HomeMy WebLinkAboutJackson, JC 84614CPrevious permit
Qaywarr41&IMCAMA 2DREDGE & FILL NO 84614 A B C 'D
3 GENERAL PERMIT Date previous permitissued
.F]New []Modification []Complete Reissue [-]Partial Reissue
As authorized by the /Stt1ate of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
I SA NCAC 0 :1'f , �� ❑ Rules attached. /`t General Permit Rules available at the following link: www.c1eq.nc.goy/CAMAnuIes
Applicant Name
Address '12 ? ? alt
City ,'+. A. '% State \/�� ZIP
Phone # ( )'.. •��
Email
Affected ❑ cW ❑ E W ❑ PTA - Q S" ❑ Prs
AEC(s): ❑OEA ❑IRA ❑UW SPIMA ❑PWS
ORW: yes/no PNA:yes/no j
Type of Project/ Activity { >
Authorized Agent V NI ( V
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision
City i, e .k;V _O{ _, .. ZIP
Adj. Wtr. Body (
Closest Maj. Wtr. Body
Floating Platform(s)
Finger pler(s)
Groin length/#
Bulkhead/ Rprap length
dist ance offshore
Breakwater/Sill
Other
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SAV observed: yes no
Moratorium: n/a yes
Site Photos: yes no
.Riparian Waiver Attached: yes no
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A building permit/zoning permit may be required by:
Permit Conditions
❑ 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. (Please
lease Initial)
Agent or Applicant PRINTED Name 1 Permit Officer's PRINTED Name
Signature **Please read compliance statement on back of permit** // Sig Ire/ {y
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Application Feels) Check N/Money Order Issuing Date EzplratJ
Date
000"r4 pCAMA R, DREDGE & FILL N9 84614 A B C is
Previous permit
sa
. 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:
I SA NCAC ❑Rules attached. ii General Permit Rules available at the following link: wwwdec.nc.gov/CAMArules
Applicant Name Authorized Agent
Address Project Location (County):
City State ZIP Street Address/State Road/Lot#(s)
Phone # (_ )
Email
Affected ❑ CW ❑ EW ❑ PTA
AEC(s): ❑OEA ❑IHA ❑UW
ORW: yes/no PNA: yes/no
Type of Project/ Activity
11 ES ❑ PTS
❑SPIMA ❑PWS
Subdivision
City
Adj. Wtr. Body
Closest Mal. Wtr. Body
.
Access Length
Pier (dock)
lengthFixed Platform(s)
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Bulkhead/ Riprap length
Avg clist ance offshore
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A building permit/zoning perm!): may be required by:
I
Permit Conditions
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
r�
I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT.
Agent or Applicant PRINTED Name l�' Permit Officer's PRINTED Name,
I Ii 2
Signature "Please read compliance statemj�nt on back of permit' Sig rrr� j
IL s�
Application Feels) Check N/Money Order Issuing D to
/C
Date
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: /V� 1� 11 OL6kDV)
Mailing Address: �SC t LP1
gear art t AlC a��«
Phone Number: oZ S oZ ' is 3 (P 7 91
Email Address: t(�fdl� ��JJ� C I aCr1 , iivvl
I certify that I have authorized R I C�afar 1 a�/�ot'
Agent / Contrbctor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development
rlPf-&D PIVeMM f , A
at my property located at 3 a
in Aj-rf- � County.
dock r fPatVrs4
hood 14� 10144I)4�
Lh
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.
Prope4 Owner Information:
I C Sjnature /
JerenV L
('■�)Pnrriint or Type Name
Title
I I t
Date
This certification is valid through 4 I (4 1 ,to 13
N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONNVAIVER FORM
CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner: �11C A AC VSO V\ n I -
Address of Property: Jna 1 /,A't L oLx t I� (w4 Vi
Mailing Address of Owner: 6 0.1 Seel L avle-
�/j
Owner's email: jfr<T 1C,14C�ksuA Owner's Phone#: r gS a-�3(P' 70C
%
Agent's Name:
Agent's Email:
Agent Phone#:
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 proposea, you musr norny me im- urvramn vi a uaaim
Management (DCM) in writing within 10 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 15' from 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 sometall of the 15' setback
Signature of Adjacent Riparian Property Owner
MR
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO: 3tl/? ✓1 2f
Mailing Address of ARPO: d 1 "r Q�S{ LQ N/C�
ARPO's email: �4O*4 ?,112 l,M ARPO's Phone#:
Date: �� *waiver is valid for up to one year from ARPO's Signature*
Revised May 2021
N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to b/e� completed by owner or their agent)
Name of Property Owner: V ^^C J A C vsov% Address of Property: A 64 stq LNv1C f B&A-A4A
Mailing Address of Owner: a 3 3 C At 5 c jtgn t
Owner's email:gl frCMiQ C Soh•Co Owner's Phone#:
Agent's Name:
Agent's Email:
Agent
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 proposea, you musr noury me rv.�. ummiun yr i,vaaaat
Management (DCM) in writing within 10 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 15' from 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 sometall of the 15' setback
Signature of Adjacent Riparian Property Owner
KOM
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
11
Typed/Printed name of ARPO: yPlil N ( ek W/Q
Mailing Address of ARPO: I 4 4st`' 1. A A e
ARPO's email:
ARPO's Phone#:
Date: *waiver is valid for up to one year from ARPO's Signature*
Revised May 2021
Project Description:
All rotted boards will be replaced on
existing dock. The pilings closest to the
shoreline will be replaced. Riprap will
be placed under the dock at the shore-
line, extending out a short distance on
either side. A boat lift will be added on
the north end of the dock, on existing
pilings.
New Hf ,,,
e
i
10 ftdeep II
Core Creek
3
Property of: i
Ann Kirkbridge
M
oi-
CD
CDI
Applicant:
Jeremy Jackson
321 Gatsey Lane
Property of:
Paul Schwartz
1