HomeMy WebLinkAbout88510C - Gallo, GiovanniM1 s- u:
h EICAMA ❑ DREDGE & FILL
=GENERAL PERMIT
New ❑ Modification ❑ Complete Reissue ❑ Partial Reissue
f, ' 48 8 5 1. 0
A B C. D,
Previous permit
Date previous permit issued
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: www.deq.nc.gov/CAMArules
Applicant Name i Authorized Agent
Address
z' r a ;"ti t",.•`-� " a V191 Project Location (County):
City "?.1 x State tP ZIP c r .�% Street Address/State Road/Lot #(s)
Phone #
Email Subdivision
City ZIP
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body a.. - c` 1 r') (nat/man/unk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body
ORW: yes/no PNA: yes/no
Type of Project/ Activity'
Shoreline Length
Access Length
Pier (dock) length
Fixed Platforms).
Floating Platform(s)
Finger pier(s)
Total Platform area
Groin length/#
Bulkhead/ Riprap length
Avg distance offshorer,tpa
Breakwater/Sill
Max distance/ length
Basin, channel
Cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
SAV observed: yes no 7 0
Moratorium: n/a yes no
Site Photos: yesno
Riparian Waiver Attached: yes no.,,, • n
A building permit/zoning permit may be required by: _
Permit Conditions '± i ��
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
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** Jp Signature
r ,
Application Fee(s) Check #/Money Order Issuing Date Expiration Date
�1*°1COAS'41�c❑ CAMA El DREDGE & FILL NO 88510 A B C D
s = GENERAL. 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:
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. Wtr. Body (nat/man/unk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body
ORW: yes/no PNA: yes/no
Type of Project/ Activity
'
E (Scale:
Shoreline Length _ Z
Access Length f;
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)
Total Platform area
Groin length/#
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill
Max distance/ length
Basin, channel
Cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
SAV observed: yes
Moratorium: n/a yes
Site Photos: yes
Riparian Waiver Attached: yes
A building permit/zoning permit may oe requirea py:
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 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" mow. aM. Signature
Application Fee(s)
Check #/Money Order Issuing Date
Expiration Date
United States
Postal Service
USPS TRACKING # s _ First -Class Mail
Postage & Fees Paid
USPS
Permit No. G-10
9590 9402 7332 2028 6324 71
Un
ited States • Sender: Please print your name, address, and ZIP+4° in this box•
Postal Service
SCAN
.;.:•���..�.� .�.!�1llli���1illli�l{It�i1li,�il1�'11i11111i'l�l�ll�fl11i1�'1111t1(
USPS TRACKING # First -Class Mail
:80 Postage & Fees Paid
USPS
3'L 1111..11 1 Permit No. G-10
9590 9402 7332 2028 6223 35
• Sender: Please print your name, address, and ZIP+4° in this box•
3 -3
III III I1111111111111111111111l11111111111111111itI111111111111111
■ Complete items 1, 2, and 3. I
■ Print your name tun her card n youevers
so that we can
■ Attach this card to the back t the mailpiece,
or on the front if sp
1 Article Addressed s.
to'
A.
X
B,
D. Is delivery,
If YES, delivery
3. Service Type
Coal
ult Signature
dult Signature Restricted Delivery
IIIIII ertified Mail@ Restricted
Delivery
mfrOrS
Certified Mail R❑ Delivery5971 ❑ Collect on tricted Delivery
9590 9402 ❑ Collect on�DeliveryResran, 5 8 3 9 la l Restricted Delivery
2, Article Number (� n Q no 8 916
�13,21 �Julya
PS Form811,020 PSN 7530-02-000-9053
Co►
lete items 1, 2, and 3. I
,. our name and address on the revers
■ Print y can return the card to YOU -
so so that we
Attach this card to the back
t the mai p
■ the front if spa p
or on essed to' )l,
1 Article Ad[\dr��
\Iv \ %11M\1�12
i
A-111Y
II IIIIIII�
I
9590 9402 7332 m028 6223 35
service label)
2. Article Number fTr7 a f ❑ a 8 91 ",
7 a 21 2 2020 PSN 7530-02-000-9053
PS Form 3811, July
❑ Agent
of Delivery
—0 s
n 'f d Yes
., `1Ci No
p Mail Express®
❑ Registered Mali'm
❑ Registered Mail Restricted
Delivery
❑ Signature Confirmation?"' ❑ signature Confirmation
Restricted Delivery
Domestic Return Receip
If YES, -enter delivery duel'
E
ail FJcpress0
❑Priority M
❑ Registered Mall"'3 Service Type ❑ Registered Mail Restricted
❑ A 1t Signature Delivery
dult Signature Restricted Delivery [3 Signature
Confirmation?"'
Certified Mails ❑ Signature Confirmation
❑ Certified MDeR esryicted Delivery Restricted Delivery
❑ Collect on Restricted Delivery
❑ Collect on Delivery
4 51 )� I Restricted Delivery
Domestic Return Receipt