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Home My WebLink AboutPalm Adventures, LLC 87307C#[]New ❑CAMA ❑ DREDGE & FILL Na 87307 A B C D GENERAL PERMIT Previous 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: I SA NCAC ❑ Rules attached. ❑,General Permit Rules available at the following link: www.deo nc gov/CAMArules 11, Applicant City Phone # I—) Email Affected ❑CW AEC(s): ❑OEA ORW: yes/rlo ❑EW ❑PTA 1--1IHA ❑uW PNA: yes/( \) Type of Project/ Activity Authorized Agent Project Location (County): _ZIP Street Address/State Road/Lot #(s) Subdivision City (4ES ❑ PTS Adj. Wtr. Body I,... ❑ SPIMA ❑ PWS Closest Mal. Wtr. Body ■ ■■■■■ ■ �qp■■■■■■■■■■■■■ MENEM ■ I ■®■■� ■■am I NE Floating Platform(s)■ ■� ■■ ■■' ■1■■' �■ ■■ ■■■■■ ■ ■■■■■■��■■��■■ Avg distance offshore :Max distance/ length Basin, channel Cubic yards Beach Bulldozing Other SEMI 0 .:�Q f,i �.. ....■C�I� ■■ ■ r ■n■ ■■■ ■ ■■■■ t MEMEMI SAV observed: yes no n/a yes no V �� Q°i�i��n��■iMoratorium: A building permit/zoning permit may be required Permit Conditions THIS ❑ TAR/PAM/NEUSE/BUFFER (circle one) See note on back regarding River Basin rules See additional notes/conditions on back VENT.%(Please Initial)_:�� 1 Agent or Applicant PRINTED Name - - Permit Officer's PRINTED Name Signature "Please read dompliance statement gn back of permit" Signa ore Application Feels) Check#/Money Order Issuiyng Date Expiration Date #F1 ❑CAMA ❑ DREDGE& FILL N9 87307 A B C D Preous GENERAL PERMIT Dtepre iouslpermitissued 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: waw.degDagov/CAMArules Applicant Name _ Address City Phone # (_ ) Email Affected ❑CW AEC(s): ❑OEA ORW: yes/no State ZIP ❑EW ❑PTA ❑IHA ❑UW PNA: yes/no Type of Project/ Activity ES ❑ PTS ❑SPIMA ❑PWS Authorized Agent Project Location (County): Street Address/State Road/Lot #(s) Subdivision City Adj. Wtr. Body Closest Mal. Wtr. Body (Scale: Access Length Pier (dock) length Fixed Platform(s) J ■■■■■■■■■■■■MEN 0 MEMENMOMME■ ■■■'■ili�.■■.■■■.■■1C.C■■■C®CC■■■ MEN •�•�"•••:::C'000 ON . Floating Platform(s) :AC ::I: � ENMENNE:0:a:: :N:■■ � :� Finger. 11C.. :CC .■■■■■■■ . Total Platform area Groin length/# Avg distance offshore C71'Breakwater/Sill■■■ Max distance/ length Basin, channel Cubic yards.■■ :� ■® BEEN N■■■■■1■� ■Odii�t■iii� ■in�iii�'■■ME� 111® i `�`■■�� ■■�■ ■■■■■■CCiis�j�■■�� l�■■ �:0 l.�i�l11001 MMMMMMIV M MEMO so 1119 ■/_G�6 ■■■■ ■■■■ 1 ■■■� - .►...�..�■&I ��■�.. L.C. ..agll�l.MEN ■■1�1�■��..1_1■■■■..lO■■1 iAV observed: yes no11111■� Moratorium: n/a yes no CitePhotos: yes no �Rfl��E�USI i11�■rNMEMEM l� ■►11 ■■■■■ ■ ■■■■■■ ■■ A building permit/zoning permit may be required by: Permit Conditions i AND CONDITIONS THAT APPI Agent or Applicant PRINTED Name Signature "Please read compliance statement on back of permit" /O0`l,yl7"'h a� Application Feels) Check #/Money Order ❑ TAR/PAM/NEUSE/BUFFER(circle one) ElSee note on back regarding River Basin rules See additional notes/conditions on back JD REVIEWED COMPLIANCE STATEMENT.. (Please Initial) Permit Officer's PRINTED Name Signa ore Issui g 6ate Ezpliahon Date AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: Y� I ✓ C/o Mailing Address: Phone Number: 26Z ai,�(- y / 7� Email Address: I certify that I have authorized gent / Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: IE at my property located at c�� ' 6c�. . ixn.Q in n' c 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. I Property ,49rint or Type Name Titley �x 1_ Date 3 3% This certification is valid through ` !__../ 1 2Z-' N.C. DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM CERTIFIgD MAIL RETURN RECEIPT REQUESTED or HAND DELIVERY (Top p ion to be completed by owner or their agent) Name of Property Owner. �` U ' vk r Address of Property: Mailing Address of Owner: ,2(_i l f ._ f Owner's email: M 0. F�';3 Q NM A , nC f Owner's Phone#: x j Agent's Nance: a , s>s o Agent Phone#: Agent's Email: ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION (�gRrn-t oartion to ba camoletsd by the Adiasent Proaerty 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. I DO NOT have Objections to this proposal, i DO have objections to this proposal. If you have objections to what is being proposed, you must notify the N.C. Division of Coastal Management (,DCM)1n writing within 10 days of receipt of this nollm Correspondence should be matted 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 N you have been notified by Cardfled Mall, WAIVER SECTION I understand that any proposed plot, 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 at n the appropriate blank below.) I DO wish to waive some/all of the 16' setback 1 Signature of Adjacen fRiparian property Owner -OR- I do not wish to waive the 15' setback requirement (initial the blank) Signature of Adjacent Riparian Property Owner: �tJ� �� vU1 Typed/Printed name of ARPO: _ e r� ly�a rY /)IV A-E o L!iR'�'C5 Mailing Address of ARPO: _a2 ��7� ARPO's small; r� rfFC.yr c's Phona#: ZSZ — 2 Date; _ zlz --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 NOTIFICATIOWWAIVER FORM CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY (Top po ion to be completed by owner or their agent) _ J Nameof Property Owner:6''ri'l1 ✓ f<S, it ( �jTr l' �1�/SP �� Address of Property: S� X ✓ { i h `�. Ci_/Y Mailing Address of Owner. r Owners emajl: M rt �� i c �i"v .M�t k , r9fi Owners Phone# ( �[[f 11—%t.� Agent's Name: t,l OSo Prt)orc� r Agent Phone#: P5A— 6 (6 — 176(o Agent's Email:IU�pJ+--- 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. j I DO NOT have objections to this proposal. 1 DO have objections to this proposal. if you have objections to what is being proposed, you must notify the N.C. Division of Coastal 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 ff 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 t0 waive the setback, you must sign the appropriate blank below.) I DO wish to waive some/ail of the 15' setback Signature of Adjacent Riparian prop6Hy 0wper -0R- I do not wish to waive the 15' setback requirement (initial the blank) Signature of Adjacent Riparian Property Owner: I/Printed name of ARPO: __S-1, tLr \ E (d'� Ott Mailing Address of ARPO: ARPO's Date: i :m 'waiver is valid for up to one year from ARPO's Signature Revised May 2021