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Home My WebLink AboutEborn, Jerry 80691C—. 1CFE / ❑DREDGE & FILL ! 9 80691 A B � D RAL PERMIT Previous permit# NModification ❑Complete Reissue. ❑Partial Reissue Date previous permit issued As authorized by the State of North Carolina, Department of Environmental Quality 9 and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC Rules attached. Applicant Name C^' Project Location: County_ Address P / %, Street Addlr s/ Sta a Road/ Lot'#js)� City State ZIP ` / -- — �° Phone #- -Mail Subdivision AuthorizedAgen�'_K _ f City Z /'� _ ZIP_ L�,CW �(J�EW �/1�PTA El ES ❑PTS Phone # G %�F(rver Basin_ Affected ElOEA ❑ HHF + ] IH ❑ UBA El N/A � AEC(s): Adj. Wtr. Body �� na l man unkn ❑ PWS �� Closest Maj. Wtr. Body.,,.. ORW: yes /�-, .- PNA yes / '�/ Type of Project/ Activity Pier (dock) length y7a jdV-A--y' Fixed Platform(s) Floating Platform(s) Finger pier(s) Groin length -- number' Bulkhead/ Riprap length -- avg distance offshore --� max distance offshore Basin, channel cubic yards Boat ramp Boathouse/ Boatlift Beach Bulldozing' 0thers5wc �� Shoreline Length _--1 SAV: not sure yes no Moratorium: n/a yes no Photos: yes no Waiver Attached: yes no A building permit may be required by: ( Note Local Planning Jurisdiction) Notes/ S1Special Conditions [ ,i 0 Jerry Eborn� Agent or Applicant Printed Name Jerry Eborn Signature ** Tease read compliance statement on back of permit Application Fee(s) Check # PermT4,er'��ri Signatur 01 Issuing Date i See ote on back regarding River Basin rules. 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 [)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 how to comply with these buffer rules. Division of Coastal Management Offices Morehead City Headquarters 400 Commerce Ave Morehead City, NC 28557 252-808-2808/ I-888-4RCOAST Fax: 252-247-3330 (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) Washington District 943 Washington Square Mall Washington, NC 27889 252-946-6481 Fax: 252-948-0478 (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 RpvkPH 7/06/17 GCAMA / ❑DREDGE &FILL ,Far 51patove, NO8069 1 ENERAL PERMIT Previous permit# A B D XNew ❑Modification ❑Complete Reissue El Partial Reissue Date previous//permit issued As authorized by the State of North Carolina, Department of Environmental Quality n9 /20 and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC / �� Rules attached. Applicant Name ISA rLA Project Location: County rt1-1'1fA0A e i` Address Street Add r s/ Sta Road/ Lot #(s r- 3 City ryry� ll 2 / j� State ZI P Phone #_:4��4 >' `I(.LR`_Mail r� _ Subdivision _ Authorized Agent Affected icw AEC(s): ❑ OEA ❑ PWS: ORW: yes /� EW IPTA ❑ES ElPTS HHFIH ❑ UBA ❑ N/A PNA yes / Type of Project/ Activity Pier (dock) length ; ) A 42C Fixed Platform(s) Floating Platform(s) Finger pier(s)'"�' Groin length number'--" Bulkhead/ Riprap length avg distance offshore -- max distance offshore Basin, channel cubic yards Boat ramp ' Boathouse/ Boatlift �- Beach Bulldozing" Other ) 'es5 Shoreline Length _ I_.c—� SAV: not sure yes Moratorium: n/a yes Photos: yes Waiver Attached: yes A building permit may be required by: ( Note Local Planning jurisdiction) �Notes/ Special Conditions f Agent or Applicant Printed Name Signature * lease read compliance statement on back of permit" I -- - 3 aah Application Fee(s) Check # City 110 Phone # Adj. Wtr. Body—' Closest Maj. Wtr. Body LI See Permit ffi er's rinted arr Signatur r� � Issuing Date ZIP Basin (Scale:/1 .",To ) on back regarding River Basin rules. � l /--. /1 /) _ — 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, certifythat this project is consistent with the North CarolinaCoastal 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 comply with these buffer rules. 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, 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) Washington District 943 Washington Square Mall Washington, NC 27889 252-946-6481 Fax: 252-948-0478 (Serves: Beaufort, Bertie, Hertford, Hyde, Tyrrell and Washington Counties) Wilmington District 127 Cardinal Drive Ext. Wilmington, NC 28405-3845 910-796-7215 Fax: 9 10-395-3964 (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 AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: r�/ jit/'rdl Mailing Address: ZV- X!Verf YC' v �� Phone Number:..T'� Email Address: I certify that I have authorized 1(-0 Agent / Contractor e of applying for and obtaining all CAMA permits to act on my behalf, for the purpose �( i IV necessary for the following proposed development: I '0 p0� at my property located at in�+�� 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 enter4 on the aforementioned lands in connection with evaluating information related to this permit application. i Property Owner Information: Signature Print or Type Name Title &Q—E—NT AUTHORIZATION FOR CAMA PER PLICATION Name of Property Owner Requesting Permit: Mailing Address'. Phone Number: Email Address: Z T Z 7-S I certify that I have authorized /A- Agent contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: .1�' ck at my property located at i in. County. / furthermore certify that / 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 pennit application. Property Owner Title e D pr:FT rc�PA+��An� Pr�vP� rvK,K 1 H I hereby certify that I own property adjacent to . - d. ;LS&S za&!? � -__-- ,s Name of Property Owner) property located at - ddres , Lot, Block, Road, etc.) on y I �� , in KC. (Waterbody) ( i� tyrr wn 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 �+Jj� �y �R j }i��py }' r h/Vi117ny�jy'R+1I 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.) I do wish to waive the 15' setback requirement. Ae I do not wish to waive the 15' setback requirement (Property Owner information) Sig lzl Print or Typ,6 Name M. ailinc Address, (Adjacent Property Owner Informat o'l .Si al re* Print or, Type -Name n GitylStateVip ri Telephone Number/email address Telephone Number/email address Date � - (Revised Aug. 2014,) ;lic for one calendar year after signature* ADJAG-�N1 Klto "IAIV 1'KVrtK i Y l?W1Mf:»rr 51 h i tmcn � I hereby certify that I own property adjacent to z r2 _ `s i T(Name of Property Owner) property located at "' —ZZSddres , Lot, Block, Road, etc.) - on _ l:'�� - in �w�" �V�_Rc�ta , KC, (Waterbody) ( Ity/Town andlor County) The applicant has described to me, as shown below, the development proposed at the above tocativ . I have no objection to this proposal. —4— I have objections to this proposal. r DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT " "l Al r 5 s. WAIVER SEC ION I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin lust 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.), I do wish to waive the 15' setback requirement. 1 do not wish to waive the 15' setback requirement. Property owner Information) (Adjacent Prop" Owner Information) Qzgalvz Sig tUSi ZZ. t1 Print• or T Name print or i` � amp rr Yr� Y � � Mailitt Address M iH g Address c0e, .� -�- j0 w D rt . , Ate- - Ylu Telephone Numbed email address (Revised Aug. 0 4) 'lalid for one calendar year after signature* ADJ C NT R1 ARIA P Q fl1X E STAT E T l hereby certify that I own property adjacent to - is _ ame of Property Owner) op�"y located at on (Address, Lot, in 1Naterbody) (CityfTown and/or County) he aPPlicant has described to me, as shown below, the development proposed at the above Iocation. I have no objection to this proposal. I have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT l f '# t PiOpoStr <deve ont must fill'in description b*10w or attaCh a ,site drawing) W 1V R SECTIG,N understand that a pier, dock, mooring pilings, boat ramp. breakwater, boathouse, tilt, or gram just be set back a minimum distance of 15' from ray area of riparian access unless waived by ie. (If Yoe' wish to waive the setback, you must initial the appropriate blank below.! i do wish to waive the 15' setback requirement. i .6., -. a- utich in waivr, the 1 5' setback requirement owner Information) �iyfi.�I r1M' Tejept)one Number / email address _q " t)rTr' (Revrsiod Aug. 2014) after signature` z; o N 4 m 3 'm O a� M 10 a d N c • o— c�n � 3 E aN U � E rd o 2 0 Y T6 N • C�i N O N m K N 01 C N T r N Yp � L L � N N m � }� o m m m rn o c C_ N N w O C O � O mU oU m � N N L � T 15 L O J w N C A, L_ O —O C l0 jp fi v v U ( 0 U N Z L O E Xi g 0 fir. 3 0 N II c m o 6 y N U L N r � cUv c L c0 O o�N 'a CI O O x o a N 00 O W pN O �+ O N n@' 0- g p x bA bA U C40 A t cd =�> ° v v, Z aG PQ C7 pa o sQ0 4 0 �o W N w d=d C� N °� d q > Pyce)00 cq ce)LO ON00 )pC) " o o Od i Cr md N E CY)GO + N v Q N Ef3 � N O C` S m co Ao o A a `� a o oN F+ C 5 z z a �a a: v a w H H a c4 H A a A w .6 Si ky f 4-d 1 M ��'��"�'L''rr.. .qi'T fi L a�' .:emu -, •g uffi S s� �eiC � ��? 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