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Home My WebLink AboutKelmell, John 84158C1+°``°"S'^I ❑CAMA ❑ DREDGE & FILL N9 84158 A B C D 0 3 GENERAL PERMIT Previous 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: 15A NCAC ❑ Rules attached. ❑ General Permit Rules available at the following link: www.deq.nc.gov/CAMArules Applicant Name _ Address City Phone # ( ) Email Affected ❑ CW AEC(s): ❑ OEA ORW: yes/no State ❑EW ❑PTA ❑ IHA ❑ UW 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 Authorized Agent Project Location (County): ZIP Street Address/State Road/Lot #(s) ES ❑ PTS ❑ SPIMA ❑ PWS SAV observed: yes no r Moratorium: n/a yes no Site Photos: yes no Ij - Riparian Waiver Attached: yes no A building permit/zoning permit may be required by. `u l Permit Conditions Subdivision City ZIP Adj. Wtr. Body (nat/man/unk) Closest Maj. Wtr. Body fr Y' (Scale � �,� 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 Application Feels) 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: 1-1 Tar - Pamlico River Basin Buffer Rules F] 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*`(OAS r', ❑CAMA ❑ DREDGE & FILL N9 84158 A B C D 2 = ermit GENERAL PERMIT Date DS previous 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: 15A NCAC ❑ Rules attached. ❑ General Permit Rules available at the following link: www.deq.nc.gov/CAMArules Applicant Name Authorized Agent Address Project Location (County): City State ZIP Street Address/State Road/Lot #(s) Phone # (_ ) Email Affected ❑ CW AEC(s): ❑ OEA ORW: yes/no DEW ❑PTA ❑ IHA ❑ UW PNA: yes/no Type of Project/ Activity ❑ ES ❑ PTS ❑ SPIMA ❑ PWS Subdivision City ZIP Adj. Wtr. Body (nat/man/unk) Closest Maj. Wtr. Body Shoreline Length t i Access Length - - — Pier (dock) length Fixed Platform(s) — ._._.. i.._ Floating Platform(s) ? " 3 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 required by: Permit Conditions (Scale: ) ❑ 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" Application Feels) Check #/Money Order Signature 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: 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 AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: 1- ec- rat. h -J cji" Kee"-Cll Mailing Address: Phone Number: 518 4c / - Email Address: ��nE (I c� /�� I certify that I have authorized Agent J Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: 011C K <<,z ncx. I' / 14 , at my property located at I ) L-14? CC' _ 0r . 11'e-" -A/ ,C- , in (z-,f61r"e County. I furthermore certify that l 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: K" RECEIVED f� Signature NOV 2 4 2021 /'�e//.,e %/ Print or Type Name DCM- ill) CITE' 0/).- Tide / : Date This certification is valid through I l 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: 14 et, + A e r'-t' T.) �, N Address of Property: L/ G/, }, CC,? %C_ It r� �`� w '?�� % _ S-3 70 Mailing Address of Owner: ___.I j r ._- S`A�? Owner's email: _ �ri, // �„K� 4: Owner's Phone#: Sri S c, ff S Agent's Name: AP1.1 JG Agent Phone#: a2aZ -fit: `, Agent's Email: _-- (AIC j,, f) CU G /_.. �► � % Lc� 4x 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. 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 90 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 1 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 Signature ofAdjacent Riparian Property Owner K612 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: ARPO's email eARPO's Phone# f ��3 rr—= Date: ___... t i) (� ) "waiver is valid for up to one year from ARPO's Signature* RECEIVED NOV 2 4 2021 0C -MHD CITY Revised May 2021 N.C. DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM ER'IJFIEQ MAIIL RETURN RECEIPT REQUESTED or HAND DELIVERY (Top portion to be completed by owner or their agent) Name of Property Owner, .-_-.- 14 _�,? L� Se_ ` ' 4" _ ' . . ,,.. r ...___....._.. r Address of Property: Mailing Address of Owner: :. Owner's email: _,_7 i �� "4 / —Owner's Phone#: , )j_.� r ssr — �',` Agent's Name: /¢r) , e- t1,A � Agent Phone#: ��_-_�t' � �� j 71 ,gent's Email: -� dA c !. ��c r) - r . .v. fit_..__.__.,,..} .�__...._,.___ .._ ..__,_ _....._._.._..__. _._. -- ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION (Bottom portion to be completed by the Adjacent Property Owner) I hereby certify that 1 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,prravidadwitl this letter. I I DO NOT have objections to this proposal. I DO have objections to this proposal. If you have objections to what Is being propased, you must notify the —WC, 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 beer? notified by Certified Mail. WAIVER SECTION i understand that any proposed pier, dock, mocring 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 nprap revetments). (If you wish to waive the setback, you must sign the appropriate blank below.) I DO wish to waive somelall of the 15' setback P a l Signature of Adjacent Riparian Property Owner -OR- NOV 2 4 ?021 I do not wish to waive the 1S' setback requirement (initial the blank) -- ....r._._._..__ Signature of Adjacent Riparian Property Owner ` Typed/Printed name of ARPO�� Mailing Address of ARPO: r �i t ARPO's email: •+.ARPO's Phone#: `waiver is valid for up to one year from ARPO's Signature' Revised May, 20211 t i0 t 9/Q -599-Z5Z `jW X° uom� NVId US 03SOdONd Z959Z 7N'NM MIN t-;:'L :Bulm,,pQNOd wcuv Q10 61K ON '18OdM3N 3N60 avo v3S 8411 WN WNN �zce/ct/u 313W33N NHOf '7NI'�c1aM 0 D 0 D 0 0 w d 0 a 0 0 -- — --------------------------------------- / ------- — — — W z 0 0 � a a '9 0 0 D 0 w3 D D rc ��z d]C d 0 E Z d RECENED 0 0 0 0 a7 tV 0 U O ay a� N 0 0 � J 0 0 w a 0 Nov ------------------------------------------------------------------- - - 0 0 0 D o D