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Home My WebLink About88409C - White, DouglasIMCAMA U DREDGE & FILE GENERAL PERMIT Previous Nu �er4U9 A B permit � � Date previous permit issued ew ❑Modification ❑Complete Reissue ❑Partial Reissue As authorized by the State of Noo1nh Carolina. Department of Environmental Quality and the Coal I Resources Commission In an area of environmental concern pursuant to: ISA NCAC.yL__I_TtT I G-LJ� Rules attached. General Permit Rules available at the following link: w�c nov/CAMq les Applicant Name_ Address Q Uri city='i,�riClr-TbCYC� z-- State NC_ LIP Phone # (_ ) Email hnnf1c1Y1 (20(\i 7.L 1n0A,, . cOIV� Affected E1CW MEW dPTA dEs �PTS AEC(s): OOEA ElIHA OUW EISPIMA E]PWS ORW: yes/no PNA: yesig Type Of Project/ Activity QYI)92 e (p n-1R 171 t 1"AIA. Shoreline Length Access Length �\ Pier (dock) length Fined Platform(s)� Floating Platform(;) / Finger pler(s) Total Platform area Groin length/q �T n Bulkhead/Riprap length I' \`� Avg distance offshore L i W Breakwater/Sill ` n Max distance/length Basin, Channel I ._ Cubicyards ---- Boat ramp / Boathouse/ oa liR I �t 1(17 / Beach Bulldozing / J Other / Authorized Agent Project Location (County): CIA -) Street Address/State Road/Lot#(s) a Subdivision city 71P Adj. Wtr. Body \L ) ki i' Viec 'a arVurdt) Closest Maj. Wtr. Body Qq,L_ o_ So,]n (scalej*v,� PI[W'teLM �1 ti� 12xta.'t.,4+ I SAV observed: yes no \ y Moratorium: n/a yes no 1111 (31L,IIe.k QaA Cloak Site Photos: Les no Riparian Waiver Attached: Qey no 1Q(yY.y+�y! A building permit/zoning permit may be required by� e J r� �r)511F+ ��Qer•F Qrltx�aed) �Permit Conditions 0TARIPAM/NEUSE/BUFFER(circle one) e011 t- IX&& J (,t M P See note on back regarding River Basin rules t _lsrto. ---- See additional notes/conditions on back I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATMENT. Inleaze Coast-- 0-"[IQ Cal Tir�nt Mn�n Agent ylica+ t PRINT D N_ Pit Olfi+^: e�pRl TED Name SICna[ur Please read compliance statement on back o(permil" dL �tJ✓ �p RA SI nat e n �/ Application Feels) C eck q/0 Money Order � t `tom F:zpi ation Dai � R/��LL ❑DREDGE & FILL N9 88409 A B O'D t GENERAL PERMIT Previous permit Date previous permit issued [Lew ❑Modification ❑ Complete Reissue ❑ Partial Reissue As authorized by the State of North Carolina, Department of Environmental Quality and the Cow I Resources Commission in an area of environmental concern pursuant to: 15A NCAC C)� t �� Rules attached. General Permit Rules available at the following link; www.deq.nc.gov/CAMArules Applicant Name U4 `\\AJ�� `�t�'TEf, Address , \ � Un T LhLA-Q— City �( 0tXY0 State N L ZIP Phone l#�(_) rrrt�� Email t anclo—,^ DiCa��1 .VmSkmnnne Cmiyzic4irn • CONN Authorized Project Location (County): C. Street Address/State Road/Lot #(s) Subdivision City Affected ❑ CW EW M PTA LJ ES ❑ PTS Adj. Wtr. Body \ l ire i-te vaL_ �-_WQJ (( nan/unk) AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body o� 5oJnolk .vq Type of Project/ Activity Shoreline Length I OW Access Length Pier (dock) length Fixed Platform(s) Floating Platform(s) / Total Platform area Imo, '3 S'Ci T Groin length/ri Bulkhead/Riprap length Avg distance offshore Breakwater/Sill Max distance/ length e� Basin, channel Cubic yards 1-1 Boat ramp 1-1 Boathouse/i o`atiJ ' 7C IZ/ Beach Bulldozing Other / SAV observed: yes no Moratorium: n/a yes no Site Photos: yes no Riparian Waiver Aytt�a�d: ® no A building permitJzoning permit may be required CONDITIONS THAT Signature **Please read comp ia�rrent on back of permit** %2.100.°0 4I1ggf5 Application Feels) C eck M/Money Order T K"fesl S�1 6-,J� ❑ TAR/PAM/NEUSE/BUFFER (circle one) ❑ See note on back regarding River Basin rules ❑ See additional notes/conditions on back (Please Initial) t AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: �Ou qiq� w Y1 i+ Mailing Address: 110 t-iV-, AwanctoOrO- NC, 7 3s S4 Phone Number: Cl to - 2bS - 3 S ;R �e Email Address: CII0q!21d4wV-%i±e eG hr GOm I certify that I have authorized r,rls!i-W C-opS} Mghine �raahikIg Agent / Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: _Cons{-V o c+ %nn OF Q GOnGUIP dOOK w'14-4-\ nne he)(N+ li-p+ at my property located at l 10 W ne FSOq♦ L-og n in OrtS1ow County. r l 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 InPoratation: Signattr �oti�ta� wht+e Pnnt or Type Name OVVKVe 7ftle / / Date This is valitl throuuh ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to W i t e, s ame of Property Owner) property located at _110 L=Ih e j SQQ-V Lone (Address, Lot, Block, Road, etc.) on -zthi+C OAK in Swcl.nSboro jonGtow N.C. (Waterbody) I(City/Town And/or County) The app icant has described to me, as shown below, the development proposed at the above lo¢ o I have no objection to this proposal. I have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (Individual proposing development must rill in description below or attach a site drawing) WAIVER SECTION I understand that a 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. (I you wish to waive the setback, you must initialthe appropriate blank below.) I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Property Owner Information) (Adj ent Property Ow er Formation) J Signature* �-' DenniS Ve ¢era- Botharn Print or Type Name Lq Swc%nSho,ro NG Z$s4Z Meiling Address City/State&Z p 1 N Citylsta _qjLo 2R ho r c� nt G 2 85 8 4 Telephone Numberl email address Telephone Number/Pmail addme s ! 3 , !" Z. Z Date - p�� ! 'Valid for one calendar year after signature- (Revised Aug. 2014) wh'�+e oak Q,vey -2' vvoiev depth at Iow i ide 31 4,$0 O grgSS vo\ng\FS w h\-tC o \-,re Qoo\t L-a ne 15' Derv; s Bo,r hanl ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to o aS is Name of Property Owner) property located at ►1 O t_i r1 e' BOAT' (Address, Lot, Block, Road, etc.) on Why--e OAK ,in 1 "SIOvV N.C. (Waterbody) (City/Town findlorCounty) The applicant has described to me, as shown below, the development proposed at the above loca 'on. I have no objection to this proposal. I have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (individual proposing development must fill in description below or attach a site drawing) WAIVER SECTION I understand that a 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. (If you wish to waive the setback, you must initial -the appropriate blank below.) LI do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Property Owner Information) (Adjacent Property Owner Information) .Signature Si + WplTe- VAhCS O OI Print or ype Name Print or Type Name 94. tic ►_;ne ROa+ d I.ne to53Z. Elrnda►e �oaCl Mallrng Address Walling Address Swar�sbovo SIC, A►ex&'n dh iqr V A 22 Al2 City/StatelLip Cd-lsle eleph1141 f`Q Telephone Number/email address — no Numberl �fa 0 '" O To/email address -- D°'e" 15 APP, L- U o 1,1, 'Valid for one calendar year after signature (Revised Aug. 2014) \k2-