HomeMy WebLinkAboutPruden, William 88658C®kattnAsr, LAMA El DREDGE & FILL
I A B D
PERMIT M I T Previous permit
R GENERAL
Date previous permit issued
ffi)�qew ❑ Modification [:]Complete Reissue [] Partial Reissue
As authorized by the State of o .1 Car lin ent of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
1 SA NCAC _ .... _ ❑Rules attached. eneral Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Authorized Agent
Project Location (Courfty):
Street Address/State Road/Lot #(s)
Affected L.__� CW tAl PTA ❑ ES ❑ PTS Adi. Wtr. Body la (n an ik)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body Via: --th
ORW: ye PNA: yes t�
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, channel
Cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing "
Other
SAV observed: yes atko'
Moratorium: n/a yes
Site Photos:
Riparian Waiver Attached: yes
Ji
A building permit/zoning permit may be required b L7
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 S'[ATYTERC RULES AND CONDITIONS THAT �APPLY TO THIS PROJECT AND REVIEWED CQ PLIANSE STATEMENT. (Pleas Initial)
Agent or(AppIiNnf PRINTED N 1 Permit Officer's PRINT
Sig tore "Pleasead con is ce re'IK ent on back of permit** � S" i a re � �
Application Fee(s) Check it/Money Order ISSLIfngJate Expira on t7 e
I�
p�OFCUAST41 CAMA ElDREDGE & FILL iV O 88658 A B c) D
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J. = GENERAL PERMIT Previous permit
Date previous permit issued
New ❑ Modification [—]Complete Reissue ❑ Partial Reissue
As authorized by the State of No th Carf lin ent of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
15A NCAC t t '� ❑ Rules attached. eneral Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Authorized Agent
Project Location (County):
Street Address/State Road/Lot #(s)
Affected ❑ CW W PTA ❑ ES ❑ PTS Adj. Wtr. Body (n an/ k)
AEC(s): ❑ OEA ������ "````❑����'''"' IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body`s C�
ORW: yell 74� 4 4
n PNA: yes'
Type of Project/ Activity L-)_ ? "ii Ck
(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, channel
Cubic yards
Boat ramp
t
Boathouse/ Boatlift
Beach Bulldozing
Other
SAV observed: yes
y
Moratorium: n/a yes _ (�
Site Photos:
Riparian Waiver Attached: yes
A building permit/zoning permit may be required by: oil l S? l -o
Permit Conditions A ,/ I
'A�`- -�1
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
I AM AWARE OF SWATYTES; f RC RULES AND COVDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED C,QMPLIAN E STATEMENT. (Pleas Initial)
Agent or(Applica,nt PRINTED Name
Permit Officer's PRINTER N'me
Sig' ture **Pleas ad compliance statement on back of permit*
iU :f7
Application Fee(s) Check #/Money Order
Sila re
l,
Issu I fng' late Expira on Date
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N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner: ` �,�:, ►�s t�; ��, c•�.rt. 0 e= ;,cy�r�. ill_
Address of Property: 14na SL, s fic,
i
Mailing Address of Owner: r .: _, A1.ra
Owner's email: Phone#:
Agent's Name:
Agent's Email:
Agent Phone#:
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
description or drawing, with dimensions, must be provided with this letter.
VI DO NOT have objections to this proposal. I DO have objections to this proposal.
If you have objections to what is being proposed, you must notify the N.C. Division of Coastal
Management (DCM) in writing within 10 days of receipt of this notice. Correspondence should be
mailed to 400 Commerce Ave., Morehead City, NC 28557. DCM representatives can also be contacted
at (252) 808-2808. No response is considered the same as no objection if you have been notified by
Certified Mail.
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 15' from 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 sign the
appropriate blank below.)
I DO wish to waive some/all of the 15' setbac
Sign ure of � jacent Riparian Property Owddr
-OR- <<
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO: _ ,,-10r,!,J V.
Mailing Address of ARPO: L� ?,� G 'C-Oa(' Lo 'C . 9S� �
ARPO's email: C�(;Lt��i.J (h�1 ++ ARPO's Phone#: � - q���
R F i
Date: r7- r,: *waiver is valid for up to one year from ARPO's Signature*
Revised Mar 2no
e
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Jooccaspd)
fj�xry
RECEIVED
JUL 25 202?
DCM-MHD CITY
® - C.*mplete items 1, 2 and- 3
■;.Rrintyobr.name-and,; ddres� on the reverse
so that, we can return th " card to you.
® Attach this card to theack of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
� r•
A. Signature �; ��1' `
X caJ - 60 ❑ Agent
.�i� El Addressee '
B. Received by (Printed ame) C Date of Delivery
D. Is d ' ery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
ld I�
3. Service Type
❑ Priority Mail Express@
❑ Adult Signature
❑ Registered MailTM
❑ Adult Signature Restricted Delivery
❑ Restricted
Mail Restricted
❑ Certified Mail@
Delivery
9590 9402 7237 1284 2804 22
❑ Certified Mail Restricted Delivery
❑ Signature Confirmation TM
❑ Collect on Delivery
❑ Signature Confirmation
2. Ai
❑ Collect on Delivery Restricted Delivery Restricted Delivery
7021 2720 0000 7989
6248 ;trictedDelivery
PS Form 3811, July 2020 PSN 7530-02-000-9053
Domestic Return Receipt
o Complete items 1, 2, and 3.
M Print your name and address on the reverse
so that we can return the card to you.
M Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
t--
c
D. Is deliveryaddress different from
If YES, enter delivery address b
I I I I i II 3. Service Type
Signature0 Adult Signature
0 Adult Restricted Delivery
El Certified Ma
9590 9402 7237 1284 2802 17 ❑ Certified Mail Restricted Delivery
❑ Collect on Delivery
AI,, L v /Tronofor f, ,, man �o ��tion ❑ Collect on Delivery Restricted Delivery
7021 2720 0000 7989 6255 tricted Delivery
, -- W .-j
i/ ❑ Agent
71 ❑ Addressee
Date of Delivery
—��
1? ❑ Yes
XNo
❑ Priority Mail Expresso
❑ Registered Mail"
❑ Registered Mail Restricted
Delivery
❑ Signature ConfirmationTI
❑ Signature Confirmation
Restricted Delivery
Domestic Return Receipt
PS Form 3811, July 2020 PSN 7530-02-000-9053
USPS TRACKING #
I L
9590 9402 7237 1284 2804 22
United States
Postal Service
United States
Postal Service
f
First -Class Mail
Postage & Fees Paid
USPS
Permit No. G-10
Sender: Please
-print your name, address, and ZIP+4® in this box*
Cr 'I a O�F 14
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,11IId1111 1,1,,,i1111111,11,11„111111111,I,ili,III !,Ili!!pli
First -Class Mail
Postage & Fees Paid
USPS
Permit No. G-10
° Sender: Please print your name, address, and ZIP+40 in this box°
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