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Home My WebLink AboutWax, Nathan 84605CAnerwdl Lim Elm OjqjL �6 OM A&w Elm& OMA Oiuw bimm opws Ty afPtojftV Acftft` 0,4$ftv, 540hol B"shmse/8"IrA SAW 6W=I., Yet M.,.too fliq yps SttefMOV r� IVA RipWrdwwaw Attached' A 7 514 904,041 ow, tfvr. 4� TAFVPWNEU5&WfF.R (ori* 666) See note an back reotdirtMei hsl"wles CAMA ❑DREDGE & FILL GENERAL PERMIT dNew ❑Modification ❑ Complete Reissue ❑ Partial Reissue N° 84605 Previous permit Date previous permit issued A B (5 D 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 7—U . IMC? / ❑ Rules attachoa rt Rules available at the following link: www.deq.nc.gov/CAMArules Affected ❑CW ❑EW ❑P AEC(s): ❑ OEA ❑ IHA ❑///rrr'''U��l ORW ye no PNA: yes/no Type of Project/ Activity l/ 4 Shoreline Length S;' 0'4� Access Length _ Pier (dock) length Fixed Platform(s). Floating Finger pier(s) // unty): Roald� #<9 VA116 "L ZIP 10?<//�p— <00*00 (na an/unk) J Ja�UP /r C1A61 N# v (Oases (Scale: IV Total Platform area t`X/51/7 k MaA Gr in length/# �✓`ll7 lift �`I Q / �(01/"� Bulkhead Riprap length 1 `�l�S ,.•� ��i54t7 Avg distance offshore `r — Rmv4w»or/Gill I Max distance/ lengl Basin, channel Cubic yards _ Boat ramp Boathouse/ Boatlift Beach Bulldozing _ Other SAV observed: yes Moratorium: n/a es n Site Photos: fe no Riparian Waiver Attached: yes G A building permit/zoni! perrrmiitmay/be nn Permit Conditions Vl l% / T�.7(_ Agent or Applicant PRINTED Name V1- 7 wte* Wow PrVP by: �+ UGJn O+" Gr'rV�r-vy >lYi ❑ 0-C &% N��% /r y{ 3 • �fe%•�/ / TAWPAM/NEUSE/BUFFER (circle one) Uf� �✓j4%s�Q v L - !i5 WlQ/.e.*.ry ❑ See note on back regarding River Basin rules Ail fw GI/1 nfqAptr n , -r - _ _ ��T `0 �y{� �__- n See additional notes/conditions on back L17[iL�44Lo.9 7Rq�' DITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please. lnloAl)l Signature *r*Plpase rr d compliance statement on back of permit** Signaturre Application Fee(s)G Check #/Money Order Issuing t�� Date AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: Mailing Address: Phone Number: Email Address: V AN// (43 I certify that I have authorized C it 4 Str 1 COgSt Mctr I h P YYtr()Ctl t-)q Agent / Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: _t Qri Sti- UCf 161i ice_ ct COrIC r ete C-t OCK at my property located ata iQft /slfif« in County. '7 A+Z YC.a l 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 will. evaluating information related to this permit application. Properly OwnInformation: vv � Signature Print or Type Name Cuynet- Title Date This certification Is valid through ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to property located at Owner) I (Aaaress, Lot, Block, Road, etc,) on, A nrje— ()Q in 2Q1 E+t ey I GAV+CVf+- N.C. (Waterbody) (City/T n and/or County) The appli t has described to me, as shown below, the development proposed at the above loc I have no objection to this proposal. I have objections to this proposal. utscRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (Individual proposing development must fiff in description below or attach a site drawing) WAIVER SECTION 1 understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin must be set back a minimum distance of 16 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 Informatio�n (AdjacentPro Information) or its ZWo.3 r Hai 040� ,t, (Coll (Revised Aug. 2014) 'Valid for one calendar year after signature` ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that 1 own property adjacent to )o per, — . I I i I property located at I '-t' cl S� Cd I' K p .I (-,v p (Name of Property Owner) on t hl+t (Addresd, Lot, (tigK- ,in (Waterbody) N.C. 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. uravrar I rvN AND/OR DRAWING OF PROPOSED DEVELOPMENT (Individual proposing development must fill In description below or attach a site drawing) 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. I do not wish to waive the 15' setback requirement. (Adjacent Property Owner Information) Si aiw*e• '> M ueveloot'YS L LG Pnnt or Type Name ` I2- (actrn .t arir Mailing Address .IacKSrizu v i I I C I NG 2 city/state/zip Telephone Number/email address `Valid for one calendar year after signature- (Revised Aug. 2014) m -■ Complete Items 1, 2, and 3. A. Slgnature ■ Print your name and address on the reverse X so that we can return the Gard to you. [—c� ■ Attach this card to the back of the mall piece, B• Rec ved or on the front if space permits. l /b, 5*11 Developers L-%..0 12.1 C-owne4 �-qhe l a cKSonvi llC , N C IIIIIIIIIIIII11111111111INI1111111 11,, 9590 9402 5845 00381053 48 7020 0640 0000 2724 3409 PS Form 3ts11. July 2uib PsN ybau-tro-uuu-auoa ❑ Agent ❑ Addra Name) 0. Date of Deli D. Is delivery address different from item 14 ❑ Ye: If YES, enter delivery address below: ❑ No a. oarviw type 14Aduit signature ❑ Priority Mal Express® ElAdua Signature flasViioted Delivery ❑ Registered Mal- ❑ R�s�,V Mal Restricted ❑ Ceruw Mail® Delivery D cerlifled Mal Restricted Delivery ❑ Relum Receipt for ❑ Collect an Delivery Merehe rdise ❑ Cdlect an Delivery ReeWded Delivery O Signature Danfir dmg ❑ Inwred Mal ❑ signature canamatim —wmd Mal ResMeted Delivery Restrieled Delivery ver$500) . , staf Service"' CERTIFIED O Domestic S m Ja1: fVT1 VIP y�1'I f 54 ,M1 CerlaadMailFee $3 75 0584 n' 05 Pxea ar�le"fh erPed:m,..eew.InfftY`°) 0 o oawuni Rar.mgt ma«pPp : ❑ aeum aernlpt (e§onM a ED-DR — Poaenark I3 DCe`mw Mes RebkfWD-" ego 00 Here C3 54,Wvleigret.piepiisetl s-4pl.06 Q [1Mwt8wwenae FeaMcwO wy& Paetage $1.36 S o s 12/30/2021 Ie Poefegeen 'ff. ff o $ 16 ru oT M. Po.p�YS._.c olY Domestic Return Receipt 0 V- B v X y� O -- 9 0 y tA � o t + W .H � J y Y 6 V � A m J 6 — y s D -r � S >�?z i s � L � L a'_ o - .