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Home My WebLink AboutGiles, Schuyler 84452C'1*OFCOAST41 m❑CAMA ❑ DREDGE & FILL NO. 84452 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: SA NCAC ❑ Rules attached. ❑ General Permit Rules available at the following link: www.decnc.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 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 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 ' gar F t l ✓ A , ' (! if AN Signature "Please read compliance statement on back of permit" Signature Application Fee(s) Check #/Money Order Issuing Date Expiration Date 1* &- ❑ CAMA El DREDGE & FILL NO 84452 A B C D y 2 G E N E RAL 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 Phone # ( ) Email State 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 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 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 AGENT AUTHORIZATION POR CAMA PERMIT APPLICATION dame 01 Property Owner Requesting Permit: Z Mailing Address: Phone Number: Email Address: -5- certify that I have authorized /'V Agent I Contractor to act on my behalf, for the Purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: at my property located at — - " , '- ev 16�) - in County. / furthermore certify that / 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: Signaftlr6- Print or -type Name Title JL Date This certification is valid through x CERTIFIED MAIL •RETURN RECEIPT RE Uts t to -- - _ _t_ DIVISION OF COASTAL MANAGEMENT ADJACENT -RIPARIAN PROPERTY OWNER-NoTIFHCATIONMAIVER-FORM - - Name of Property owner: / rr Address of Property: (Lot or Street 0 Street or Road, City & ounty) prlv Agents Name #: Cl r,� G /1i e�' -f �/Mailing Address: Agents phone #: �`°;� st ��- ; Z I hereby certify that I own property adjacent to the above referenced property. The individu-al applying for this permit has described to me as shown on the attached drawing the development they are proposing. - I bane no objections to this proposal. I have objections to this proposal. If you have —objections to what is being proposed, you must notifythe Divislon of Coastal Management PC* in writing within 10 days of receipt of this notice. Correspondence should be mailed to 400 Commerce Ave, Morehead Cfty NC 28557. DC*M representatives can also be contacted at(252) 808- 2808. No response is considered the same as no obfectlon if youhave been noted by Centffied Mail. WAIVER SECTION understand that a pier, dock, mooring pilings, breakwater; bcathouse, lift, or groin must be set back a minimum distance of 1 05' from my area of riparian access unless waived by me. (if you wish to waive the setback, you must initial the appropriate blank below.) I do wish to waive the 1 05' setback requiramer;. do not wish to waive the 15' setback requirement. Pr perty O'er In rm ti (Adja t) rty Owner Information) 3- jgnatuJ-e Sig, Vie ' Print or T e Name Mailing Address ) -,'Azi f'� City/ ate�?ip Telephone Number z Data Print orype Na e Mailing Address CV/State/Lip ('2— Telephone iNiumber Date Ievised 3/11" C 12 CER. 7'1FiED MAIL RETURN RECEEPT REC2utzs t t=u DIVISION OF COASTAL MANAGEMENT ADJACENT-RlPA- RtAN PROPERTY OWNER -OWNER- FORM Dame of Property owner: ��• �'' � .r S & ; J t -S Address of Property_ 'Z, '� e rc-x J L � � I f c�i a +� (Lot or Street #, Street or Road, City & County 1 Agents r_ — g Name #:L , ;'�"� 6l Mailing Address: Agent's hone #: 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. �f -- I have no objections to this proposal. i Dave objections to this proposal.. If you ha ve.objections to what is being proposed, you must not0the Division of Goal-W (management MCM) in writing wtthin 10 days of receipt of this notice. Correspondence should be mailed to 400 Commerce Ave, Morehead City, KC, 28557, DCM represerrtatfves can also be contacted at (252) 805- 2808. No response is considered the same as no objection ifyouhave been notifred by GertifledWall. WAIVER SECTION 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 access unless waived by me. (It you wish to waive the setback, you must ihitiai the appropriate Mark below.) I do wish to waive the 13` setback sequiremeK I do not wish to waive the 15` setback requirement. (Proper Omer Informatio y� (Adjacent Property Owner information) Siena e U — Sigratzue Print or Tyye Name Mailing Address City/state/Zip Telephone Number Date 4. 9 c'S C Print or Type Name Mailing Address Ceti/State0p . 4 7 - 931 Tefepnone ►%lumber Dart re+used 0/1 S%2012 -5Aq\e\ C-,� C, cc AJC,. L-16,