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Home My WebLink AboutMooring, Martha 88576C,��F`°"S'",& ❑CAMA ❑ DREDGE & FILL 9 88576 A B C D 0 z 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.gov/CAMArules Applicant Name Address City State Phone # ( ) Email Authorized Agent Project Location (County): ZIP 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/nb 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 s Max distance/ length , — -- Basin, channel Cubic yards Boat ramp Boathouse/ Boatlift Beach Bulldozing { �. Other SAV observed: no es Y � Moratorium: n/a yes no N Site Photos: yes no ---- Riparian Waiver Attached: yes no / A building permit/zoning permit may be required by. 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" Signature Application Fee(s) Check #/Money Order Issuing Date Expiration Date N 1*°jCOA 41&FICAMA ElDREDGE & FILL N9 88576 A B C D y = GPrevious permit GENERAL 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.gov/CAMArules Applicant Name _ Address City Phone # ( ) Email State ZIP Authorized Agent Project Location (County): Street Address/State Road/Lot #(s) Subdivision City P Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body (nat/man/unk) AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Mal. Wtr. Body ORW: yes/no PNA: yes/no Type of Project/ Activity 3', !( f (Scale:.(-_...;jt Shoreline Length Access Length --- �— i 1 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 required by: 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" Application Fee(s) Check #/Money Order Signature ` Issuing Date Expiration Date AGENT AUTHORIZATION FOR LAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: �.0 0 /� l Mailing Address: `iC�1 50 tj C— le- C , r Phone Number:" t Email Address: I certify that I have authorized ►� tiJ �=�, `� Agent. Contr r to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: f V LK l ff Sac at my property located at e Ptq,-V g: 0 tJ C r in �i- r� 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 Owner Information: l Signature M 0 Print of ype Name Title This certification is valid through AJO cis c,k DECEIVED JUL 2 9 2022 DCM-MHD CITY property located at tz etc.) / (Address, Lot Bloc, aad,— N.C. . on ir'(GRYf1owa andtor County) (1Materbodyj The applicant ha s described to me, as shown below, the development proposed at the above location- have no objection to this proposal. _ l have obi�cttoCts_ o�-prop-Q — ---- __— DESCRIPTION AND/OR DRAWNG OF PROPOSED DEVELOPMENT aattach s development meat must flI1 in description i�e(aI' o� ai#aeh site c�rawingj tlndivrdua( proposrng . P 05V 0 k) . VXY L _ WAiV:R SECTI-ON _ or groin must be sat breaft�yater, Lroathouse, tft, me. (If you -- - i urdarstand 'that a pier, dock, mooring Pilings, ara of riparian a�xess unless waived by back a minimucr; distance of 15` from rnY ro daie bla*bS1o.` _) wis: to �raive tha setbacK, You must initial th� aPP P _ l do wish to waive the 1 5` setback requirement. 1 do not ,Msh ;o IN the i 5' setback requirement_ anon 'Property owner Informat ten, (Adjacent Property Owner Irif ) ?rrnc or Type ar11e rinf or Tx e me P' - - i' jW 7g a ir1ddre s a; '"Cf�StateT/ip City /Staie�L // � `- j Zpharre Number Telepttcne Nrrmber 7D are 1� Dr, ate 12) FCFIVIFF"[t JUL 2 9 M/ DCM-MHD CITY property located at �' ' (Address, Lot 131oc 1Road, etc.) N.C- _ in on (CityiYown and/or County) (Materbody) The applicant has described to me, as shown below, the development proposed at the above {ocat _ I have no objection to. this proposal. _ I have obLectio i-1o�s-P�QRasaL— ------ -- -- DESCRIPTION AND/OR DRAWING OF PROPOSED ow f DEVELttach OPMENT �e drawing/ (lndni/dual proposing development trust fill /n description be/ o o5 J1-- �00V r ow, f� VyIANF-R SECTIONboathouse, , ^o� rain must be set --- I understand that a pier, .dock, mooringllpiiiarea ofbreakwater p aanraaess unless �waived by me_ (If you back a minimum distance of 15 fromy riate blank below.} wish to waive the setback, you must initial the appro p I do wish to waive the 15, setback requirement. I do not wish to waive the 15' setback requirernent_ (Property owner Inforrnatig-n) P� SG�YtLZL(.G! �A Print or Type Wme ` (' 1W ling Add re s ) Ci /State/z fill i 0 f� To epnone Number l' Date .V. x (A 'cent PTopeft1 uwner Si 11C Print or Typ;AeS me q, /crn ivi 'ling Address g �s 7 6 rr C' Stat ' � look" 5` Telex f mbef y Z g p Z (Revised 6/18/1k012) 40 2, 9 ?w t;-04l40 N D,