HomeMy WebLinkAbout84212C - Keeler, Brenden�° °"" ❑CAMA ❑DREDGE & FILL N9 84212 A B C `:D
3 GENERAL PERMIT Previous permit
Date previous permit issued
New ❑ Modification ❑ Complete Reissue ❑ Partial Reissue
As authorized by the State o North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
I SA NCAC / � " � (00 ❑ Rules attached. General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Affected ❑ CW ❑ EW ❑ PTA ❑ ES �.�.PTS Adj. Wtr. Body 'ii C 7 i'.P l-A LI O f(QM.n/unk)
AEC(s): ❑ OEA ❑ INA ❑ UW ❑ SPIMA ❑ PWS,. Closest Mal. Wtr. Body 'A ' % -
ORW: yes/no ,.% PNA: yes/no.:
Type of Project/ Activity (A,�
Shoreline Length _I
Access Length Z 4_4
__Pier(dock)len/
Fixed Platforms) � I ,
Floating Platform(s)
Finger
Total Platform area
Groin Iptngth/q
% Bulkhe7}1/ Riprap length
`Avg distance offshore _
Breakwater/Sill
Max distance/ length _
Basin, channel
Boat
Beach Bulldozing / _ ' iy
Other
14+
SAV observed: yes no
Moratorium: n/a yes no i '�" - `-- L
Site Photos: yes no - --
Riparian Waiver Attached: yes no
P 1 _
A building permit/z mng permit may be requued[by
l (� I /�,:; .. ❑ TAR/PAM/NEUSE/BUFFER (circle one)
, P rmit Conditions d.X.. , t • I ("I.�1 (! -
^, A if !- Q I ii^ / !i i _ eiwtpl ><._. ❑', See note on back regarding River Basin rules
}� t k " 1 q/ I f•�fi�a ff t tl y I r—C"�7 ` ari (! <� ❑ See additional notes/conditions on back
Agent or Applicant PRINTED Name
Signature "•Please read compliance statement on back of permit**
Application Feels) Check M/Money Order
VD REVIEWED COMPLIANCE STATEMENT.
(Please Initial)
Permit Officer's PRINTED Name
'
S5,nature 11
21
Issuing
Expiration Date
�° °"" ❑CAMA ❑DREDGE & FILL N9 84212 A B C `,.D
° Previous permit
3 G E N E RAL PERMIT Date previous permit issued
❑Modification []Complete Reissue ❑ Partial Reissue
As authorized by the State io( North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
I SA NCAC - I i. I' ❑ Rules attached. R General Permit Rules available at the following link: w ,deq.na¢ov/CAMArules
Applicant Name
Address
City State ZIP -
Phone # (_ )
Email
Affected ❑CW ❑EW ❑PTA ❑ES ., PTS
AEC(s): ❑OEA ❑IHA ❑UW ❑SPIMA D,17
ORW: yes/no% PNA: ye;/ho� /�(\
Type of Project/ Activity
Project Location (County):
Street Address/State Road/Lot #(s)
f
Subdivision
City ZIP
Adj. Wtr. Body
Closest Maj. Wtr. Body
Access Length
Pier (dock) length
Fixed Platform(s) Z
�■■■
H■■■■�■■
■
■■■
■■■■
0
Nis
Max distance/ length
Basin, channel
Cubic yards
Boat ramp Z
No
I
iI
�■�m�na�■
�r
.
.1
SAV observed; yes no
Moratorium: n/a yes no
Site Photos: y
Riparian Waiver Attached: yes no
A building permit/zoning permit may be required by:
Permit Conditions '`• I'1 �'.G�t'? ,' '�fi'a((/1'%Ll�; ❑TAR/PAM/NEUSE/BUFFER(circle one)
See note on back regarding River Basin rules
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. (Please Initial)
�r
Agent of -Applicant PRINTED Name _ Permit Officer's PRINTED Name
Signature **Please read compliance statement on back of permit** Signature
Application Fee(s) Check #/Money Order Issuing Date Expiration Date
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N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date S _ I
Name of Property Owner Applying for Permit:
Mailing Address:
,j'ta Dori iF 404A5 LL L
I certify that I have authorized (agent) _ / r m B1 9 1 to act on my
behalf, for the purpose of applying for and obtaining all LAMA Permits necessary tos �p �
install or construct (activity) _ /'1 /��o✓I U� L� ✓ olyU TpM-(� j�41 ✓y
,�'p�_p7�I%(,/��
at (m) property located at) L4f1f)e V 61
This certification is valid thru (date)
Property Owner Signature
Date
1 of 1 2/11/22, 11:15
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Rrendon Keeler 's
(Name of Property Owner)
property located at 388 Selhorn Blvd
(Address, Lot, Block, Road, etc.)
on Brices Creek in New Bern N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
C,i1ty l 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)
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.)
umCK-�— I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
9.0f, X'"&4
Signature
Brandon Keeler
Print or Type Name
111 Conner Grant Rd
Mailing Address
New Bern NC 28562
City/StatelZip
7043977590
Telephone Number/email address
3/10/2022
Date
`n (Adjacent Property Owner Information)
Signature*
or
K -aa-ss i
alyli(.(r�e-tte.f4il,u
enfail address
aoaa
(Revised Aug. 2014)
`valid for one calendar year after signature"
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Rrandnn Keeler — s
(Name o}Property Owner)
property located at 388 Selhnrn Blvd
(Address, Lot, Block, Road, etc.)
on Brices Creek , in nlo1�� Bern N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.�—
1� 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)
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.
( ation)
Brendon Keeler
Print or Type Name
111 Conner Grant Rd
Mailing Address
New Bern NC 26562
City/State/Zip
7043977590
Telephone Number/email address
311012022
*Valid for one calendar year after signature*
(Adjacent Property Owner Information)
Signature
li�111 [Ten
Prin�9t or U TypeSNam
Mailing ddress
ecy .Bees, /VCt arGS62
Ciryi as2 ip 631-fS�3S b9e i - /
�O e,, M ;t
Telephone Number/email address e�
3-/s-A> /
Date*
(Revised Aug. 2014)