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Home My WebLink AboutCannon, Roma 88738C❑CAMA ❑ DREDGE & FILL 3 = GENERAL PERMIT ❑ New []Modification Z Complete Reissue ❑ Partial Reissue N9 88738 Previous permit Date previous permit issued A B C D 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 z�{,,�� ❑ Rules attached. ❑ General Permit Rules available at the following link: www.deq.nc.gov/CAMArules Applicant Name (4A 1() Authorized Agent Address Project Location (County): - I City State ZIP . tl Street Address/State Road/Lot #(s) Phone#O - Email i' Subdivision City ZIP Affected R CW \❑- EW ❑ PTA ❑ ES ❑ pTS Adj. Wtr. Body i ` - r(njt/man/unk) AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body ORW: yes/no % PNA'.yes/no Type of Project Activity YP 1 / Y f I . Ir (Scale. Shorelinelenvrh � /✓�� 1 . �_ Access Length Pier (dock) length I I. t -!-` f t, - fM Fixed Platform(s) r Floatin Platform(s) Finger piers) Total Platform area)"1 _.�I -- Groin length/ft Bulkhead/Riprap length Avg distance offshore '�_ -- Breakwater/Sill -r- Max distance/ length i — — i— �- Cubicchannel Y I I I 1 ` Boat ram p I Boathouse/ Boatlift - — _� I Beach Bulldozing j e Other -i- - I j T -, SAV observed: yes no -- - - Moratorium: n/a yes noSite 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. i Agent plic t PRI N Permit Officer's PRINTED Name (Please Initial) Signature**Pleaser Ilancestatementon back of permit** Signature 't ( f iT r Application Feels) Check #/Money Order Issuing Date Expiration Date &6011d1Ae&ZCAMA ❑ DREDGE & FILL N9 88738 A B C D GENERAL PERMIT Previous permit 3 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.deg.nc.gov/CAMArules Applicant Name If /,' )) City Phone # (_ ) State Authorized Agent Project Location (County): Street Address/State Road/Lot #(s) Subdivision - City Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Ad!. Wtr. Body (nattman/unk) AEC(s): ❑OEA ❑IHA ❑UW ❑SPIMA ❑PWS Closest Maj. Wtr. Body ORW: yes/no PNA,yes/no Type of Project/ Activity (Scale: C4,nrelinn 1 nnm,F Access Length Pier(dock)length Fixed Platform(s) . _' I ! , Floating Plafform(s) Finger piers) Total Platform area Groin length/q Bulkhead/ Riprap length— Avgdistanceoffshore Breakwater/Sill Max distance/length Basin, channel Cubic yards Boa[ ramp Boathouse/ Boatlift Beach Bulldozing_ Other — __I I — I 1 -- —_i. � 1 — — SAV observed: yes no Moratorium: n/a yes no Site Photos: yes no yes Riparian Waiver Attached: no J ---' - 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) :"I Agent A plic qt PRIN2B N fiie Permit Officer's PRINTED Name Signature""Please read coMplUn�tementon back of permit" Signate / I I I I': n� ! Application Feels) 'Check M/Money Order issuing Expiration Date ...'�k 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. k 4xV1 0 Address of Property: air)e-lal) T516, Ak d8q)y Mailing Address of Owner: p305 (AruA� Ov Eniefiimtl __];Ie xc- dbrj`)`'% Owner's email: �AwN�•ti }wt 71 t� rjtM •-60ner's 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. 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. 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 somelall of the 15' setback Signature of Adjacent Riparian Prop y Owner -OR- I do not wish to waive the 15' setback requirement (initial the blank) Signature of Adjacent Riparian Property Owner: I Typed/Printed name of ARPO: 1 AA 11JE.. `1A/�'L Mailing Address of ARPO: 1 t fy4 (.Nef S l ICY Q IZ • r Nit I A C S�r 1 C Sri ARPO's small: ARPO's Phone#: )S) - So �' GI 16 Date: 10-(23 - e a `waiver is valid for up to one year from ARPO's Signature' RECRNED OCT 14 2022 Revised July 2021 DCM-MHD CITY 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: 1" J Address of Property: 71 I. r 1f Ch t, u Mailing Address of Owner: _q31,3 (i,uA l W i✓itei(�i l rl Tsle d br7`W Owner's email: l ANmW .„ 65c 711 P501!0 6%ner's Phone#: Agent's Name: Agent's Email: Agent 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. 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. 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' setback Signature of Adjacent Riparian Property Owner -0 R- I do not wish to waive the 15' setback requirement (initial the blank) Signature of Adjacent Riparian Property Owner: Typed/Printed name of ARPO: Yt' l//i��C hih f I l �,(C�f f[� 1�^1 Mailing Address ofARPO: ")ticl I lckefS ccce� 6L rmt(AI� -.,) IQi` A-59" ARPO's email: ARPO's Phone#: Date: ll ( *waiver is valid for up to one year from ARPO's Signature* RECEIVED OCT 13 2022 Revised July 2021 DCM-MHD CITY � R6�zzz 5 . , , | JI�] $ g, k � � \ lm,, 2 # e a01, J .6 . HEX Rfflg ] Q ; ARCHERS CRCK.,, _ COTTAGE40C a` \ WN PLAN R HOME RNC 28594 CREEK OR 919-795-9594