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Home My WebLink About84476C - Dougherty, Danielo ❑CAMA ❑ DREDGE & FILL 9 8L.��76 A B C D poi COASrq! y = GAL PERMIT Previous permit GENERAL 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 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 rty Y. Permit Conditions (Scale:; 3 a ) ❑ 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 WAN, &❑ CAMA ❑ DREDGE & FILL N9 84476 A B C D y@Wk ermit GENERAL PERMIT Previous sous 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 Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS 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 Authorized Agent Project Location (County): Street Address/State Road/Lot #(s) Subdivision City Adj. Wtr. Body Closest Maj. Wtr. Body (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) Check #/Money Order Signature Issuing Date Expiration Date KC DIVISION OF QQASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM CERTIVIE:D MAIL RETURN RF-r-Cl REQUESTED ar WAtJD DELIVERY (flop portion to be Corrlpleted by owner or their agent) Name of property Owner � ) lA. 2]k(1' Q /;'I . Address of Property 4- _L1121 / Melling Address or OwnerFi.+�Prar` �Ive 2 P" a1 Owner'semai c Xk6—) .k� �i c_i1o�t �n - (S Pnoneq �b i �� (( .�-'IS i Agent's Name __— _ Agent Phone# Agents Emar ADJACENT RIPARIAN PROPERTY dwNFR'S CERTIFICATION Bottom portion to be eomoleted thr_Ad, taccnt Property Owner I hereby certify t^at I own o-ope"y adjacent to the above re', "ced property Thu, vrdual applying for this permit has dest;r%e; to me as showr* on the attached drawing the dove opn'!ent they aree proposing fA description or a!awr^a, with armensrons mu r yr ed with this letter ' CQ otiect.cns to this proposal _ _ I DO nave objections to this v000sal N you have objections to what is being proposed, you must notify the N.C. Division of Coastal Management (DCMt in uniting within fa days of receipt of this notice. Correspondence should be mail e!—, enn C r. rerrr, Ave., Morehead Citv NC 28557. DCM representatives can also be contacted of (252) 808.2808. No response is considered the same as no objection it you have aeon riuirified by Certified Mail. WAIVER SECTION i ,urde,s;a, � . 3r a,, :.'1GGsea p,vr, dock, moor r4 pilings boat ramp hreatwater boalbouse M,, cr 9rr r Mutt be se' L-i • c n.mum distance of 15' frcr, Ily area of riparian access unless waivad ey oews 90, acc Z., kneads or r,prap revetments: J you wish to waive the setback you must sign the C-0 m5•` is r d .e s •r e.ai of the 15' setbacks Sigr,arurr. >iAd ace f Ripanan Property Owner do not u s^ vw re t"e ' S setback requirement! initial the blank) 5;,ro1.•'@ �` .�.�7;;iGent F?it;ar�dr� p'UPer'.y C}Wn['r __—__ �'� `�. ''�_ ._. _._ TypodlPrinted name of ARP!) Marling Address of ARPn .r, �/tn +r/ y C,* t- 1 r n AFtPO's email: �;�, J �,1.� -' ;. (..-.�'� �`,�b'a PhoneN: I J(;%�.�._ -- Date: ,r 'waive(is valid 1:,r up to one year from ARPO's Signature' -Hevrsed May 2021 N.C. DIVISION OF COASTAL_ MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM CERTIFIED MAIL RE�f URN RECEIPT RI QUFSTE[l or F1ANf� DELIVERY (Top portion to be completed by owner or their agent) Nance of Properly Owner / Address of Property 6a� Mailing Adtlress of C�•„�r r Owners ema i jt�r�{ } V of �Nne� s Phone# Agent's tvw-- Agent Phone# Agent's Email_...___ .r ADJACENT RIPARIAN PROPERTY OWNFR'S CERTIFICATION ;Bottom portion w be_corn eted by th4 C nt Property Owner) I hereby c:e't�ly !pat I own property adjacent to the above referenced property The individual applying for this permit has deScr,oed to me, as showr on the attached drawing, the development they are proposing A descnptio d aw,n wdh d,"en tons._? us e r v.�l vvdn this tetle_r V ! DO NOT nave objections 'o tnis proposal ._ I DO have objections to this proposal Il you have objoctians to what ii 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 bo moiled to 400 Commerce Avo., Morehead City, NC 28557. DCM representatives can also be contacted at (252) 808.2808. No response is considered Cho same as no objection if you have been notified by CortiRod Mail, WAIVER SECTION dock mooring pilings, twat ramp, breakwater, boathouse, lift, or groin c • mum distance of 15 from my area of riparian access unless waived by me (this a: ; "eads or nprap revetments) (it you wish to waive the setback, you must aian the appropriat(:: oe,ow ) 100 wish to r.,, somerall of the '5 setback S,gnafuro of Adjacent Rrpanaa property Owner -OR. I do not wish :o ,v ,;ve the 'b setbaGK reauirement (initial the blank) _� C— Signature of Adjace^i r4it; fan properly Typed/Printed name of ARPO: 2F�37 Mailing Address of ARPO:i> �ARPO's email: ARPO's Phonorti: Date: l'G r'e'waiver is valid for up to one year from ARPO's Signature' Revised May 2021