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Home My WebLink AboutFrick, Andrew 84564CCAMA ❑ DREDGE & FILL N° 84564 A B (c' D 5 GENERAL PERMIT Previous permit 4MI Date previous permit issued MNew ❑ 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. General Permit Rules available at the following link: wwwdea nc eov/CAMArules Applicant Name - Authorized Agent Address Project Location (County): City I State !',fit zip is"'7!;;'! Street Address/State Road/Lot#(s) Phone#(_) i Email Subdivision `- / `� I �• City ZIP Affected � CW ❑ EW PTA ❑ ES ❑ PTS Adj. Wtr. Body, �J tv-' I-1 �G- �i�-l'.%�l�- (nat]rnan/unk) AEC(s): ❑OEA ❑IHA ❑uW ❑SPIMA ❑PWS Closest Maj. Wtr. Body &61or' (,IQk PA ORW: yeto 1 PNA: yes/no Type of Project/ Activity (Scale:))1;' ) Shoreline Length Access Length UI 7. Pier (dock) length 1.1 1-�i'Ih Via. -_ -*— ,A L Fixed Platform(s) �R-�1 I _ h Floating Platforms) Finger pier(s) Total Platform area 1 Groin length/ _ �_.—L _ -i- 1 "� _i �i Jt • l T- t Bulkhead/Riprap length i � Avg distance offshore Breakwater/Sill— Maxdistance/lengthBasin, channel Cubicyards Boat ramp Boathouse / Boatlift Beach Bulldozing Otherv,- - SAV observed: yes no ._._ t�t �_ Moratorium: n/a r_ yes no iG )( G itIj L Site Photos: yes no Riparian an Waiver Attached: yes no I- !t.i J - A building permit/zoning permit may be required by. Permit Conditions AIJr,S. -�r :f;(,i 'j[: [(--�„'� ❑TARtPAM/NEUSE/BUFFER(circle one) (jf(•�y( -�S 2 11I( See note on back regarding River Basin rules See additional notes/conditions on back I AM AWARE OF STATUTES, 48C RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial) 1 - r✓ Agent0 PRINTEb Name ' Signature **Please read compliance statement on back of permit** A16 s _ Application Feels) Check JI/Money Order Permit Officer's PRINTED Name , at Sign �/ r% b al I (z W - { Isslifing Date Expiration Date o��`°"'"CAMA ❑DREDGE & FILL N° 84564 A B C E GENERAL PERMIT Previous permit 3 Date previous permit issued New ❑ Modification El 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: wwwdeq nc.gov/CAMArules Applicant Name Authorized Agent Address Project Location (County): City State ZIP Street Address/State Road/Lot#(s) Phone#(_) ' Email Subdivision - v City ZIP Affected ❑ CW ❑ EW ❑ PTA ❑ IS ❑ PTS Adj. Wtr. Body !' (naan/unk) AEC(s): ❑OEA ❑IHA ❑UW ❑SP1MA ❑PWS Closest Maj. Wtr. Body ORW: yes/no PNA: yes/no Type of Project/ Activity (Stale: Access Length Pier (dock)length Fixed Platform(s) j t r Floating Platform(s) Finger pier(s) ! I Total Platform area '! Groin length/# - �✓ .--I— ! I I,: - I I Bulkhead/Riprap length. - — ! — — t'�---- -- -- r�- -- {---� Avg distance offshore Breakwater/Sill y Max distance/ lengthBasin, channel Cubic yardsI —.�f—__ Boat ramp i J' I Boathouse/Boatlift_ ! I ( I Beath Bulldozing Other SAY observed: yes no Moratorium: n/a yes no Site Photos: yes no Riparian Waiver Attached: yes no - I -.- A building permit/zoning permit may be required by Permit Conditions I AM AWARE OF STATUTES, CRC RULES Signature **Please read compliance statement on back of permit** Application Feels) Chetk #/Money Order TAR/PAM/NEUSE/BUFFER (circle one) See note on back regarding River Basin rules See additional notes/conditions on back VD REVIEWED COMPLIANCE STATEMENT. (Please Initial) )4--Vt `—f4,;- j > Permit Officer's PRINTED Name Signat re Issuing Date Expiration Date ADJACENT RIPARIAN PROPERTY OWNER STATEMENT G^� I hereby certify that I own property adjacent to /°%/D&etd G�� 's (Name of Property Owner) property located at 73/2 &/Va z G ��// / (Address, Lod Block, Road yy,etcc.. on /�,GGLise i C[ tG/G , in r' z/J leX1� le N.C. (Waterbody) (City/Town and/or County) The app icant has described to me, as shown below, the development proposed at the above locatio . I have no objection to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (Individual proposing developme t must fill in description below or attach a site drawing) C7.��``Qt� rr , I f1) , '' o / 1 -"C,r- , , WAIVER SECTION I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set back a minimum distance of 15' from my area of riparian xess 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. (Property Owner In ormation) Sig ature ..j��KGwJ yCName ,r�& / I.c. Mailing Addres I / tatelfi Telephone Number Z9 we- toe-! Date (Adjacent Property g Print or Tye Name It g Address City/statelzi - Telephone Number Date (Revised 611812012) ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to 4VpA', -/ 2 lo5j�(C t47 's (Name of Property Owner) property located at 3/Z &,'eya ! �G �J / (Address, Lot,, Block, Roady,etc on /N.GC4,4y Ce e4,k in / 4-1e}L..L.. Z: N.C. (Waterbody) (City/Town and/or County) The ap scant has described to me, as shown below, the development proposed at the above locati I have no objection to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (Individual proposing development must fill in description below or attach a site drawing) nv, I t...7I ? tie? u'-1 1,x) r f� 'A iA , .� i _D&c,r. , - WAIVER SECTION I understand that a pier, dock, mooring pilings, 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. (Property Owner In ormation) Si ature � 9'x/ wJ /521 Date (Adjacent Property Owner Information) Signature , �^ Print or Type Name 7_S /10 C AAAQ Mailing Address k'i r34-3 IScE �a✓CzYSG2 Citylstate2 620 Telephone Number 2 9 A-S'e 1� / FORM (Revised 611812012) I 1 ♦ ' x 1 t PY ok V ,�• r.J- � ( r