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Home My WebLink AboutEverett, George 84719C0 1*jWAS'^1&❑CAMA ❑ DREDGE & FILL N9 8471.9 A B C D y = 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 4f ' r f ❑ Rules attached. ❑ General Permit Rules available at the following link: www.deq.nc.gov/CAMArules Applicant Name Authorized Agent Address t Project Location (County): City State ZIP Street Address/State Road/Lot #(s) Phone # (_ Email Subdivision City ZIP 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 ,t I (Scale• f Shoreline Length Access Length Pier(dock)length L 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 I 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: r 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 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 conditiqns. 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 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`°"Sr"1 ❑CAMA ❑ DREDGE & FILL N9 84719 A B ' C Previous o mit y = GENERAL 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_ Authorized Agent Address City Phone # Email State ZIP Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS ORW: yes/no PNA: yes/no Type of Project/ Activity Shoreline Length Access Length Pier (dock) length Fixed Platform(s) rioaang viarrormis) ringer pierls) 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 i mL Moratorium: n/a yes no Site Photos: yes no Riparian Waiver Attached: yes no A building permit/zoning permit may be required by TAR/PAM/NEUSE/BUFFER (circle one) Permit Conditions ElSee note on back regarding River Basin rules ElSee additional notes/conditions on back Project Location (County): Street Address/State Road/Lot #(s) Subdivision City P Adj. Wtr. Body (nat/man/unk) Closest Maj. Wtr. Body (Sca 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 Fee(s) Signature Check #/Money Order Issuing Date Expiration Date Statement of Compliance and Consistency This permit is subject to compliance with this application and permit c+onditiops. 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 APPUCA'nON Name of Property Owner Requesting Permit: Mailing Address' Al f / 7 rig 1r ctrt�- Me re Phone Number: V9 - -Ze $ - 71 SY Email Address: � �- ' t e-U e r e ff-`j .`f r,'I I CCw% I certify that I have authorized R w' e k b Agent / Cortractor to ad on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the fo4lowing Proposed development: c> t r'✓n r 4, v • e�� 1 at my ply located at Z cL 4A e-_ T in _ /' rr"� County. 1 furthermore certify that 1 am authorized to grant. and do in fact grant permission to Divi5ron of Coastal Management staff, the Loca/ Peru* Officer and their agents to enter on the aforementioned lands in connection with evaluating info matron related to this permit application. ProperW Owner Inforrrrahon: ,�' Signature 1 in or Type Name Title i7 1 �°;1 Date This 0ettification is valid through / 2 1 ?l 1 Z�2r N.C. DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONNVAIVER FORM CERTIFIED MAIL - RETURN RECEIPTTjEQUESTED or HAND DELIVERY (Top portion to be completed by owner or their agent) Name of Property Owner G e o re P_ P CJe ry- Address of Property: - 4? / 7 Hy ll Sj t-a.heJ Aore.i eAs Cr fy Mailing Address of Owner. sit /h e... OwnerGr 's email: to r w 'r Je !(tA ( n tOwneIs e Phone#: q m 71 Agents Name: An &re- tJe_bb Agent Phone#: --(1 G 5'— �! 3 7 $ Agent's Email: we? b b d d G-�p 4 ehQL.t C.m.r+*- ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION (Bottom Portion to be completed by the Ad*acent 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 provided with this letter. I DO NOT have objections to this proposal. ^ I DO have objections to this proposal. if you ham objections to what is being proopose4 you moist noW 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 con aded at (252) 808-2808. No response is considered the same as no objection if you have been notified by Certified AfiaiL WAVER SECTION I understand that any proposed pier, dock, mooring pilings, boat ramp, breakwater, boathouse, Oft, or groin must be set back a minimum distance of IS! 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 somefall of the 1 S' setback -OR- Signature of Adjacent Riparian Properly Owner 1 do not wish to waive the IS' setback requirement (initial the blank) Signature of Adjacent Riparian Property Owner: Typed/Printed name of ARPO: Mailing Address of ARPO: n / ARPO's email: �t h i'touw Q q AU ARPO's Phone#: �l % 4 Date: "j ^ •waiver is valid for up to one year from ARPO's Signature* Revised May 2021 Address of Property: N.C. DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONI WAIVER FORM CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY (Top portion to be completed by owner or their agent) Name of Property Owner. 7r y 17� t-F o y L ��z riUl o r h e e� C; f y N G 5- 7 y e in JYi 0 c. e- It Mailing Address of Owner. Gu , 9 �� l - GOvri ' Owners email: c� ` ztts� �`�k /Owner's Phone#: 7 n Agent's Name: f� c b�--1" A c,cr r e. t �t t� Agent Phone# ± I -A ' 6 (o 5 '� 3 7 g Agent's Email: W e✓ b b d d (Aj_ Vv,0, i CC) ✓1I 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 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. ff you have objections to what is being proposed, you must notify the N.C. Division of Coastal Management (DC69 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 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.) I DO wish to waive some/all of the 15' setback -OR- Signature of Adjacent Riparian Property Owner I do not wish to waive the 15' setback requirement (initial the blank)r Signature of Adjacent Riparian Property Owner. (77( 11.1 &-Q�� Typed/Printed name of ARPO: 1 i r l W L l-L 1 `5 Mailing Address of ARPO: 42l O LtA 114 �{��R 1 I� ;� CAT4 0C , ARPO's email: IS rn(D ��i� ec.rt_ W�pRPO's Phone#: Z52 -1 ZU - Gb$g Date: �t - �� - Z� *waiver is valid for up to one year from ARPO's Signature* Revised May 2021 P F3i^2""S��C�`'i'� 1 t J r .. �.4' ' ,a. .. 1 . .. LA.'�i�i„ . ��. "'�• -. .. ��:, i ?i'+i�': ��k' �G^'��N7y�';�Me'Ts'.ran»w'lR"t. dK�)M. F ..'�j�4T.�d�^�h .�`14.�' .-_. f S- .. _ ♦ ..:��,G ., _. .,�.:_. :-•,. „-i.:. .s. .c.5 .._vai`: �t S.- p"i -s. �d3 �e-: r.'i40 ,y;: _ ,fir xMg�` _..y# i of" q'' ritZ!i'%1V�?jjyyl,! i.. ";+. �` c; b.'.#, :fi •. .. z.' c-.�'{C�,tl, ��'#� ie ::=`y, ''SS7�, -�y :..#��.f�i4�a„ h # en. '.- .. .,. �+1 � ;-f -'� . � - ."r; ,r'-;+7•.�_:�%�v . 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