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Home My WebLink AboutPusateri, Thomas 87353C❑CAMA ❑ DREDGE & FILL No 87353 A B C D ermit GENERAL PERMIT Date Previous 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: 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 City ZIP Affected ❑ cW ❑ EW ❑ PTA ❑ ES ❑ PTS Acl Wtr. Body (nadman/unk) AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Mal. Wt, Body ORW: yes/no PNA: yes/no Type of Project/ Activity (Scale:/i�.. i ) AccessLength Pier (dock) length Fixed Platform(s) ■ r i i i�� C�i C�n■■�■■..IN Finger pier(s) Tot al Platform area■ Other 0i �� u■��.L! bWli■�1�4■� ,� IN ■im■i . i ■■ERIMIN ONE �■ �■i■n IN I in's Sol SAV observed: yes no� Moratorium: n/a yes no Site Photos: yes no Waiver Attached: yes no ~ ' NNE® ':�:�::: E ME ■■ ■.,1�■ � 1) ■N■■■■■ ■■■■■.Riparian A building permit/zoning permit may be required by: Permit Conditions TARIPAM/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 Initial) Agent or Applicant PRINTED Name Permit Officer's PRINTED Name Signature *'Please read compliance statement on back of permit" Sign a Lre _ Application Fee(s) Check N/Money Order Isgui gDate Expiration Date o,A00A9j"r ❑CAMA [IDREDGE & FILL N° 87353 A B C D �a Previous permit 3 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: ISA NCAC ❑ Rules attached. ❑ General Permit Rules available at the following link: w .deq.nc.gov/CAMArules Applicant Name Authorized Agent Address Project Location (County): City State ZIP Street Address/State Road/Lot#(s) Phone#(_) Email Subdivision City ZIP Affected ❑CW ❑EW ❑PTA ❑ES ❑PTS AEC(s): ❑OEA ❑IHA ❑UW SPIMA ❑PWS ORW: yes/no PNA: yes/no Type of Project/ Activity Adj. Wtr. Body (nat/man/unk) Closest Maj. Wtr. Body (Scale:! )` �"�■' . ��_.�� .CSC:.■ CCC.�.►�C.C■CCCCClC.. mill Bulkhead/ Riprap length A building permit/zoning permit may be required by: Permit Conditions ❑ TAfVPAM/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 Initial) Agent or Applicant PRINTED Name Permit Officer's PRINTED Name i A Signature **Please read c,mpIiahcestatement-on back of permit'* Signapy,re ��Q Application Feels) Checktt/�Mo)e Order Iss ui g� Date Expiration Date N.C. DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER N0TIFICATI0NIWAIVER FORM CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERY (Top portion to be completed by owner or their agent) Name of Property Owner Address of Property: /C? J T�t�,� E T ��%% C.y�I� r"&x� /y - MailingAddressofOwner�: "r 5o3 l%�Lx (tee- Zmet&� Owner's email: Du:koa Owner's Phone* Agent's Name: %E'-eW_ r�rr✓ Agent Phone#: Agent's Email: ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION {Bottom portion to be oomnleted by the Adjacent promw 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. 9 descriadon or drawina with dimensions must bg orovided with this lette - V�I DO NOT have objections to this proposal. I DO have objections to this proposal. it you nave aojecuor s to wBtlt to voeny FF. #p ..mow X" ..•-_..._. _. . 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) 808-1808. No response is considworl Ov same as no objection if you have been notified by Certified Mail. , 41V R SECTION I understand that any proposed pier :: v,00r ing pilings, boat ramp, breakwater, boathouse, lift, or groin must be set back a minimum a!:lar;ce of 15' from my area of riparian access unless waived by me (this does not apply to bulkheads or nprap rovetmente). (If you wish to waive the setback, you MHRLSijLn the appropriate blank below.) I DO wish to waive somelell of the 15' setbac"J }7�/ Signatum of Adjacent Riparian Property Owner .OR - I do not wish to waive the 15' setback requirement (initial the blank) . _ Signature of Adjacent Riparian Property Owner: 44.00jr6sl/Q�� Typed/Printed name of ARPO: `MOM A-S A, S A (E ED J J R Mailing Address ofARPO: 3301 (�ENCvON P12, r SU.ITF_— 1 03 , AR O r17Cd�Ei hj OOs e80.mail: SAI I"EV a PEE& hjja C 4P01a Phona#: `� (�, ?"I 03 G1 (O d G =am Date: O3 -0 22 "waiver is valid for up to one year from ARPO's Signature" Revised May 2021 v \ %_. N.C. DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERY (Top portion/to be completed by owner or their agent) Name of Property Owner: % `I S Address of Property: I /L7 L AVI/ 15 y er,- Y /�Ppi��tiQT /I/ G-_ Mallinp Address of owner: ,7,9o-27 1,4D,&t-' /. t E16w- /t/C --x 7/-0 0 Owner's email: D a ]e✓/ C:1 !d24G,C4V m Owner's Phone#: Agent's Name: 67E'wG-'- YZ)i✓ - Agent Phone#: Agent's Email: 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 demotion 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 proposed, you must nouty me N.U. urvrsron or wdsta, 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 sian the appropriate blank below.) i DO wish to waive some/all of the 15' setback r Signature of Adjacent Riparian Property Owner -OR- I do not wish to waive the 15' setback requirement (initial the blank) Signature of Adjacent Riparian Property Owner: /J r- Typed/Printed name of ARPO: 7-10M A-S A. S A I E ED r J R. Mailing Address ofARPO: �3.3 01 GENSD N PR I SRi (Z ARPO'ssemaiAlEt�@ �C �LrrtRs c�NPo'sPhone#:`6-112.2-2103 21IoDd Date: 03.0 S . 22 *waiver is valid for up to one year from ARPO's Signature* Revised MaPAIiFIVFD MAR 31 7021 DCM-MHD CITY AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: Mailing Address: Z'503 Ella i�2 ��• %i76U� Phone Number: `%1 y SS `} 07� Email Address: 1'161g6Aet '; ca Ina . Co&i I certify that I have authorized G:: ?5-r tiI , Agent / Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits / necessary for //the following proposed development: (,tom i� dOe Yo P�GSTu�r. 17 ,,9i4 .4ne,,n✓-5Y",a%p Ai, 16 r IVA4 . at my property located at 10 Z- AA SIk�ne _ -e [ IgT�0_7— We—' in County. 1 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. Property Owner Information: Signature 7-tow*s 9tA9.4'rs(l Print or Type Name Z I / i Z2 Date This certification is valid throughRECEIVED MAR 312022 DCM-MHO CITY N.C. DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERY (Top portion to be completed by owner or their agent) Name of Property Owner: M1 Address of Property: Z AlAl Mailing Address of Owner: "50 3 Owner's email: OriS//GTPI/ �'�/tIQL, (eaq Agent's Name: t�ev e_ � kaid Agent's Email: v Owner's Phone#: Agent Phone#: 9I I Jab Y' 73� 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 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 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 some/all of the 15' setbacJr�/ Signature of Adjacent ipa ion Prollerty OVner -O R- I do not wish to waive the 15' setback requirement (initial the blank) Signature of Adjacent Riparian Property Owner: Typed/Printed name of ARPO: t /r e- M4 ' fy00ov/ )w 4 Mailing Address of AR/PO: r/rr✓ S� IJ�/Qu�D/L7— /v ARPO's email ( r jgkRPO's Phone#: ;3 Date: 2)I- I1L *waiver is valid for up to one year from ARPO's Signature* Revised M2y202W I-D DCM-MHD CITY 0 RECEIVED MAR 3 12022 DCM-MHD CITY Ij e 5 s` i 3 j E 9 W �s� E�; ��'f��sa �•mrY !,.y9DD99p °' A pz e�a�zube AAR 0 a 2022 M-MHD CITY