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HomeMy WebLinkAboutQuinlan, Chuck 84832C0 1*F`°"R", ❑LAMA ❑ DREDGE & FILL 9 84832 A B c D 3 Previous permit s GENERAL PERMIT Date previous permit issued N.UNew []Modification [—]Complete Reissue ❑ Partial Reissue 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: r` 15A NCAC ( { i ❑ Rules attached. ❑General Permit Rules available at the following link: www.deq.nc.gov/CAMArules Applicant Name = Address City Phone # ( r_ ) Email r" i be t,- t ,Ii it - j .1 State ZIP i Authorized Agent Project Location (County): Street Address/State Road/Lot #(s) Subdivision City Affected ❑ cW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body (nat/man/unk) AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body ORW: yes/no PNA: yes/no Type of Project/ Activity Shoreline Length Access Length Pier(dock)length r Fixed Platform(s) Floating Platform(s) Finger pier(s) Total Platform area Groin length/# Bulkhead/ Riprap length Avg distance offshore Breakwater/Sill Max distance/ length Basin, channel Cubic yards Boat ramp Boathouse/ Boatlift Beach Bulldozing Other SAV observed: yes no — Moratorium: n/a Site Photos: yes no yes no - -- Riparian Waiver Attached: yes no 1 A building permit/zoning permit maybe required by: F , 1 ,-V i Permit Conditions ❑ TAR/PAM/NEUSE/BUFFER (circle one) ❑ See note on back regarding River Basin rules ❑ See additional notes/conditions on back I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial) Agent or Applicant PRINTED Name Permit Officer's PRINTED Name Signature "Please read compliance statement on back of permit" Signature s Application Fee(s) Check #/Money Order Issuing Date f Expiration Date Statement of Compliance and Consistency This permit is subject to compliance with this application and permit 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 from the adjacent riparian property owner(s) has been obtained, or proof of delivery of certified mail notification of the adjacent riparian property owner(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: 1-1 Tar - Pamlico River Basin Buffer Rules 1-1 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. If you have any questions, please contact the Division of Water Resources at the Washington Regional Office (252-946-6481) or the Wilmington Regional Office (910-796-7215). Notes/Additional Permit Conditions: Please ensure all debris associated with the removal or construction of the permitted development is contained within the authorized project area and disposed of in an appropriate upland location. Division of Coastal Management Offices Morehead City Headquarters 400 Commerce Ave Morehead City, NC 28557 252-808-2808/ 1-888-4RCOAST Fax: 252-247-3330 (Serves: Carteret, Craven — south of the Neuse River, Onslow Counties) Elizabeth City District 401 S. Griffin St. Ste. 300 Elizabeth City, NC 27909 252-264-3901 (Serves: Bertie, Camden, Chowan, Currituck, Dare, Gates, Hertford, Pasquotank and Perquimans Counties) Washington District 943 Washington Square Mall Washington, NC 27889 252-946-6481 Fax: 252-948-0478 (Serves: Beaufort, Craven — north of the Neuse River, Hyde, Pamlico, 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 and Pender Counties) http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021 1*1`°""41&❑LAMA ❑ DREDGE & FILL N9 84832 A B C D y_Nk GENERAL PERMIT DatePrevius permit Date previous permit issued ❑New ❑ Modification ❑ Complete Reissue ❑ Partial Reissue 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 ❑ Rules attached. ❑ General Permit Rules available at the following link: www.deq.nc.gov/CAMArules Applicant Name _ Address City Phone # (� ) Email Authorized Agent Project Location (County): State ZIP Street Address/State Road/Lot #(s) Affected ❑ CW ❑ EW ❑ PTA AEC(s): ❑ OEA ❑ IHA ❑ UW ORW: yes/no PNA: yes/no Type of Project/ Activity Shoreline Length Access Length Pier(dock)length Fixed Platform(s) Floating Platform(s) Finger pier(s) Total Platform area Groin length/# Bulkhead/ Riprap length Avg distance offshore Breakwater/Sill Max distance/ length Basin, channel Cubic yards Boat ramp Boathouse/ Boatlift Beach Bulldozing Other SAV observed: yes no Moratorium: n/a yes no Site Photos: yes no Riparian Waiver Attached: yes no A building permit/zoning permit may be r(=Lj—,—, y. Permit Conditions ❑ ES ❑ PTS ❑ SPIMA ❑ PWS Subdivision City Adj. Wtr. Body (nat/man/unk) Closest Maj. Wtc Body (Scale;, ) U TAR/PAM/NEUSE/BUFFER (circle one) See note on back regarding River Basin rules ElSee additional notes/conditions on back I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial) Agent or Applicant PRINTED Name Permit Officer's PRINTED Name Signature "Please read compliance statement on back of permit" Signature Application Fee(s) Check #/Money Order Issuing Date Expiration Date Statement of Compliance and Consistency This permit is subject to compliance with this application and permit 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 from the adjacent riparian property owner(s) has been obtained, or proof of delivery of certified mail notification of the adjacent riparian property owner(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: F-1 Tar - Pamlico River Basin Buffer Rules 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. If you have any questions, please contact the Division of Water Resources at the Washington Regional Office (252-946-6481) or the Wilmington Regional Office (910-796-7215). Notes/Additional Permit Conditions: Please ensure all debris associated with the removal or construction of the permitted development is contained within the authorized project area and disposed of in an appropriate upland location. Division of Coastal Management Offices Morehead City Headquarters 400 Commerce Ave Morehead City, NC 28557 252-808-2808/ 1-888-4RCOAST Fax: 252-247-3330 (Serves: Carteret, Craven — south of the Neuse River, Onslow Counties) Elizabeth City District 401 S. Griffin St. Ste. 300 Elizabeth City, NC 27909 252-264-3901 (Serves: Bertie, Camden, Chowan, Currituck, Dare, Gates, Hertford, Pasquotank and Perquimans Counties) Washington District 943 Washington Square Mall Washington, NC 27889 252-946-6481 Fax: 252-948-0478 (Serves: Beaufort, Craven — north of the Neuse River, Hyde, Pamlico, 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 and Pender Counties) http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021 AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: Cbu--4 � Mailing Address: 7) ,� T Phone Number: Email Address: (( q lc I certify that I have authorized s- _ -/� — _I IA en / Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: f-4CX !�, at my property located at in Ca 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. Property Owner Information: X Signature a ��Wool� Print or Type Name Title 1/--I Q I—�---- Date This certification is valid through - ?' rT' dP. •:�ir Imo. a M e y��"y��8' 1� %MSr�r :�•i tyr��F�'rl t r+�p� _�I + e3 - N 4 s-'r4Y'Ad�,9�rG�{' - Fed• r� r'' 1 f _ .. C,'. Ir:; r� - ��r1�8S SK � 1 f- �'�,':�� �G -- � :.;��V r'L,ih� �.��: � ,• P:, .. J�- ! u ivy} to '% - �rcR tt ,;�c�j Y fl L' -I• � H :. �1 � , ,.. Ij tL Ti �1 I A. z-ts' �- i a •' 'r�,,k{' �� liy t; ask: 1uK ADJACENT RIPARIAN PROPERTY OWNER STATEMENT hereby certify that I own property adjacent to (�2_6CJe 4 A M \ Name of Pr rty Owner) property located at 1 �� l G_v� on SW?�I TS (dress, Lot, Block, R Qjad, tc.) in , t, L e-1,,-nq- N.C. l Waterbod - - � Y) u (CityITown and/or County) The applicant has described to me, as shown below, the development proposed at the above location. I have no objection to this proposal. I have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT OZ-D dci ar\ 4 6> V (0,-b 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.,, you wish to waive the setback, you must initial the appropriate blank below,) I do wish to waive the 15' setback requirement r xt, I do not wish to waive the 15' setback requirement. (Prr #or tion) Signature 4 '`a + Print or Type Name Mailing Add "Ss. City/StafeMp 1 if- ) `7-30 OG� Telephon Number / email address Date Property Owner X Prim & 2Typeli �7rr� Mai ' Addres 1� --- A)� -�_ (Cs� City/S 7�t ;� i -) .? Telephone Number/ email address Date* (Revised Aug. 2014) *Valid for one calendar year after signature* I yl Upul ty wuditia at ! U tta ! ( 6-"h cr (Address, Lot, Block, Roa ,etc.) on , in _ � cu- r'f" , N.C. Y r- Pi ater odY) (City/Town and/or County) The applicant has described to me, as shown below, the development proposed at the above location. / I have no objection to this proposal. I have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT ` ��jC�UBi`prQ/�?!RS'lIS1.tlBVe/QXat»etlf.mtSf.f!/l=l'Z �lartrnr�f.Pi��nr.'n�fs:•t�-'�e'��;;srs u:�.-� 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.) do wish to waive the 15' setback requirement. /J 1� 1 do not wish to waive the 15' setback requirement. e 0 (�P Pe wn Ipform ion) X Signature 'hl' d -- Print or Type pN me /11�'3/�r,,,� G Mail ngAddre City/ tate/Zip 1 ng ) Tgo - a2v6 Telep one Number/email address Date *Valid for one calendar year after signature* (Ad' cent Pr Signa�7tt�ure ---�FLA�Ic�r J BCD h Print or Type Name S" t7kf ai ing AddAss fw 9 {.rr-- City/State&ip Telephone Number / email address Date (Revised Aug. 2014) 13 � a i 0 m u!7 & 3y