's Signature* Revised JWv 902f AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: &fhleZ Mailing Address: „S /1 Z 2 J ou 17 64 f. '�67,*x era V ls% VC Phone Number: T - a / r O Email Address: e• ,(X e. f k 1 certify that I have authorized G! twd A (AS e xrq (rc-- � q�/ Agent t Cont for to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: Yi S+61 1 I rl SIB at my property located at S- in r fete County. eawa l l 'fib re ockl r QXil 110 4)1 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. 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