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Home My WebLink About84692C - Gielink, MichaelCAMA FJ DREDGE & FILL p Previous permit-- t GENERAL PERMIT Date previous permit issued _- X'New Modification [J 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 rvCAC J jt 'Z^ Rules attached oral Permit Rules available at the following link: y�ww i r n ,�oYrCA`llilul�`. Applicant Narne...--...ffi� , ` M i Authorized Agent ' — Addre —.._._._ Project Location (County) _--'�— — City . S ZIP .__ Street Address/State Road/Lot #(s) Phone V /� Fina11 �f�rr L3_ �.,�rT '� '� $ubdwrsron _F� City �--- Affected CVY EW Fs7A ES PTS Adj. Wtr. Body ' �. nat/Inan/unk ' . r{ , AEC(s) OEA C IHA UW SPIMA PWS Closest Mal. WE Body ORW yes /tto0Z PNA ei o �A Typ of Project/ Activity �r . , , , .�.. rR C (Sei31ei�; �01 a w i 1 Shoreline length i Access length Pier(dock)length ! Fixed Platform(s) Floating Platform(o Finger pier(s) Total Platform are Groin length/a Bulkhead/ Rrprap Avg distance offsh Breakwater/Sill_ Max distance/ len, Basin, channel Cubic yards Boat ramp Boathouse Boatli Beach Bull opng r Other C SAV observed: Moratorium. n/, Site Photos: Riparian Waiver At A budding permit/: Permit Conditions I AM AWARE OF STATUTES CRC RULES 4ND CONDITIONS THAT APP Y TO THIS PROTECT AND REVI-LWEU L"OM I f — - - '' Agent or A' lican Permit Officer's PRI Si at re PI- a read compliancb statement oll6backolf permit" Slg tur A Ircation pp Fee(s) Check it/Money Order Issui g Dated 0 Colo TARIPAMiNEUSE/BUFFER (circle one) See note on back regarding River Basin rule See additional notes/conditions or back MENT, Please Initial(___ 0lip A Al `o1AcomTv CAMA ElDREDGE & FILL fs N� �9� A g J.=G*' ENERAL 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: 0 15A NCAC f > ' �+A2W ❑ Rules attached. eneral Permit Rules available at the following link: www.deq.nc.gov/CAMArules Applicant Name .- Authorized Agent Addres Project Location (County): City ZIP Street Address/State Road/Lot #(s) Phone # ) Email Subdivision City ZIP Affected ❑ CW EW TA AEC(s): ❑ OEA 1-1IHA UW ORW: ves/rh PNA-AA)no Type -,of Project/ Activity _ Shoreline Length Access Length _ Pier (dock) length Fixed Platform(s) . Floating Platfo Finger pier(s) Total Platform area Groin length/# Bulkhead/ Riprap ler," th Avg distance offshore Breakwater/Sill Max distance/ len Basin, channel Cubic yards Boat ramp Boathouse Boatlift Beach Bulldvzing Other « P m t. V observed: SAV 09on Moratorium: n/a yes Site Photos: yes Riparian Waiver Attached: es no A building permit/zoninnng��er it may bjee required by: Permit Conditions At, T t"i I AM AWARE OF STATUTI ❑ ES ❑ PTS Adj. Wtr. Body ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body !at/)nan/unk) (Scale��( Q ) ❑ TAR/PAM/NEUSE/BUFFER (circle one) ❑ See note on back regarding River Basin rules ❑ See additional notes/conditions on back CRC RULES AND COND TIONS THAT APP Y TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. gPlease In f�L a o i C, a e i ��, * r'� illy �� s m Agent orfpPlicaj PRINTED Name Si at re **PI read compliance statement on back of permit** l�'�✓�57,�7 Application Fee(s) Check #/Money Order Permit Officer's PRIN,TZD N Sig tur Issui Expiratibn D M C S Q,4-o� Rst,)-cav� X16 N.C. DINPSION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY UWNER NOTIFICATIONfWAIVER FORM CERTIFIED MAIL., RETURN RECEIPT REQUESTED or HAND DELIVERY Jop portion to be completed by owner or their anent) Nanie of Property Owner: I, I et, cj, --A �.1 f..,-- e Address of Property: Mailing Address of Owner, Owner's email,' 8 Owner's Phone# Aaent's Name, Agent Phoneik_ Agent's Email: . ...... Nuns= ADJACENT RIPAMAN PROPERTY OWNER'S CERTINCATiON' 'Bottom portion to be completed bathe Adjacent Property Owner) I hereby certify that I own property adjacent to the above referenced property.1-he individual applying forthis permit has described to me, as shown oln the attached drawing, the development they are. proposing. A description or dr,:::ming, with dimensions, must be provided -,.vith this letter. /I DO NOT have objections to this proposal. I DO have objections to 'Uhis proposal. IT you have objections to what is being proposed, you must notify the N.C. Division -;T, _Coiaskgal Ailanagement (DCM) in writing within 10 days of receipt of this notice. Correspondence shotdd be -,naded to 400 Commerce- Ave., P-6177orehead Cify, NC 28557. DC111 representatives can aiso f"Jc Ccptawie& at (252) 808-2808. No response is considered the same as no objection if you have beer; notified by Certified Mail. WAIVER SECTION I - I 0- understand that any proposed -d pier, dock, mooring pilings, boat ramp, breakwater, h0aU10US&., lift, groin must he set back a rninimum distance of 15' frorn my area of riparian access uniess waived by me (this does not Fpply to bulkheads or riprap revetments). (11' you wish to waive the sotback, \,'OU rnL]S-t sign the appropriate blank below.) DO wish to waive some/all of the 15' setback Signature of Adjacent Riparian Property Owner -r)R- I do not wish to waive the 15' setback requirement (initial the blank) Signature of Adjacent Riparian Property Owner.-. Type-, d/Pri rited name of ARF0 ., -� - f) � e- J,,l OL N'lailing Address of ARPO: tjol -6a � C', C>)N� ARPO's entail: ARPO'sPhone* qL"�-LJ(5-cj,(tGCS ___"waivew is valid foi, tip to one year from ARP01--, Signature RECEIVEI� Rovi.sed May 2021 .o 0 9 ZOIN Y,hc-� kL4ol-� R� N. c 01V\ 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: M (C,� Otj Ctdol Address of Property: r Mailing Address of Owner: 26+- ]-P 6I- n�c, Z S2 N 7- 9SZ� Owner's email: �-PA C,S 12(F.o Y`-\ Sn ce.&I Owner's Phone#: 3 l �" �f-� t 9 Agent's Name: Agent's Email: Agent Phone#: 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 descriDtion or drawina. with dimensions. must be provided with this letter. 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 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' setbac �--' Gam, Signat re of Adjacent Riparian Property Owner -OR1. - I do not wish to waive the 15' setback requirement (initial the blank) Signature of Adjacent Riparian Property Owner: �.� Typed/Printed name of ARPO: ,�� ✓ , �� Mailing Address of ARPO: ARPO's email:,✓'rZL/v� �ARPO's Phone#:.��-� Date: / *waiver is valid for up to one year from ARPO's Signature* I " ; I E `. Revised May 2021 JUN 0 8 20?.' DCM-MHD CITE' I N j � k 00 �''� �►e A LD ECEIV' U` I � 2022 40 DCM-MHD CITY 6 aux �31141rec -C Ca vi lup"') -o ,p C-fc LiFt ever.