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HomeMy WebLinkAboutHelwig, Ronald 88860C30+° °ter" ❑CAMA ❑DREDGE & FILL NU 88860 A e C D GENERAL PERMIT Previous permit Date previous permit issued ❑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.ncgov/CAMArules i Applicant Name Authorized Agent n i> (_I /'d' t �, r Address Project Location (County): City State ZIP Street Address/State Road/Lot #(s) Phone # (_ ) Email Subdivision City ZIP Affected CW F] EW E] PTA ❑ ES PTSAd' Wtr. BodY 1J -'"e, (na iK_!4nk) AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Mal. Wtr. Body- ORW: ves/nog PNA: ves/no) Type of Project/ Activity p Chit line I noarh Access Length - Pier (dock) length- FixedPlatform(s) � Floatin s g Platforml) I. I I — Finger pier(s)-OL(,lal Total Platform area Groin length/# Bulkhead/ Riprap length --- - -- -- i I - -- - Avg distance offshore - I Breakwater/Sill + Max distance/ length '— `- -' - 7 - — - - - -y-j Basin, channel Cubic yards r Boat ramp Boathouse/ Boatlift t a i t� tit Beach Bulldozing ' 0..x I i Other------ � _ _ SAV observed: yes no_4_ Moratorium: n/a yes no Site Photos: yes no 'yes _ --- --- Riparian Waiver Attached: no it ouiimng permyzoning permit may oe requirea Dy: Permit Conditions ❑ TAWPAM/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 r Agent or Applicant PRINTED Name Permit Officer's PRINTED Name /; Signature --Please read compliance statement on back of permit"• iliw Application Feels) . Check #/Money Order Signature Issuing Date Expiration Date ❑CAMA ❑ DREDGE & FILL N9 88860 A B C C 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: 1 SA NCAC ❑ Rules attached. _.❑ General Permit Rules available at the following link: wvrw.deq nc gov/CAMArules Applicant Name _ Address City Phone # (_ ) Email Authorized Agent Project Location (County): Street Address/State Road/Lot Subdivision City Affected ❑CW ❑EW .PTA ❑ES ❑PTS Adj. Wtr. Body (nat/man/unk) AEC(s): ❑OEA ❑IHA ❑UW SPIMA ❑PWS Closest Mal. Wtr. Body ORW: yes/no PNA: yes/no' Type of Project/ Activity Shoreline Length Iir-) Access Length Pier(dock)length Fixed Platform(s) ' Floating Platforms)-!(, �X 10 Finger pier(s)T' Total Platform area i Groin length/q 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 w ❑ TAR/PAM/NEUSE/BUFFER(circle one) ❑ See note on back regarding River Basin rules ❑ See additional notes/conditions on back 1 AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. Agent or Applicant PRINTED Name Permit Officer's PRINTED Name (Please Initial) Signature **Please read compliance statement on back of per it** Signature. Application Fee(s) Check p/Money Order Issuing Date Expiration Date AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Lp.. �I I Name of Property Owner Requesting Permit:j,�U1G� dy 1"`� l��a �°' S Mailing Address: ��P IJrC{,Y1y2 Phone Number: aoa• (0q6 - 5io5 Email Address: I i1011t)bgEc&- (f - WM I certify that I have authorized Man ��� N�uG Wafter /�irr NN Cortsf Agent / ContRactor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: u1, 5 P4rorP1. OFF 4/j<ACn'p at my property located at ( (4 P�CeC G1W00L� 2 T 4����Qi , in County. 1 furthermore certify that I 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: 1 Signature LA\446 0-0-64,WlU Print or Type Name OI KLk) REM70 Title v I O , zq I d0a2. NOV 0 0 2022 Date DCM-MHD CITY This certification is valid through I N.C. DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER 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: Mailing Address of Owner: S'[Il Owner's email: 1VVAWL4 l0 eC. (tM Owner's Phone#: aJ (oLKp' 5905 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 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) 515-5400. 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 rip rian access unless waived by me (this does not apply to bulkheads or riprap revetments). (If you wish waive the setback, you must sign the appropriate blank below.) I DO wish to waive some/all of the 15' ISITCa I do not wish to waive the 15' setback requirement (initial the Signature of Adjacent Riparian Property Owner: P rF-!VFD NOV 0 9 2022 Typed/Printed name of ARPO: I� J, 1- 101 )41,>_ _1 I� (� E)CM-1vIHD CITY Mailing Address of ARPO: V , B�� 9 �Q `1 f: l 0^/1 ARPO's email: Dr-(r F�2 /7i 11i60 ARPO's Phone#: �lli 'Zy�' 30&� Date: 10 liq 7, *waiver is valid for up to one year from ARPO's Signature* Revised May 2021 r-- � � za LU (� Z z —I— O z O U z Vf Z a J I cZ C 1 fK'Sk:rYj �ja\&hCQJL 1 54 balk I r A j. uc OLL LL j LL Q C C_ `< t wog W Q (gUL 4 0 l Q�ZW t- ZI 001 U}, O bi W 0. 00 y n. > Z �a UR za Z W U i ❑ a C m rn m Y 0 N 0 O Y N Q E U 0 0 0 a 0. I-0 T U) N —I LE' c ' 3 3 I O N O � a `o 4) a z w o a) d C C C Z Q 2 0 Q ¢ w O E O C' O O o O T I C O- y °. '�- L U O off e —a o O° c 0, `m a o o a o 3 O T a) In F; > C d O (p N U N a1 Z c a > w O O m a1 a u t O C p a 0 �. 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