HomeMy WebLinkAbout87332C - Pendergraph, Frankiea❑CAMA I_ I DREDGE & FILL
GENERAL PERMIT
-F]New ❑ Modification ❑ Complete Reissue ❑ Partial Reissue
N9 87332 A e' c D
Previous permit --- -
Date previous permit issued ---
As authorized by the S of North Carolina, Department of Emironmental 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: www.dea.nc.gov/CAMArules
Applicant Name r -41 W Eyi (
Address
City C State ZIP _
Phone # I o —
Email
Affected ❑ CW EW ❑ PTA
AEC(s): ❑ OEA ❑ IHA ❑ uW
ORW: yes/no PNA: yes/no
Type of Project/ Activity
chm.eR�e I nnetl. I O
❑ES ❑Prs
❑SPIMA ❑PWS
Authorized Agent
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision
city ZIP
Adj. Wtr. Body - (dat/man/unk)
Closest Maj. Wtr. Body _
(Scale:) � " '-1 )
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Total Platform area
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A building permit/zoning permit may be required by; -/ I
Permit Conditions ❑ TARMAM/NEUSE/BU FER(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 Initial)
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name
31
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Signature "Please read compliance statement on back of permij•,"
57
Application Fee(s) Check N/Mooney Order
SI
Issuing Date Expiration D to
Statement of Compliance and Consistency
This permit is subject to compliance with this application and permit conditions. Any violation of these terms may
subject the permittee to a fine or criminal or civil action; and may cause the permit to become null and void.
This permit must be on the project site and accessible to the permit officer when the project is inspected for
compliance. The applicant certifies by signing this permit that: 1) prior to undertaking any activities authorized by this
permit, the applicant will confer with appropriate local authorities to confirm that this project is consistent with the
local land use plan and all local ordinances, and 2) a written statement from the adjacent riparian property owner(s)
has been obtained, or proof of delivery of certified mail notification of the adjacent riparian property owner(s).
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certify that this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
1-1 Tar - Pamlico River Basin Buffer Rules Neuse River Basin Buffer Rules
If indicated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules
for the River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the
NC Division of Water Resources. If you have any questions, please contact the Division of Water Resources at the
Washington Regional Office (252-946-6481) or the Wilmington Regional Office (910-796-7215).
Notes/Additional Permit Conditions:
Please ensure all debris associated with the removal or construction of the permitted development is contained within the authorized
project area and disposed of in an appropriate upland location.
Division of Coastal Management Offices
Morehead City Headquarters
400 Commerce Ave Morehead City, NC 28557
252-808-2808/ 1-888-4RCOA5T Fax: 252-247-3330
(Serves: Carteret, Craven — south of the Neuse River, Onslow
Counties)
Elizabeth City District
4015. Griffin St. Ste. 300
Washington District
943 Washington Square Mall Washington, NC 27889
252-946-6481
Fax: 252-948-0478
(Serves: Beaufort, Craven — north of the Neuse River, Hyde, Pamlico,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext. Wilmington, NC 28405-3845
Elizabeth City, NC 27909 910-796-7215
252-264-3901 Fax:910-395-3964
(Serves: Bertie, Camden, Chowan, Currituck, Dare, Gates, Hertford, (Serves: Brunswick, New Hanover and Pender Counties)
Pasquotank and Perquimans Counties)
http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021
AciVO 41 ❑CAMA ❑ DREDGE & FILL N° 87332 A B C D
GENERAL PERMIT Previous 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. ❑ General Permit Rules available at the following link: v~vdea.nc.goYJCAMArules
Applicant
City State
Phone # (_ r
Email
Authorized Agent
Project Location (County):
ZIP Street Address/State Road/Lot #(s)
Subdivision
City ZIP
Affected ❑ cW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body (nat/man/unk)
AEC(s): ❑ OEA ❑ INA ❑ UW ❑ SPIMA ❑ PINS Closest Maj. Wtr. Body
ORW: yes/no PNA: yes/no
Type of Project/ Activity
(Scale:
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A building permit/zoning permit may be required by:
Permit Conditions
❑ TAR/PAM/NEUSE/BUI(FER (drcle 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 Initial)
Agent or Applicant PRINTED Name
Permit Officer's PRINTED Name
Signature **Please read compliance statement on back of permi ••
570
Application Feels) Check g/Money Order
Issuing Date Expiration D to
Statement of Compliance and Consistency
This permit is subject to compliance with this application and permit conditions. Any violation of these terms may
subject the permittee to a fine or criminal or civil action; and may cause the permit to become null and void.
This permit must be on the project site and accessible to the permit officer when the project is inspected for
compliance. The applicant certifies by signing this permit that: 1) prior to undertaking any activities authorized by this
permit, the applicant will confer with appropriate local authorities to confirm that this project is consistent with the
local land use plan and all local ordinances, and 2) a written statement from the adjacent riparian property owner(s)
has been obtained, or proof of delivery of certified mail notification of the adjacent riparian property owner(s).
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certify that this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
ElTar - Pamlico River Basin Buffer Rules El Neuse River Basin Buffer Rules
If indicated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules
for the River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the
NC Division of Water Resources. If you have any questions, please contact the Division of Water Resources at the
Washington Regional Office (252-946-6481) or the Wilmington Regional Office (910-796-7215).
Notes/Additional Permit Conditions:
Please ensure all debris associated with the removal or construction of the permitted development is contained within the authorized
project area and disposed of in an appropriate upland location.
Division of Coastal Management Offices
Morehead City Headquarters
400 Commerce Ave Morehead City, NC 28557
252-808-2808/ 1-888-4RCOAST Fax: 252-247-3330
(Serves: Carteret, Craven — south of the Neuse River, Onslow
Counties)
Elizabeth City District
401 S. Griffin St. Ste. 300
Elizabeth City, NC 27909
252-264-3901
(Serves: Berne, Camden, Chowan, Currituck, Dare, Gates, Hertford,
Pasquotank and Perquimans Counties)
Washington District
943 Washington Square Mall Washington, NC 27889
252-946-6481
Fax: 252-948-0478
(Serves: Beaufort, Craven — north of the Neuse River, Hyde, Pamlico,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext. Wilmington, NC 28405-3845
910-796-7215
Fax:910-395-3964
(Serves: Brunswick, New Hanover and Pender Counties)
http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021
wUJAtaNI KII'AKIAN YKUYtKIIT UWNtK NU I WICATIONMIAIVER FORM
CERfIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY
t.. p, r.......,. — -- -, .,,r,....... -Y ....... ... ....... ..v..,,.,
Name of Property Owner: FF?-A At Is i hi RzA) i� rL2V 24P 1+
Naaress oT rrooenv: y 7 D A S a*J Su A �J )=1 fLLL r� mofte I•tvAt)
Mailing Address of Owner: ei3ZA Ho+c wJ DrL
ownersemaii: FP_sJAn5,�#4X-ALd--_ ownersrnones 9('-a(gt 373-3
Tne�f Ln CL : c c •'ti
Agent's Name: Agent
,aenrs Email:
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adjacent Property Ownsri
�dreov cea ry mat I own orooenv aoiacem io me aoove reTerence(l DroDeriv. 1 ne 1norviouai aDDlwng Tor tms
3ermit has described to me. as shown on the attached drawina. the development thev are or000sino. A
description or drawing, with dimensions, must be provided with this letter.
I UU NV i nave oniectlons to tms DroD0sa1. 1 UV nave ooiecaonS to mis oroDosa1.
If you have objections to what is being proposed, you must notify the N.C. Division of Coastal
manauemenr lucm) in wrmna wttnin Ta clays or recemr or rms nonce. Gorresponaence snoma De
mailed to 400 Commerce Ave.. Morehead Citv. 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 unaerstano mat anv proposea pier, oocK, Mormq prongs, Doat ramp, DreaKwater, Doatnouse. nn, 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 anornnriate hlank hpinw )
I DO wish to waive some/all of the 15' setback
11612
I do not wish to waive the 15' setback
Hw,a an Prnnart✓ r)wner
(initial the blank)
agnature or Aalacent Kipanan l ropeny vwner:
Typed/Printed name of ARPO:
Mamna Address or AKFV;
ARPO's email:
Date*
ARPO's Phone#:
"waiver is valid for up to one year from ARPO's Signature'
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Revised July 2021
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.v. V,• VIVI\ VI VVfIV IfIL IIf\I\r1V L1\ILI\1
aDJACEN T RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
:ERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY
t 1 V'/ �./VI LIVII w VV VVI11'/Il-\VV VY VYIIIVI VI 111V11 um'jl'
Name of PrODerty Owner F (Z44QIK i E Q E N ] Iii- IL G tZr} P M-
+caress or rropehv: Lr7 O s g,+IV 5NA- J CI RCLq--
Mailina Address of Owner: 9324 DrL "'Jc 27b I J
uwner s emaa: FPende-r\ ca ran), o-+A,euwner s t•none- 419 Q 19 7 -1 2
psl�cog, coT�,
Agent's Name: Anent Phone#.
enrs Email:
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adlacent Ptoperty Owner,
�I ury mat i own orooenv aalacem to the aoove reTerehceo orooerty. i ne marviouai abowino Tor this
-mrt has oescriDea to me. as shown on rite Attached drawina. the development thev are or000sina. A
—motion or orawma. with almensions. must be orowaea with this letter.
✓ i uu ivu i nave owections to this proposai. i uu nave ooiections to this Dr000sai.
If you have oblectfons to what Is being nrogosed. you must notify the N.C. Division of Coastal
management Iucmr in wrap within ru aays or recervt or ans nonce. i onesoonaence snoula oe
nailed to 400 Commerce Ave.. Morehead City. NC 28557. DCM representatives can also be contacted
at (252) 808-2808. No response Is considered the some as no obiection ff you have been notified by
Certified Mar,
WAIVER SECTIQN
i unaerstano that any proposea pier, aocK, mooring plungs, boat ramp, oreaKwater, ooamouse. un. or
xom must oe set back a minimum distance of 15' from my area of riparian access unless waived by me
(this does not apply to bulkheads or nprap revetments). (If you wish to waive the setback. you must sign
the aooropriate blank below
I nit wish to waive some!aA of the ? 5' setback ' 1 D N x" /J Q
--'innahlra nr nr Pinarian P nerty Owner
-OR.-
1 do not wish to waive the 15' setback requirement (initial the oianK)
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...,nature or Halacent nipanan rropeny uwner: W o V
1 yped/Printed name of ARPO: Go =
W W
U cx--
maumg Aaaress of Arcru tU Q
U
ARPO's email: ARPO's Phone#: G
Date: *waiver is valid for uo to one vear from ARPO's Sianature•
htevlSed JUIV 2U21
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