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Home My WebLink About84567C - Stapleton, StuartoFCOASTq�NO � A B C D ❑LAMA ❑ DREDGE & FILL a: 9c 3 GENERAL PERMIT Previous permit z � Date previous permit issued El 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 )k' City State( ZIPS c/ Phone # ( ) Email Authorized Agent Project Location (County): Street Address/State Road/Lot #(s) _ Subdivision City Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body // (nat/man/unk) AEC(s): 1-1OEA ElIHA ElUW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body f..r �k- �'~` !. t ORW: yes/no PNA:..yes/no Type of Project/ Activity a � '. 0 A (Scale:�,}I) Shoreline Length Access Length Pier (dock) length Fixed Platform(s) Floating Platform(s) Finger pier(s) Total Platform area 1I 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 ' �q � L A building permit/zoning permit may be required by: TAR/PAM/NEUSE/BUFFER (circle one) Permit Conditions See note on back regarding River Basin rules �.(' f r�' !�, /•'' j 1"k'l. t'i f See additional notes/conditions on back I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. Agent or Applicant PRINTED Name Permit Officer's PRINTED Name Signature "Please read compliance statement on back of permit" Signature (Please Initial) Application Fee(s) Check #/Money Order Issuing Date Expiration Date A B C D ❑CAMA El. DREDGE & FILL O 84567 i 9c Previous permit 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 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 AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body ORW: yes/no PNA: yes/no Type of Project/ Activity Shoreline Length Access Length f' 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 SAV observed: yes no Moratorium: n/a yes no Site Photos: yes y no Riparian Waiver Attached: yes Sno A building permit/zoning permit may be required by: Permit Conditions (nat/man/unk) (Scale: i" ) j ❑ TAR/PAM/NEUSE/BUFFER (circle one) i ❑ See note on back regarding River Basin rules ❑ See additional notes/conditions on back 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 AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: Ir 26 C h Mailing Address:• Phone Number: 13'6 �:5" 9 Email Address: U) I certify that I have authorized A ent / C96tractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: I�LL b at my property located at �, rGarlArAd fkwt:5 in 6)rj:5_10 County. I furthermore certify that 1 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: Signature Print or Type Name N= Title 3 Date ,� This certification is valid through �l 2 / )� 2' Y. 40 &xt�� 711�� RECEIVED ®CM-MHD CITY 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: Address of Property.- �. = P �Y� a Mailing Address of Owner: ,M Owner s email: z'. ' R . a '' a *-Owner's Phone#: Agent's Name: �`�'' i�7 Agent Phone#: l' , M_ Agent's Email: 11�` 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. f--,d�� 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.U. uiviston or Lxaswi Management (DCM) in waiting 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 I understand that any proposed pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin must be set back a minimum distance of 15from 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 of Adjacent Riparian Property Owner -OR- J, < I do not wish to waive the 15' setback requirement dim- tial the blank) Signature of Adjacent Riparian Property Owner Typed/Printed name of ARPO: Mailing Address of ARPO: jl__,(_hh�D"A' ARPO's email: I LtiARPO's Phone#:r- (0 *waiver is valid for to one year frDm ARPO's Signature* ®ate: � � � � p Y 9 Revised ft 8WI� MAR 2 4 2022 DCM-MHD CITY 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: a Address of Property: —z,rAZ4,j" ° Mailing Address of Owner: ��t m,-e Owner's email: 11AA rrl . fot� %Owner's Phone#: � �j �.9 � 1, .. � bf Agent's Name: 1J ) Agent Phone#: f j Agent's Email 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 or t;oastao 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 I understand that any proposed pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin must be set back a minimum distance of 15from 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 •: I do not wish to waive the 15' setback requirement (initial the blank) Signature of Adjacent Riparian Property Owner: Typed/Printed name of ARPO: Bailin Address of ARP0. a� , ( ,� i ` ' 9 s'n' i 1 ' email: �',,�1 �1 ARPO's Phone#: y 1 ARP• s ema - ®ate; ? ! , waiver is valid for up to one year from ARPO s Signature Revised M, �FMVED MARS 2 4 2022 DCM-MHD CITY �` Fa?�i G?ht 3�34E3 (OMIM CW19Y) efttft H/M/200 used SUA' 2.448-- S.F. (trriud1rg jr, ?,W; SVA obtained fraM AuraCAO Ste SWir. Pwmit for addrtizrcl it orrnrion and for sr=g1jettan. ;~cost 5men mers sh*wr am xr fi=, plan provided by zceser. i erid: Aa - Acm al}A - 3wit Lipan Area Cif - Oiard Arc ? er-^Th ! 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