HomeMy WebLinkAboutByrd, Vickie 84405C'o1pi(OAS
T41 y9c❑CAMA ❑ DREDGE & FILL N® 84405 A B C D
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:
I SA NCAC ❑ Rules attached. ❑ General Permit Rules available at the following link: www.deq,nc.Qov/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
Shoreline Length
Access Length t -1 - L - - - -- -- — —
Pier (dock) length
Fixed Platform(s)
Floating Platform(s) i
.- _..__... .. - - ...... ............ - -
Fingerpier(s)
Total Platform area
Groin length/#
€ E
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill
Max distance/ length
Basin, channel
Cubic yards
Boat ramp i
Boathouse/ Boatlift
Beach Bulldozing ;14_
Other
SAV observed: yes no
Moratorium: n/a yes no
Site Photos: yes no r'-
Riparian Waiver Attached: yes no
A b i Id
(Scale: )
uing perms zoning perms may e require y
❑ TAR/PAM/NEUSE/BUFFER (circle one)
Permit Conditions
❑ 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" Signature
Application Feels) Check #/Money Order Issuing Date Expiration Date
1*o(OAS TN& ❑CAMA ❑ DREDGE & FILL N° 84405 A B C'� D
�O YT
y S GENERAL PERM 1 T 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 _
Shoreline Length
Access Length
Pier (dock) length
Fixed Platform(s)
i
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 no
Moratorium: n/a yes no i
Site Photos: yes no
Riparian Waiver Attached: yes no
A building permit/zoning permit may be required by:
Permit Conditions
(Scale: )
❑ 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"
Application Fee(s)
Signature
Check #/Money Order Issuing Date
Expiration Date
f
AQENT AITNOB�rATWN,EOR GA_y� PCRMIT APPLIGATtON
11
Mamo of PLOP" Owner R,,*% q Petnut T? —
Meetrtg Adams*
Phone Numb":- i
EnMd ACdrtsS: Y�ttri� ?7! O)m..
cavt ty that l have atAhorired I' l- i 1. A— .r � , �S• � .•
y apw,tr�WnKta
!o act nn my behalf. for the Purpose at apply" lot and Warmnp as CAMA perrr.As
nnceesary for the following Proposed deaeJopment
al my proPOrty bcatod at '<tcv ',.,`., , ., r.i �t , • r i ".'
to Ctu er' 1" County
I furlhormore certify that I am authonted to grant, and do in fact grant permiefi*ir to
DrWW" of Coastal Manaprtntont Italy, the Local Permn Officer and fhoir agents to eintor
art the aloremanlronad lands in eonnect�on wrth evaluating m/onnation related to this
Perm, apphcol,on,
Property Amer Information:
Stgnatwo
I�•n 1.>�
Pant or Type Nano
I rJ 1X-. r
rice
Date
This certification is valid through .ti t .' I I -a., a a,
elms(
�v CCU(; 2
The 4nar"
i hereby ce I that i own property adjacent to the above rderer�ceci praP�Y
apptytng for this permit has described tome as shAi
n thea drwin the dev o
they are proposing.
I have no objectioDs to this Proposal. __— t We obj
ectiow to dlis pzopas;
red �l must notothe Division of Coastal "ag
K you ha ve obfecdons to what is baing PropO' Yo P ,� r nea should be malled
(r�A,f) !r� srvt3 ;.trr'rr f days of receipt Of thlse.0 be
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