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Home My WebLink AboutMcIntyre, Carol 84401C❑CAMA ❑ DREDGE & FILL N9 84401 A B ;'P D a Previous permit "' 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: 15A NCAC ❑ Rules attached. General Permit Rules available at the following link: wwwdeg nc Pov/CAMArules Applicant Name Address City Phone # (_ ) Email Affected ❑ CW ❑ EW ❑ PTA AEC(s): ❑ OEA ❑ IHA ❑ UW ORW: yes/no PNA: yes/no Type of Project/ Activity ZIP ❑ES OPTS ❑SPIMA ❑PWS Authorized Agent Project Location (County): Street Address/State Road/Lot #(s) Subdivision City Adj. Wtr. Body Closest Maj. Wtr. Body (Scale: ;, ) Access Length Pier (dock) length -- .. Fixed Plafform(s)- f- ..... - T' y t Floating Platform(s) ,r Finger pier(s) Total Platform area Groin length/#�— Bulkhead/ Riprap length - - - - --(-- -- , 4,1V _ -- - - __ - ~ t M) - - - - -_ — Avg distance offshore ' 1. - I - Breakwater/Sill'� i Max distance/length- I I Basin, channel '---- Cubic yards Boat ramp Boathouse/ Boatlift : I, Beach BulldozingINN T Other __ SAV observed: yes no 1 )` }� 1')` Moratorium: n/a yes nott '' Site Photos: yes no - Rioarian Waiver Attached: yes no -� - - r--�—- A building permit/zoning permit may be required by: Permit Conditions TAR/PAM/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 THATAPPLYTO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. Agent or Applicant PRINTED Name Permit Officer's PRINTED Name Signature **Please read compliance statement on back of permit**/ �. Signature t.i1.,'; Application Fee(s) Check N/Money Order' Issuing Date (Please Initial) Date dtamr"�❑CAMA ❑ DREDGE & FILL N9 84401 A B 'C D GENERAL PERMIT Previous permit ` + Date previous permit issued -- - New ❑ Modification ❑ Complete Reissue ❑ Partial Reissue As authorizedbythe 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: www deq nc.gov/CAMArules Applicant Name _ Address City Phone # (_ ) Email State ZIP Authorized Agent Project Location (County): Street Address/State Road/Lot #(s) Subdivision City Affected ❑ cW ❑ EW ❑PTA ES ❑ PTS Adj. Won Body ' (nadman/unk) AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body /' �'"1 e'� ORW: yes/no PNA: yes/no Type of Project/ Activity (Scale:. '. ) .. ..MEN .�®a: 1a: Floating Platform(s)MEMO■■Finger ON:■�■■v;�■■■ ■■�:ON ��■:�: pler(s) Boathouse/Boatlift: Beach Bulldozing Other . .OEM■:� .� ONME NONE . ..::■®�- .a..0.■.. N M � ■ ■�■ Nrli�lldn ��EEN��M M 0 SAV observed: yes no Site Phoyesno tos: ■ � ■ iii�� Na A building permit/zoning permit may be required by: Permit Conditions ❑ TAR/PAWNEUSE/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 - Application Feels) Chet((p/Money Order Signature Issuing Date Expiration Date ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to property located at j(cl- !�kej ( Lb(D' (Name of Pr perty Owner) on (Waterbody) (Address, Lot, Block, Road, ) (City/Town and/County) N.C. The applicant has described to me, as shown below, the development proposed at the above location. Q'r i) I have no objection to this proposal. I have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (Individual proposing deNNelop ent must fill in description below or attach a site drawing) N�t.J �Yt'_ r' KffioVe dyid;AJ4 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.) _ I do wish to waive the 15' setback requirement. 1 do not wish to waive the 15' setback requirement. (Property Owner Information) Sigt tur�� Print or Type Name Mailing Addre City/State2ip �/ o - 3z7,-32-'l Telephone Number/email address C4rc�MOL.�'\ I �'UVA Date I /(k,/22 r! (Adjacent Property Owner Information) Date* *Valid for one calendar year after signature* (Revised Aug. 2014) ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to J 0.r^0-6 S/ ezuv'bQ `I I •— 1 Name f Pr perty Owner) property located at �cL �A�„(� C�, (Address, Lot, Block, Road -tc.) � on uJ \\1l%etJ , in _ � r.` a-A-S , N.C. (Waterbody) (City/Town and/or -County) The applicant has described to me, as shown below, the development proposed at the above to a(ion. c� 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) removr exiStiuF iDIvIZ Q house SPAT q gall 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.) �l I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Property Owner Information) Sig ature '�gVv�eS &OtJ� Print or '51.47Z' --327 -!�Z7 Telephone Number/email address Date 17 / on) or Mailing Addres �,�c�ds� vet City/state/Zip Telephone Number/email address 4/7>7 Date* iiv4a *Valid for one calendar year after signature* (Revised Aug. 2014) AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: Car-o Mailing Address: Phone Number: 39-q"S/[ 7 n Email Address: �n �aCMc,e. \ k ccb UPAkt 1.• Corv, 1 certify that I have authorized t ( Ck 4,no5' Anent / Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: Yerr�DY'e z1 a auc- f esDIA_ 6 X12' at my property located`at in L +W*6 Cad 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. Property Owner Information: Signa ure 14 CgrD [%L g<xtl`.(_ V,0, Print or Type Name Oc,a�Q� Title It? / ZD 2-Z- Date This certification is valid through S 1 /OZ3