HomeMy WebLinkAbout87453D-CARTIER&OCAMA ElDREDGE & FILL N9 87453 A B c °
GENERAL PERMIT/�fs-fjg�'
Previous permit
3 : 17)ntP nrPvini Fc nPrmit iccl IP[I
� ❑ New ❑ Modification ❑ Complete Reissde ❑ 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.dgq.nc.Yov/CAMArules
Applicant Name
`A C' ( i r [
Authorized Agent
Address
11
V i' %!�� �h
Project Location (County):e I l i ? C n UVP r
Liu
City
X'O ( l` State �1'
ZIP
Street Address/State Road/Lot #(s)
Phone # (_)
irk i
Email r.l
�� f C i` _ i C7C r' 1
J ' j
Subdivision A ),IA
•.
r
City ZIP,
Affected ElcW
[2(EW ❑PTA
❑ ES ❑ pTS
Adj. Wtr. Body i a) j �C. I (nat>�nk)
AEC(s): ❑ OEA
❑ IHA ❑ UW
❑ SPIMA ❑ PWS
^
Closest Maj. Wtr. Body M I ( 1[ 4 1 l SU L t )d
ORW: yes/no
PNA: yes/no'
Type of Project/ Activity
Shoreline Length fi r )
Access Length (e//I X 30,
Pier (dock) length Ii'l It 1
Fixed Platform(s)
Floating Platform(s) `J 17- '
Finger pier(s) N
Total Platform area 7 Z
Groin length/#
Bulkhead/ Riprap length iJ
Avg distance offshore 01 A
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: yet, not)
Riparian Waiver Attached: I e , 1, no
A building permit/zoning permit may be required by:
Permit Conditions t_,'._ '01 L.1( f 1
c
Blip
❑ 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) %' t` i H di
Agent or Applicant PRINTED Name Permit Officers PRINTED Name
Signature **Please read compliance statement on back of permit**
SOU. UC)
Application Fee(s) Check #/Money Order
Signature
Issuing Date Expirationbate
Statement of Compliance and Consistency
This permit is subject to compliance with this application and permit conditions. Any violation of these terms may
subject the permittee to a fine or criminal or civil action; and may cause the permit to become null and void.
This permit must be on the project site and accessible to the permit officer when the project is inspected for
compliance. The applicant certifies by signing this permit that: 1) prior to undertaking any activities authorized by this
permit, the applicant will confer with appropriate local authorities to confirm that this project is consistent with the
local land use plan and all local ordinances, and 2) a written statement from the adjacent riparian property owner(s)
has been obtained, or proof of delivery of certified mail notification of the adjacent riparian property owner(s).
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certify that this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
Tar - Pamlico River Basin Buffer Rules F-1 Neuse River Basin Buffer Rules
If indicated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules
for the River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the
NC Division of Water Resources. If you have any questions, please contact the Division of Water Resources at the
Washington Regional Office (252-946-6481) or the Wilmington Regional Office (910-796-7215).
Notes/Additional Permit Conditions:
Please ensure all debris associated with the removal or construction of the permitted development is contained within the authorized
project area and disposed of in an appropriate upland location.
Division of Coastal Management Offices
Morehead City Headquarters
400 Commerce Ave Morehead City, NC 28557
252-808-2808/ 1-888-4RCOAST Fax: 252-247-3330
(Serves: Carteret, Craven — south of the Neuse River, Onslow
Counties)
Elizabeth City District
401 S. Griffin St. Ste. 300
Elizabeth City, NC 27909
252-264-3901
(Serves: Bertie, Camden, Chowan, Currituck, Dare, Gates, Hertford,
Pasquotank and Perquimans Counties)
Washington District
943 Washington Square Mall Washington, NC 27889
252-946-6481
Fax: 252-948-0478
(Serves: Beaufort, Craven — north of the Neuse River, Hyde, Pamlico,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext. Wilmington, NC 28405-3845
910-796-7215
Fax: 910-395-3964
(Serves: Brunswick, New Hanover and Pender Counties)
http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021
oI,o(° ?AeN�iCAMA ❑ DREDGE & FILL N° 87453 A B C Q
!4 Previous permit u
Date previous permit issued �)
E N E RAL PERMIT
New ❑ Modification ❑ Complete Reissue ❑ Partial Reissue
As authorized by the State of North Carolina, Department of Environmental Quality and the Coas I Resources Commission in an area of environmental concern pursuant to:
15A NCAC 0 T t k . 17nQ ❑ Rules attached. General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
ApplicantNameWa r, I r d' eAt `Authorized
Agent
Address aV— T)r. Il Project Location (County):
Ci a State C zip Z94 g0 Street Address/State Road/Lot #(s) 6 07,annetfive.
Phone # (A__11D) 7_ p — Z5-42
Email e!66mQA ec. rr: wry-) Subdivision YA
Q� ��r�
City C ZIP 28 80
Affected ❑ CW MEW [VPTA ❑ ES ❑ PTS Adj. Wtr. Body �,�►I 11�� ��/I(�QQO OCCf✓' I (nat nan nk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Mal. Wtr. Body M I Ie sciyoH
ORW: yesA0 PNA: yes)o
Type of Project/ Activity
Shoreline Length ± 0
Access Length �p1 1( 30 t
Pier (dock) length t�
Fixed Pllaat`ffoo'rm(`s')_ lS I Y 1 o
Floating Platform(s) (a X I"iS�
(Scale: K)15 )
'I-,' -BA QK.S CRAWEL -
ev-kxty-% niP 1r I�1PG�i 1 i n�
of W
N
Finger pier(s) N I ft 0
Total Platform area Z 0 • • •
Groin length/#
Bulkhead/ Riprap length N a • • • •
Avg distance offshore 1J I Ili"
Breakwater/Sill
Max distance/ length
Basin, chanNA
nel a
Cubic yards ` `� r l
Boat ramp N e)Lts� 1 e`occ� a) O�
Boathous Boatlift ' X 2'&b-) bJ
Beach Bulldozing
Other MIA.
SAV observed: yes G re �;r'y� N I `p
Moratorium: n/a yes
Site Photos: hannek Aye• QNan ret
n �/•
.
Riparian Waiver Attached: yes I no LI.0
A building permit/zoning permit maybe required byl i]
Permit Conditions_ _ bocv ina +cL6A1i yt..,t SY)a I nni- ey(ei
P� t )lIN /61-1 S.
' C ved
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
JAM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial)
`A�ent or Applicant PRINTED Name
see. aflache-i
Signature "Please read compliance statement on back of permit" Signature
Application Fee(s) Check #/Money Order Issuing
KA
Statement of Compliance and Consistency
This permit is subject to compliance with this application and permit conditions. Any violation of these terms may
subject the permittee to a fine or criminal or civil action; and may cause the permit to become null and void.
This permit must be on the project .site and accessible to the permit officer when the project is inspected for
compliance. The applicant certifies by signing this permit that: 1) prior to undertaking any activities authorized by this
permit, the applicant will confer with appropriate local authorities to confirm that this project is consistent with the
local land use plan and all local ordinances, and 2) a written statement from.the adjacent riparian property owner(s)
has been obtained, or proof of delivery of certified mail notification of the adjacent riparian property owner(s).
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certify that this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
Tar - Pamlico River Basin Buffer Rules
Neuse River Basin Buffer Rules
If indicated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules
for the River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the
NC Division of Water Resources. If you have any questions, please contact the Division of Water Resources at the
Washington Regional Office (252-946-6491) or the Wilmington Regional Office (910-796-7215).
Notes/Additional Permit Conditions:
Please ensure all debris associated with the removal or construction of the permitted development is contained within the authorized
project area and disposed of in an appropriate upland location.
Division of Coastal Management Offices
Morehead City Headquarters
400 Commerce Ave Morehead City, NC 28557 g
252-808-2808/ 1-888-4RCOAST Fax: 252-247-3330
(Serves: Carteret, Craven — south of the Neuse River, Onslow"
Counties)
Elizabeth City District
401 S. Griffin St. Ste. 300
Elizabeth City, NC 27909
252-264-3901
(Serves: Bertie, Camden, Chowan, Currituck, Dare, Gates, Hertford,
Pasquotank and Perquimans Counties)
Washington District
943 Washington Square Mall Washington, NC 27889
252-946-6481
Fax: 252-948-0478
(Serves: Beaufort, Craven — north of the Neuse River, Hyde, Pamlico,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext. Wilmington, NC 284.05-3845.
910-796-7215
Fax: 910-395-3964
(Serves: Brunswick, New Hanover and Pender Counties)
http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021
QA0CM-4'`& CAMA 7 i DREDGE & FILL N9 87451 A B C O
E N E RAL PERMIT Previous permit �J R
Date previous permit issued
New ❑ Modification ❑ Complete Reissue ❑ Partial Reissue
As authorized by the State of North Carolina, Department of Environmental Quality and the Coal Resources Commission in an area of environmental concern pursuant to:
15A NCAC OT l'[ .Q ❑ Rules attached. General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Nameu3a r/ 1 1— Cnts
Address / —/_1 vie ay- T--h—�•+
Cit) eeState Nl.. zip 2g4 g�
Phone #
Email—e-46ML eC . r-lr% CXXY-)
Authorized Agent
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision
City
P
Affected ❑ CW MEW 4PTA ❑ ES ❑ PTS Adj. Wtr. Body 59()V—� LAM' ►O J (natonk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body le OUod
ORW: yes)o PNA: yes,®
Type of Project/ Activity
1
Shoreline Length ± O
Access Length a % 5
0 1
Pier(dock)length 1
�c
Fixed Platform(s) )5' Y ) 6
Cove�cea� 1
Floating Platform(s) V % 4 S
Finger pier(s)
Total Platform area I —,I„
Groin length/#
Bulkhead/ Riprap length
Avg distance offshore _
Breakwater/Sill __w
Max distance/ length 1
Basin, channel p
Cubic yards
Boat ramp sV
YON
Beach Bulldozing N
Other
SAV observed: yes G re lJ
Moratorium: n/a yes Site Photos: & �ham6 dye/ Q1 Nanrfl
n 1
Riparian Waiver Attached: yes (no Ll_C.
A building permit/zoning permit maybe required by:
Permit Conditions A 1
• �� • • • - • . . T
11
AM AWARE OF STATUTES. CRC RULES AND
(Scale: N75 )
off. W
N
r-e bon
n [�
Pj tblIN /gl-i S.
Wo.s'�Cw ve(s)
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditio son back
PROJECT AND REVIEWED COMPLIANCE STATEMENT.
L CL V
A ent or AppI* nt PRINTED Name �y P i fficer P NTE
Signature "Please read compliance statement on back of rmit" Signature
(Please Initial)
7 /is ev/ -17
N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONMAIVER FORM
CERTIFIED MOIL RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner:
Address of Property:
J/A
/) >C01C)qt;1--
Mailing Address of Owner.Ltd A)L ZG
Owner's email: e cc. rr,(1YYi Owner's Phone#: �)�x/o - 542-
Agent'sName:,5-i5n/1 (�YCLSL-/ Agent Phone#. 91U Z66 -ZSyZ
Agent's Email: P_ 5 S Pl:- LcDe.C. re- C U'f1
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adiacent Property Owner)
I hereby certify that t 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.
ff 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 127 Cardinal Drive EXT. Wilmington, NC 28405. DCMrepresent3dves can also be contactedat
(910) 796-7215. 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.) WW
1 DO wish to waive some/all of the 15' setback ��L�e %
Signature of Ad)acent Riparian Property Owner /
-OR-
I do not wish to waive the 15' setback requirement (initial the blan
Signature of Adjacent Riparian Property Owner: �J.oc
Typed/Printed name of ARPO: i �--���
Mailing Address of ARPO: 310 33 LOlZ � In�A`f , E , Gq
ARPO's email: ►r0 ZJD t Z-/Z MO.C,, CARPO's Phone#: 4-, q=_I 39- o73,,30 33�
Date: 3 Z� '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 NOTIFICATION/WAIVER FORM
CERTIFIED MAIL " RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner
-
eror their agent)
�iA V
Name of Property Own,,'rmel z�1
fy�T nV�LC �n "' n fFr
Address of Property: I0 l�1 1%1�! JAie V t'r.lr 451 11A �`I /W
t� d
Mailing Address of Owner �� L/VC' �k �� I/1�r1G/7�✓/%/e l3P�c%I %Irk Z�
Owners email: ��PnF,.�CG! /'.C�21 owners PhoneX: Gil(] "Z 502
Agent's Name: ,�a n/1 L.��iY -S I Agent Phone: q�=�"6 "4Z
Agent's Emal: r :-lv �y' re- C
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adiacent Property Owner)
I hereby certify that 1 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 d ion or drawl with dimensions must be provided with this letter.
1 DO NOT have objections to this proposal. I DO have objections to this proposal.
..ram:.....,/ r`�stat
/f you have objecbmS to what is being proposed, you must noury urc •,... - -
Management (DCII� in writing witAin 10 days of 2s40 Xof this notice. Correspondence should be
errtatives can also be contacted at
mailed to 127 Car&na/ Drive EXT, W1111in9ton, NC Z&W5. D repres
(910) 796-7215. No response is considered the same as noo objection if you have been notified by
Certified Mail.
WAIVER SECTION
I understand that any proposed pier, dock r�nng pilings, boat ramp, breakwater, boatho
must be set back a rrbnimum distance of 15' from my area of riparian access unless waives
does not apply to bulkheads or riprap revetments)- (If you wish to waive the setback, you n
appropriate blank below-)
I DO wish to waive some/all of the 15' setback
Sig iafa a ofAdjacent Riparian Property Owner
-OR-
I do not wish to waive the 15' setback requirement
J-,2
Signature of Adjacent Riparian Property LAVr
Typed/Printed name of ARPO: Vv77I v G p kit or VVI I VNI✓l f sN N c 2gy as
Mailing Address of ARP'. .
fi 23 OG��� f �► 0 2 5
Vy10 YI s 1 C' a►� �f ARPO's Phoned.
ARPO's email: g Signature*
�2, Z -waiver is valid for up to one year from ARC' Revised May 2021
Date:
N.C. DIVISION OF COASTAL. MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONMAIVER FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner:
Address of Property: ih '' U rioA A ir1
Mailing Address of Owner: L.1,yr,, 62-14' W�)QPlt)%-k % Lit 1V6
Owner's email: li CLrr-,c1m, owner's Phone#: 1 15/0 'Z54Z
Agent's Name: 5rtA t� — Agent Phone#: � lID-Z66 -ZS'f 2-
Agent's Email; � S1W- ez l" r co
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
- (Bottom portion to be completed by the Adjacent Props 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 (DCO in writing within 10 days of receipt of this notice. Correspondence should be
mailed to 127 Cardinal Drive F.X7, Wilmington, NC 28405 DCMrepresentadves can also be contactedaf
(910) 796-7215 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.)
ck15'r7 S<uvAfiiIwo —1a��' S
1 DO wish to waive somelall of the 15' setback 1
Signature of Adjacent Riparian Property Owner
-OR-
I do not wish to waive the 15' setback requirement (initial the blank)
Typed/Printed name of ARPO: Z , llfl1 77'//,f 4f !f d Allf I & c
Mailing Address of ARPO; %�t13 % 7� `� v - ✓�
ARPSi's email: ARPO's Phone#:
Date: 12- ! �- *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 NOTiFICATION/WAIVER FORM
CERTIFIED MAIL . RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed' by owner or their agent) avyy
Name of Property Owner C! dot ve ,/� l LLt� is
Gr %3
Address of Property: a V VY -7 yyd e c
Mailing Address of Owner_ f 05 LvZ 11 k ZX J WY),h- 'g le "j, !VC lvweb
Owner's emaii: a.a fsG ACC- !'Y,= Owner's Phone#: C110 '2�-6 -25412,
Agent's Name: ,� J n (" �'PQ � i .l Agent Phone#:
Agent's Email: 2 S5fa-ED— e-z, rr•C011"
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adiacent 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.
I DO NOT have objections to this proposal. i DO haveobjections to this proposal.
If you have objections to what is being proposed, you must notify the N.C. Division of Coastal
Management (DCAI) in writing within 10 days of receipt of this notice. Correspondence should be
mailedto 127 Cardinal Drive EXT, Wilmington, NC 28405. DCMrepresentalives can also be contacted at
(910) 796 721,5 No response is considered the same as no objection if you have been notified by
Certirled 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
-OR-
I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner K p v T-
Typed/Printed name ®f ARPO:
Mailing Address of ARPO: YL_�raJ �c�ptn c_Q ��YTi..CQ r
ARPO's email: v�1e�11+�Q ARPO's Phone#: rr�y(oB�S�l9�
Date: 3 Z "waiver is valid for up to one year from ARPO's Signature*
Revised May 2021
Dom MP-1
APPLICATION for
Major -Development Permit
(last revlsed 12/27/06)
North Carolina DIVISION OF COASTAL MANAGEMENT
�=PnmaryAppl�cant/LandownerinfQrmatcon 4 � E � `' '.iY`
Business Name
Project Name (if applicable)
, / �F/v� l6-xr7s
69 ( /Ye& �� 00
Applicant 1: First Name
MI
Last Name
5 it 5 oL-
e. 2- SAS
Applicant 2: First Name
MI
Last Name
If additional applicants, please attach an additional page(s) with names listed.
Mailing Address
105 L! v- 0� Pizw
PO Box
City
f�. ��
State AA
2gy �a
ZIP
Country
Phone No.
FAX No.
2 S-` 9D
I L54
410 - 25 (o 2 5 gelr
- -
Street Address (if different from above)
City
State
ZIP
Email
5 5CR91 G �C . >ri. C6Y4
2s Agent/Contractor Intormat�on s : r � � f � ..
Business Name
�� � a/L PU a✓5 [ 2uC� ll3 N l .tJ �
Agent/ Contractor 1: First Name
MI
Last Name
V
Cam-, r. =-v—
Agent/ Contractor 2: First Name
MI
Last Name
Mailing Address
PO Box
City
State
�� J,5:A S I A TL03TA
wnz. Ock-�
{►J C—
ZIP
Phone No. 1
Phone No. 2
Z I?+
q1,0 ll� S! 7/ ext.
- - ext.
FAX No.
Contractor #
5 6
Street Address (if different from above)
City
State
ZIP
Email
<Form continues on baclo
252-808-2808 .. 1-888-4RCOAST e: wrw►wr.nccoastaimanagement.net
Form DCM MP-1 (Page 2 of 4)
APPLICATION for
Major Development Permit
3` Project Location � hg
'
x
County (can be multiple)
Street Address
State Rd. #
Aleut a ✓
(p C av 14Vc
Subdivision Name
City
State
Zip
2&-VFZ)
Wr[�Af5bI
A.C--
Phone No.
Lot No.(s) (if many, attach additional page with list)
lo % �� 7 ( exi,
,
a. In which NC river basin is the project located?
b. Name of body of water nearest to proposed project
.F.4J45 C66*VN�
c. Is the water body identified in (b) above, natural or manmade?
d. Name the closest major water body to the proposed project site.
Platural ❑Manmade ❑Unknown
T64W7R(!!_ 0 CZAIQ
e. Is proposed work within city limits or planning jurisdiction?
f. If applicable, list the planning jurisdiction or city limit the proposed
.Yes []No
work falls within.
4 Site Description;
a. Total length of shoreline on the tract (ft.)
b. Size of entire tract (sq.ft.)
Ste- p
� DD a
c. Size of individual lot(s)
d. Approximate elevation of tract above NHW (normal high water) or
NWL (normal water level)
(if many lot sizes, please attach additional page with a list)
5 ❑NHW or ❑NWL
e. Vegetation on tract
(J-) 1 W /1' 'aV DAAr- (j) n cop/vt_ AA ► S C �A-0 0
f. Man-made features and uses now on tract
�Z; a
g. Identify and describe the existing land uses adjacent to the proposed project site.
h. How does local government zone the tract?
i. Is the proposed project consistent with the applicable zoning?
(Attach zoning compliance certificate, if applicable)
Ayes ❑No ❑NA
j. Is the proposed activity part of an urban waterfront redevelopment proposal? []Yes 43Vo
k. Has a professional archaeological assessment been done for the tract? If yes, attach a copy. ❑Yes ❑No PWA
If yes, by whom?
I. Is the proposed project located in a National Registered Historic District or does it involve a ❑Yes ONo ❑NA
National Register listed or eligible property?
<Form continues on next page>
252-808-2808 va 1-888-4RCCAsST v., www.necoastaimanagement.net
Form DCM MP-1 (Page 3 of 4)
APPLICATION for
Major Development Permit
m. (i) Are there wetlands on the site? []Yes 'Alo
(ii) Are there coastal wetlands on the site? ❑Yes ZNo
(iii) If yes to either (i) or (ii) above, has a delineation been conducted? ❑Yes []No
(Attach documentation, if available)
n. Describe existing wastewater treatment facilities.
o. Describe existing drinking water supply source.
A44 tia,( ? (/t/
p. Describe existing storm water management or treatment sys/Ps.
i
5�Ac�ivr#>iesa»d�r�►pac�s� � �� � �� � _� � � ,,� � r� � � ��� � � �� ' ��� ���n ��
a. Will the project be for commercial, public, or private use? 12t V Q C C ❑Commercial ❑PublicfGovernment
private/Community
b. Give a brief description of purpose, use, and daily operations of the project when complete.
c. Describe the proposed construction methodology, types of construction equipment to be used during construction, the number of each type
of equipment and where it is to be stored. W 0 D 1,> FAA -►'VI q —P I cal- D� IZO U IUi-> rued
A-)G S 3flJzG� M 0 � �C-�D rt_c S�i`i'I N PAV,4Z-%.
d. List all development activities you propose.
1A'2 5—VJ-L L- P 1164 y p t vA- a4-zV-3 o f Fl eM t W 6 bO CK
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e. Are the proposed activities maintenance of an existing project, new work, or both?
[.4-C W& f 5-,;><r 5 i i Au 6
f. What is the approximate total disturbed land area resulting from the proposed project? 4u o A.,'❑Sq.Ft or []Acresc
g. Will the proposed project encroach on any public easement, public accessway or other area []Yes ONo ❑NA
that the public has established use of?
h. Describe location and type of existing and proposed discharges to waters of the state.
i. Will wastewater or stormwater be discharged into a wetland? ❑Yes SKo ❑NA
If yes, will this discharged water be of the same salinity as the receiving water? ❑Yes []No ❑NA
j. Is there any mitigation proposed? []Yes Mo ❑NA
If yes, attach a mitigation proposal.
<Form continues on back>
252-8e8-2808 .. 1-888-4RC®AST :o www.necoaetalmanagemernt.enet
Form DCM MP-1 (Page 4 of 4)
APPLICATION for
Major Development Permit
fn adtlit�on to this comptefed apptrcatran"form, (Mt?j 1) the following items below, rfapplrcable, must be subrri�tted rn order for #lie�app/rcation
package to:be complete tte»s (a) (� are always"applicable co ally major development application Please=consulthe apptrcatron M
mstrucGonbook/et ort,how to; properly prepare the required items be%wt„ t� � �� ,�e � L � � ` � ��
t ,.. ``47. .,. C1 •° ..>u t4'r�a x*.."," ;,. �_ „¢. :,v> >....: .,;¢ o ... ...;.e x..,.. .a''F, .. a,z�z. �, 4, 'Sz ,'�, ?
a. A project narrative.
b. An accurate, dated work plat (including plan view and cross -sectional drawings) drawn to scale. Please give the present status of the
proposed project. Is any portion already complete? If previously authorized work, clearly indicate on maps, plats, drawings to distinguish
between work completed and proposed.
c. A site or location map that is sufficiently detailed to guide agency personnel unfamiliar with the area to the site.
d. A copy of the deed (with state application only) or other instrument under which the applicant claims title to the affected properties.
e, The appropriate application fee. Check or money order made payable to DENR.
f. A list of the names and complete addresses of the adjacent waterfront (riparian) landowners and signed return receipts as proof that such
owners have received a copy of the application and plats by certified mail. Such landowners must be advised that they have 30 days in
which to submit comments on the proposed project to the Division of Coastal Management.
Name Phone No.
Address
AddreS$a x" d rI Rs
ti
g. A list of previous state or federal permits issued for work on the project tract. Include permit numbers, permittee, and issuing dates.
h. Signed consultant or agent authorization form, if applicable.
L Wetland delineation, if necessary.
j. A signed AEC hazard notice for projects in oceanfront and inlet areas. (Must be signed by property owner)
k. A statement of compliance with the N.C. Environmental Policy Act (N.C.G.S. 113A 1-10), if necessary. If the project involves expenditure
of public funds or use of public lands, attach a statement documenting compliance with the North Carolina Environmental Policy Act.
I understand that any permit issued in response to this application will allow only the development described in the application.
The project will be subject to the conditions and restrictions contained in the permit.
I certify that I am authorized to grant, and do in fact grant permission to representatives of state and federal review agencies to
enter on the aforementioned lands in connection with evaluating information related to this permit application and follow-up
monitoring of the project.
I further certify that the information provided in this application is truthful to the best of my knowledge.
Date
Print Name
Signature
Please indicate application attachments pertaining to your proposed project.
❑DCM MP-2 Excavation and Fill Information ❑DCM MP-5 Bridges and Culverts
❑DCM MP-3 Upland Development
❑DCM MP-4 Structures Information
252-808-2808 o., 1-8E8-4RCO AST :e www.nccoastagmanagement.net
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