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Home My WebLink AboutQuigley, Joseph 84408CjP�`COASt4l ❑CAMA ❑ DREDGE & FILL o 9 84408 A B C D y = 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 State ZIP Phone # ( ) Email 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) 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 Site Photos: yes no' Riparian Waiver Attached: yes no A building permit/zoning permit may be r� Permit Conditions (Scale:,'< ) ❑ 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" Signature Application Feels) Check #/Money Order Issuing Date Expiration Date 1**ECOAST41y ❑CAMA ❑ DREDGE & FILL N° 84408 A B _C D y Previous permit Date previous permit issued GENERAL PERMIT 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 Authorized Agent Address Project Location (County): City State ZIP Street Address/State Road/Lot #(s) Phone # (_ ) Email Subdivision City ZIP 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) - 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 SAVobserved: yes inoIL � Moratorium: n/a yes no r Site Photos: yes no' Riparian Waiver Attached: yes no W a A building permit/zoning permit may be required by / I r!i t) ' `- rJ 3 I Permit Conditions (Scale:I�I�l ) 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" Signature Application Fee(s) Check #/Money Order Issuing Date Expiration Date AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: :12 -� C-P'►k 2,.Q" (4-ra`i Mailing Address: Phone Number: Email Address: r)q&AA,,y /5�.�� Nc— MT7sA c,%'k Q ►`f i4 9 cn,- - C.0-wt I certify that I have authorized jo"' Agent / Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development:ww1 l �� at my property located at ,( a.X _&bau s J eLsNU PA rys EACAA4' I5�, VC �8s9>w in OA,416'QEr County. 1 furthermore certify that l 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: -941� � -" / /' Z��4� signature v 3AS-tA QLA.Iy Print or Type Name Title Date This certification is valid through CERTIFIED MAIL • RETURN R CEIPTRk Wr" r-L` DMSiON OF COASTAL MANAGEMENT - - ADJACENT -RIPARIAN PROPERTY OWNER -NE wicATIONMAIVER-FORM " Name of Property Owner: fo� S Q .a_, i .— � S yr rV C ,�$� 5� Address of Property: 5_Ld ..a teg fir ;Lot or Street *, Street or Road: City & „ounty) Agents Narne Mailing Address: Agents pnorne # S ,. w + n rm r+ t *� h P " 2f fCGd rrnl:em T'1e '%dli,.du•al c'i C;i f?ii/ :f'3t ✓++i- CP .f 3djac@( t.;8 aG: 3CG!!�'.rlg `Cr `i?iS perry " aS de -scribed bed `0 me 3S shown - are Te 3t.a&ed drawer! :he ievel0 Meflt are !,rx)-,Smg. b i :. ,e , ectiens . ueosa,. 20 if you have objections to -what is being proposed, you must Civision of Coastal +Waragement -DC14! in °ar.ting within 10 days of receipt of this Hance. Cor.,Wndence should be mailed to 400 :emmerceAve., Morei•.ead City, :tic:. 2855'. D'CM representative -analsobe coriactedati13Z1308- 2303.:Vo yes onse is ccnsidered the same as no ob'ection if 'oc�ave beer notified b, Certified idaii. WAIVER SECTION e �,ata; ca: r.:Sa .! ' _ ; : _S, �-a' a 'e" _• K. •"cod ;r� y5 i atCr - - ;a CA --: - a -ea .�_u must initial' a a^ -3 do not ,v;s' Property Owner information) .):Cyr. y�Y7 Jr(dot .�04•ai 4,4f fSL6, AA- Md'acert Proper^y Owner . �r atiun) r �rJQ, ✓ /r "f �, � �3 r✓ 3 3 DIVISION OF COASTAL MANAGEMENT ADJACENT-RIi'AR1AN PROPERTY.OWNER-M@TIHCAT14NwAtVER FORM Name of Property Owner.. rJ-p 4V Lam.► Address of Property: .i/_o�O J Wig _. Sx3s9 (Lot or Street #, Meet or Road. City a Uuui I►y) J Agents Name#: -K& 5%} oSoy. Mailing Address: �� `"�—�'001° kt.A . A4, Z Agents phone # ZS'L- ZbJ— TY4f I hereby certify that I own property adjacent to the above referenced property. The individual applying for this permit has described tome as shown on the attached drawingthe develo ment they are proposing. I have no objections to this proposal. l have objections to this proposal. If you ha ve.objections to what is being proposed, you must notifythe Division of Coastal Management (DCM) In wrfting wtthfn 10 days of recelpt of this notico, Correspondence should be mailed to 400 Commer-ce Ave,, Morehead City, NC, 28557. DC.M representative: can also be contacted at (252) 808- 2808. No resoonse is considered the same as no objection If youbaye been notified bX Certified Mall. WAIVERSECTION I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set back a minimum distance of 15' from my area of riparian aces unless waived by me. (It You wish to waive the setback, you must fnitiai the appropriate bank below.) I do wish to waive the 15.1 setback_'equiremeat. I do not wish to waive the 15, setback requirement. (Pro erty Owner information) Si tine n Print or Type Name 5 ou,1ro .VR t 06 Mailing Address FM 60 N _NC, of 8 9f� City/State/Zip �eelephonee Number Date (Adjacent Property Owner information) Signatwe Print or Type Name 4-0 Mailing Address City/Sia Zip Tefspnone Pf umber Date pevised 6/18/201 o u �� vy sJ r� I 's N 0 -- -- 7,-- - - -, :;:)