HomeMy WebLinkAbout88662C - Toth, Jameso LN CAMA ❑ DREDGE & FILL N9 88662 A B C D
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GENERAL PERMIT Previous permit
J 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
(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 no
Moratorium: n/a yes no
Site Photos: yes no
Riparian Waiver Attached: yes no 1
A building permit/zoning permit may be required by:
y ❑ TAR/PAM/NEUSE/BUFFER (circle one)
Permit Conditions
C: ❑ 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" I w w _ Signature
Application Fee(s) Check #/Money Order Issuing Date
Expiration Date
q``OAST"`c❑CAMA ❑ DREDGE & FILL N9 88662 A B ,c.
y Previous 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:
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
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 requirea Dy:
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" Signature
.'
Application Feels) Check #/Money Order Issuing Date
Expiration Date
Name of Property Owner Requesting Permit: ` 01"rs and ALb-SSA ZOIL
Mailing Address: !/ 3 "d- gvwj . pove Anvil narr s Nc ZK / I
Phone Number:
Email Address: ffvtl� tj ®6Ma t / .f�Ny
I certify that I have authorized Ax d re- Webb
Agoft I Carte
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: R,MASI AL#/A *Od I" PT -
at my property located at /13 Cabe& I?rxd . t�xgggPs . tVt 2S5`��
in Carhfrel: County.
I furthernxwe certify that I am authorized to grant, and do In fact grant pemission to
Dmston of Coastal Management staff, the Local Permit olfker and their agerft to enter
on the aforementioned lands in connection with evafuaft inkmudon rimed to this
pem* appiksVion.
. .:
o��Nr:R
Tfeo
DOW
Z.?This certification is valid Uuough � ------
N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
CERTIFIED MAIL - RETURN RECEIPT REClUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner. J/ >�GGi S-s'� /a i 4
Address of Property: // FQ�/1 __ o�OJ tin 6 K� ace-
Sti
l
Mailing Address of Owner. Snri+N pt /��°✓�
Owner's email: 3-4-vA /Y69 c �.Ms, 1 • ew"Owners Phone#: 9/ % Z 7
Agent's Name: /dam Fg� Agent PhoneW ZSZ -64s " Y�T78
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
perrnit has described to me, as shown on the attached drawing, the development they are proposing. A
I 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. Ofvfsfon 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 28567. OCM representatives can also be contacted
at (252) E08-2808. No response Is considered the same as no objection #you have been nolifted by
Certified
WAIVER SECTION
I understatd that any proposed pier, dock, moork)g pikVs, boat ramp, breakwater, boathouse, Oft, 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 6prap 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' setback !
-OR-
Signal �o1fAl4acce�4POKWKProperly Owner
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner.
Typed/Printed name of ARPO: _ --I o., Arg�✓e�.1
Mailing Address of ARPO: (-�D'-� �aw,S IZ1+ .
ARPO's email: G1r &J-, Phone#: Q (I -q'— " S 22 0
Date: �S/b! 2 �.-- *waiver is valid for up to one year from ARPO's Signature'
Revised May 2021
N.C. DIVISION OF COASTAL. MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIO WAIVER FORM
CERTIFIED MAIL • RETURN RECEIPT REgUESTEQ or BAND DELIVERY
(TOP Portion tO be oompieted by owner or their agent)
Name of Property Owner: J amp& and AP brA M ne
Address of Property. _1 l 3 j2edA A. /Q'n Alt. 1�%t kiln/ 1 5 i�t; riK', u C ai�L2
Mailing Address of owner 17w ee knol1 Shoa!S "VC 2 12
owners email; , fh Mo am i . fN owners phoned: 914 �71 2NC
T
Agent's Name: —AAd-!T AVA Age Ph.0- 2 S"?.taGG -Ll i
Agent's Email• kt/ & C CIng i .EOM
I hereby certify that I own property adjaeent to the above nftenced property- The individual applying for this
perm has described to me, as shown on the al.tadmd drawing, the development they are proposing. A
629MOrl or drawino- with dhner►siorls must bft provided with ft lefter.
_ I DO NOT hm objections to this proposal. I DO have objections to this proposal_
If you have O*Kt1bm to what is bebg Proposad y� must the N.G DlWsion of Could
Atantptnrei►t (OCM) in wrttbpg widrJn i0 days of r+ec&W of U* noom Coil aWcadwKe should be
me" tb 400 Conwnerue Ave., Mbnftad Cttp, NC 28M. DCM repreesarrtaYws can Ow be contacted
at (25;4 808-2W8 No response is conskhwed the some as no objection N you haw bow notltfed by
Csr~ AfAIL
WAIVER SECTION
I understand that any proposed pier, dock. mooring plus. boat ramp, breakwater, boathouse. lit, or
groin must be set back a minimum distance of 15' hon my area of riparian access, unless waived by me
(this does not apply to bulkheads or riprap revetrnuft). (if you wish to wawa the setbadk, you mug skin
the appropriate blank below.) f f-
r
I DO wish to waive somelorof the IV setback
Acoamt Property Ow�r
-OR- fir'
5
1 do not wish to waive the )V setback rsM*ment (mitial the blank)
Signature of Adjawt Riparian Property Owner:
Typed/Pdnted name of ARPO• r I st r h uJL 6 )e- hfirp w I az-
Meffing Address of ARPO: (*0'4 - Roej, /7AA021/ ,sl& ANC a& -1 z
ARPO's small: ARPO's Phonet
g%1'd;32, *walwr Is valid for up to ono your from ARPO's Sigratw
Revised May 2021
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W3 OLD AITM ROM
NEW NMI, NC 28562
252-665-018
TOTH RESIDENCE
113 CEDAR ROAD, PINE KNOLL SHORES
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SITE PLANS
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