The URL can be used to link to this page

Home My WebLink About86631A - Pilkins, David & CrystalState ZIP Authorized Agent Project Location (County): Street Address/State Road/Lot #(s) 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 (Scale: ) 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, channeh " x Cubic yards y ) 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 required by: Permit Conditions NI UCAMA ❑ DREDGE & FILL N9 86631 A B C D✓ Previous permit 4. GENERAL PERMIT 0 R, 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.dgq.nc.gov/CAMArules Applicant Name Address City Phone # Email ❑ TAR/PAM/NEUSE/BUFFER (circle one) ❑ See note on back regarding River Basin rules ❑ See additional notes/conditions on back *�.. 1 AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial) Agent or Applicant PRINT IY!439a� Per t cer's PRINTED Name Signature "Please read compriance statement on back of permit" Signature Application Feels) Check #/Money Order Issuing Date Expiration Date 1-I.' AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: -V-I D Fl-Kllj Mailing Address: Phone Number: Email Address: P D oc)2� / y V kA)o-tfs T s �4 , ✓� rlJ(:, 2,7q 5 a 703-709-37�-5 ) 1 X,.-JS i 6) Y'4' 00 C-'J I certify that I have authorized Tit V D3 , Agent / Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: 24e - 4-0 at my property located at 2-21 Z QC /� 2L ��, C-o so UW i1J(�, 2 7; 2 in CU/W / FUC 14 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 Signature Print or Type Name Title I I Date This certification is valid through I I N.C. DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY (Top portion to be completed by owner or their agent) Name of Property Owner. Address of Property: Mailing Address of Owner 6sli ,j L—he- W h l) - r7 Owner's email: '"T � /te9 lei Owner s Phone#: 72o 3 - 7g'f• _ ,3 - Agent's Name: aaie4l 7va;dN Agent Phone#: 95-Zr 7�)r7 - 69 7 6 Agent's Email_ 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 descriotion or drawing, with dimensions must be provided with this letter. AA I DO NOT have objections to this proposal. I DO have objections to this proposal. ff you have objections to what Is being proposed, you must notify the N.C. Division of Coastal Management (DCAG in writing within 10 days of receipt of this notice. Coffespondence should be mailed to 4011 GrifM St., Ste. XV, FJfzabeM City, NC, 27909. DCM representadves can also be contacted at (252) 264-3901. No response is considered the same as no objection If you have been notNfed by Certified Maf►. WAIVER SECTION I understand that any proposed pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin must be set back a minimum distance of 15from 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 slan the appropnate blank below.) I DO wish to waive someiall of the 15' setback 0 /,A- -OR - Signature of Actfatent Riparian Property Owner I do not wish to waive the 16 setback requirement (initial the blank) X Signature of Adjacent Riparian Property Owner: 5 . y Typed/Printed name of ARPO: LAwlz ._ (-,E Mailing Address of ARPO: V ¢ DQ C-r- V.joo 0 s 17*-> , s��,a�erZ�i Se s,r.4s1 ��G Z -r1+1 XARPO's emafl: fZi(-E-Siz -rY 4t- Av,,L- ,ri ARPO's Phone#: (r-s z) A--S j -_-5,v x Date: I% 9 t 17-vz-z— -waiver Is valid for up to one year from ARPO's Signature' Revised July 2021 9:26 1 sell LTE 0 Notes 10ft out 21 inches 20ft out 45 inches 30ft out 71 inches 40ft out 75 inches Left side Middle 10ft out23 inches 20 ft out 36 inches 30ft out 56 inches 40ft out 68 inches Right side 10ft out 24 inches 20ft out 38 inches 30ft out 55 inches 40 ft out 70 inches Connecting right 40 ft out 73 Left side connecting 40ft out 84 inches a— �v 7Cc+o N I 'r, p � �►,, c^s V O) �I � Oil ,rsp�i(1 I •a � � I /z�� y ` h `_%a,,A,vv"o o�-yZ �, a . st I I �VWD IPz� "al'd 0 .„ �� ``� _, 6 I � 3 A4 l � 18QUARE - a