HomeMy WebLinkAbout84152C - Sea Isle Plantation N. HOA#F]New
❑CAMA [IDREDGE & FILL NU 84152 A B C D
Previous permit
GENERAL PERMIT Date previous permit issued
[]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:
r .
I SA NCAC ❑ Rules attached. �, General Permit Rules available at the following link: wwwden nc gov/CAMIArules
Applicant Name I-- ?f f" / a l i4 1 1/t ,� {- I 1 � A Authorized Agent t - '
Address g i ] Project Location (County):
City Instate +J`��.ZIP - /�/ Street Address/State Road/Lot #(s)
Phone#(_)
Email Subdivision l� '
City :,"',(-:';w ZIP
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body, f % 1 (nat/man/unk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wt, Body
ORW: yes/ho PNA: yes/no
Type of Project/ Activity
et.5
(Scale: (. )
(dock) length
Fixed Platform(s)
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iPier
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Floating Platform(s)
Finger pier(s)
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so
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A building permit/zoning permit may be required by:
Permit Conditions ' ,'1
❑ 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.
Agent or Applicant PRINTED Name r,. Permit Officer's PRINTED Name
•'t
Signature**Please read compliance statement on backof permit** Signature
Application Fee(s) Check k/Money Order Issuing Date
(Please Initial) '
Expiration Date
aotcouar ❑CAMA ❑ DREDGE & FILL ti N9 84152 A B c D
Previous permit
. 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:
Rules attached. ❑. General PePermitW Rules available at the following link: vdeq.nc.gov/CAMArules
ISA NCAC ❑
Applicant Name r . ' t ' 1 1 Authorized Agent
Address Project Location (County):
Clry State ZIP �, Street Address/State Road/Lot#(s) -
Phone#O -
Email Subdivision
City ZIP
Affected ❑ CW ❑ EW Q PTA ❑ ES ❑ PTS Adj• Wtr. Body (naUman/unk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Mal. Wtr. Body
ORW: yes/no `. PNA: yes/no , /
Type of Project/ Activity
(scale`
■■■■■
■
-
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■
S■E■■■
■
M
aES■■■ONMM■■■■■■■■■
INS
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■■SENSE
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■
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SS:■:.■■.:■1AIS■l,:■::::.:■■..:::::::
Floating Platform(s)'::
EN
EMONSME
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::::::::::mos
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SAV observed: yes
Photos: Y ?Anp
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.MEMOSite
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A building permit/zoning permit may be required
Permit Conditions
❑ TAR/PAM/NEUSE/BUFFER (circle one)
See note on back regarding River Basin rules
1-1 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) U" (.
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name
t
Signature "Please read compliance statement on back of perpnit" Signature -
Application Feels) ICheck Jl/Money Order Issuing Date Expiration Date
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit:
Mailing Address:
IJv !? i r iv �• TG�--L
Phone Number:
Email Address:
I certify that I have authorized �i� (Carob SS�
n ......11 r`nnrr�rfnr
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: Ro-xi-"
at my property located at C4% Ste.' _ KI t>
inefltf , j�z Lz. -Lj 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 enter
on the aforementioned lands in connection with evaluating information related to this
permit application.
Property Owner Information:
Signature
Hie '• [ /'e L���t" �
Print or Type Name
Title
l 7Z-
Date a�
`/V5y
This certification is valid through 1 I RECEIVED
FEB 2 4 2022
DCM-MHD CITY
l-t
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Z c iGY �r. t�� u �� s
(Name of Property Owner)
property located at k --"I-
(Address, Lot, Block, Road, etc.)
(Waterbody) (Cityrrown and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
f 1 have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development mustfill in description below or attach a site drawing)
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7o�tc--�'
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Hve
Zy'tlt
j >_ ;fir (17 Or t l Lt'i FNI
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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.)
_'53 NA,,_- I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
"i
Signature
1ZiC1�`• �!sR'tLtrr1
Print or Type Name
z
' -I & ZGC> .. C, -X& 3 ct:k
Telephone Number/email address
7.1Z1kZ'2- —
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*Valid for one calendar year after signature`
(Adjacent Property owner Information)
A'oCU'1f� I imllM�lti->
Signaqture*
`fit 1 SQY) Zvi i 1 l 5 Url
Print or Type Name , , n
T1�1 C_Z"7 f 4
d0"tiAktn@-a0l . wt-q
(RevisedFAWOMFED
N�
FEB 2 4, 2022
DCM-MHD CITY-
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
t hereby certify that I own property adjacent to —5- iC K r ' T_-' s
(Name of Property Owner)
property located at
(Address, Lot, Block, Road, etc.)
on_�p SSifi._ Ati, cA — cin 1 v—hrc f�>flE�"�'rN.C.
(Waterbody) (Cityrrown and10 County)
The applicant has described to me, as shown below, the development proposed at the above
location.
v� I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must fill in description below or attach a site drawing)
o Zs"—
Fxiac-��tz S><�3L
J rr_ t4-
zH ,a
s �� 3 t� alp tz,L Vz t-
L_E_� i Ac_-t ti
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.)
L I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property O/w�nerrIInformatio
5'1g4qtUre
Print or Type Name ;
Mailinq Adgress
3 ! I
email address
2 1;?.t 12,2
'Valid for one calendar year after signature'
(Adjacent Property Owner information)
(Revised Aug. 2014)
FED 2 4 2022
UCM-MNC) CITY