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Home My WebLink About86419A_Kuchta, Regina & John_20211118KCAIMA ❑ DREDGE & FILL .�s jVE ® N9 86419 B c o Previous g GENERAL PERMIT Artlial°�P' i°u'permit;�'New ❑ Modification ❑ Complete Reissue Reissue As authoriwd by the State of North Carolina, Department of Environmental Quality and the Cor-Awon in an area of environmental concern pursuarrt to: I $A NCAC 114 _ 1 AM ❑ Rules =a t.& to Rules amicable at the following link: www 0l; j JCAMArules Applicant Name III 1 Autho+ized Agent V + r'Gi J I - T79 Address &&2,8 11 aular � 1 Project Location (County): city me-eh4nlesvftle- ;tits ZIP 231!(0 Street Address/5tateRRoad&ot*(s) 161 Phone # ($pl- J) (O 7o -% elf 15 156 JLi a f. Qg e Email Qrtnlc w r-I fe S @ VQ hop. cam subdivision e e c city i P oZ`7 "g Affected CW ®EW ® PTA ❑ ES ❑ PTS Adj. Wtr. Body ACQ to ` E),. /unk) AEC(s): ❑ OEA ❑ IHA UW SPIMA PWS Closest Maj. Wtr. Body AJ R e4KpT-(-e SO ORW. yes no PNA: yesA Type of Project/ Activity Shoreline Length tf $$+ �r Access Length -�- Pier (dock) length X I i Fixed Platform(s) X ZO Floating Plallorm(s) t _I i I T Finger pler(s) 'a i� Total Platform area f + 1-4- Groin length/# Bulkhead/ Riprap length 1 1 -} w Avg distance offshore y T I Breakwater/Sill Max distance/ length I"i Basin, channel-f- Cubic yards f I Boat ramp ~'— Boathouse/ Boaldift Beach Bulldozingrt- [�J1110 I 1 E _L ' Other t. I I i ,- SAV observed: yes Moratorium:-t----L_�..t_. 1 " " /a yes o 7- , I Site Photos:�- Riparian y Waiver Attached: pa - yes A building permitlzoning permit may be required by: '11m (A:,Y"X z Permit Conditions (scale:("s'P` ? e -I I rT ❑ TAR/PAM/NEUSEIBUFFER (circle one) See note on back regarding River Basin rules See additional notes/conditions on back I AM AWARE OF STATUTES, CRC RULES AND CONDMONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial) Permit Signature "Please read complianx Kennon back of permit" Sig%11 3m, e .2219 l 311V Zl Application Fee(s) Check ff/Money Order Issuing Date Expiration Date RCDENR North Carolina Department of Environment and Natural Resources Division of Coastal Management Beverly Eaves Perdue, Governor dames H. Gregson, Director Dee Freeman, Secretary AGENT AUTHORIZATION FORM FOR PERMIT APPLICATIONS Date: 9-- - 14d.� - Name of Property Owner Applying for Permit: Mailing address: 92 Ij /:4 a enticontractor), I certify that I have authorized g to act on my behalf, for the purpose of applying and obtaining all CAMA permits necessary for the proposed development of at my property located at _ This certification is valid through Y - / _-ems L' (date). / Property Owner's Signature Print or Type Name ou W '�) 9e) - 7 �< - Telephone Number 1367 U.S. 17 South, Elizabeth City, North Carolina 27909 Phone: 252-264-3901 1 FAX: 252-264-3723 t Intemet: www riccoastalmanagement.net An Equal Opportunity 1 Affirmative Action Employer - 50% Recycled \ 10% Post Consumer Paper N.C. DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY (Top portion to be completed by owner or their agent) Name of Property Owner: C' i 0 0,I) d (A W) O R b d- l c- Address of Property: Sue Lane, H CH 1 cd i NC- 2 � Ci Ll'-/ j /A Mailing Address of Owner:y��`� �� Cat' `� Uq '` Ct ��,1lCC�'1�1�(� �(� / 0 lYl � Owner's email: C�IYI IS\L V�1 t E'S� .odwner's Phone#: ()�`� (L 0��-115 `I ` Agent's Name: Agent's Email: Agent Phone#: ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION (Bottom portion to be completed by the Adjacent Property Owner) 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. 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 401 S. Griffin St., Ste. 300, Elizabeth City, NC, 27909. DCM representatives can also be contacted at (252) 264-3901. No response is considered the same as no objection if you have been notified by Certified Mail. '117/_1W ;1&*[0A F6 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 -OR- I do not wish to waive the 15' setback requirement (initial the blank) Signature of Adjacent Riparian Property Owner: Typed/Printed name of ARPO: L--illL Mailing Address of ARPO: MllC 1) C _ Hu --I Jcrd , N L� q 'f Ll ARPO's email: f/A ARPO's Phone#: 2-5 z Z (- -1 - `t (-1 .3 -3 Date: P I I I %L 2-1 *waiver is valid for up to one year from ARPO's Signature* Revised May 2021 �a �.�r N.C. DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY (Top portion to be completed by owner or their agent) Name of Property Owner: ` J��1 �1'ld C�< <1C� Ko dAA &, � Address of Property: ry C 2_1 _ t `l l-I Mailing Address of Owner: I L0 U`1 hC�`��C�� C �L� �) Ct �� 11 I ��! 1 �j V Owner's email: W)-) k V� IF I `) 1 e ne s Phone#: JO _l , LL-CID , t �A 1S —31 t Agent's Name-3-tU�iS��f �N000,1 U I � II�Agent Phone#: 2r7�.' �i�st I`t.icfilCl Agent's Email: (\-� /A ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION (Bottom portion to be completed by the Adiacent Property Owner) 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. ✓ 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 401 S. Griffin St., Ste. 300, Elizabeth City, NC, 27909. DCM representatives can also be contacted at (252) 264-3901. 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) as 1� 1 Signature of Adjacent Riparian Property Owner: A, .b. C&,�6-,.,4. Typed/Printed name of ARPO: At-A,u 3. i u1Q"FiZ Ss% 13l0u1vl r2t> Mailing Address ofARPO: r_-L(ZAZ417-9 cr-7y . ruc R79o9 ARPO's email: rwoNhRouw.>,SG e/jo7NA/t ARPO's Phone#: 25a- 33S- 177P Date: 71a4�.P0I/ "waiver is valid for up to one year from ARPO's Signature" Revised May 2021 o ,Z S a.eOILC' 6e Ade" Perquimans GIS 1:,128 11/15/2021, 9:23:05 AM o a.o i o.0101 0.03 m1 Address Points perquimans nc. easement Imagery 2020 —i�—iyr�—Lr i i Blue: Blue 0 0.01 0.02 0.04 km State of North Carolina DOT, State ofNothCarolina DOT, Esn.HERE, Garmn. perquimans_nc_misc perquimans_nc_dims y"_ Red: Red Imagery2016 INCREMENT P. USGS. EPA perquimans_^n[c_lot perquimans nc_ acres Green: Green Perquinuns GIS f or tax pu"f . s only Not a legal doconnent or survey Pergrumans rxv State of NC assume any hatnllly resulting fnxn use 01 this map NC. e�'l9gq unimea iviap Write a description for your map. M 156 Sue Ln f aEk ter, jr ,a. -- v L oogle Earth • �. Its a , . . - .