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Home My WebLink About86990A_Lassiter, Christina_20221222oA`°"r4kN❑CAMA El DREDGE & FILL N° 86990 A' B C D GENERAL PERMIT Previous permit ► i 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 " <t ' ❑ Rules attached. L: ] General Permit Rules available at the following link: www.dec nc.zov/CAMArules Applicant Name _ Address City Phone # ( ) Email State ZIP I i I - Authorized Agent Project Location (County): Street Address/State Road/Lot #(s) Subdivision City ZIP Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body (na�unk) AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Mal. Wtr. Body t- ` .. r ORW: yes/no PNA: yes/no Type of Project/ Activity 'f r l c L r. > 1-4 1 (Scale: s-, ; s 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: l� 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) 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 AGENT AUTM ORiZATM FOR CAM PBUM APRXATM Name of Property Owner Rig Pennit N:4�` M US 5 I cerWy that I have authorized HV t Ic-(�) N G cQ—?q 17 _ L?a t , 4 q ado Aamt I CorvraMr RECEIVE[ to ad on my behalf, for the purpose of applying for and obtairig all CMM permits nary for the MoweV proposed deft at my property located at I LfQ S� in C- �; � ,\�\) G� County. No v 2 2 2022 DCM-EC I furthermore certify tfW I am authorized to grW34 and do in fact grant permission to Division of C omM Qhn"ement staff, the Local PWnwt Officer and Y?mr agents to enter on the ----rrrenffoned fends in cmwcibn with evakmft kfamagon related t6 this permit apron. V P** or Type Name o t•�� Two 1 /:�,o_l� RECEIVED N.C. DIVISION OF COASTAL MANAGEMENT NOV 2 2 2022 ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY D C h /I _ E (" (Top portion to be completedbyowner or their agent) Name of Property Owner �J�(\� \ �� 1.��5 AQr Address of Property: ``J� �� i �(Y11'��1 ti��C�' �CaT C n �� r17� Mailing Address of Owner \ 4Q —j \ m sc,1 LA d a -?C Owner's email: �GSSi2 r Owner's Phone#: i �j7' �� Lt C O'Y\ Agent's Name: ` 1 �( J� Agent Phone#: c�� 33�' V�3� 3 Agent's Email: (V)cy�A i Coy) 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 401 S. Griffin St., Ste. 300, Elizabeth City, NC, 27909. DCM representatives can also be contacted at (252) 264-3901_ No response is considered the same as no objection if you have been notified by Certified Mail. WAIVER SECTION 1 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 _4 Signature of Adjacent Riparian Property caner -OR- I do not wish to waive the 15' setback requirement (initial the blank) )� Signature of Adjacent Riparian Property Owner_ Typed/Printed name of ARPO: Mailing Address of ARPO: ARPO's email: ARPO's Phone#: Date: *waiver is valid for up to one year from ARPO's Signature" Revised July 2021 IECEIVED N.C. DIVISION OF COASTAL MANAGEMENT NOV 2 2 2022 ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY (Top portion to be completed by owner or their agent) DCM-EC Name of Property Owner. ��'l\( \�� t l�f�sc�� ►' h t 17q Address of Property: `�} � �� i �1 ��sL � ��(�` U �(.j f' c�6, , / Mailing Address of Owner. t IaJ17 Owner's email: 6y\_ �G�S�'� -C) Owner's Phone#: T�Q r� - 14 u VY✓ 5-� CV) 06 , Colf y\ /�� Agent's Name: '.� � Agent Phone#: -:� �' (LJ i 3 Agent's Email ��t P,_A ��x\,( \ nH l off, Y-I(YTh � - C-L ir) 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 drawina. 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 401 S. Griffin St_, Ste. 300, Elizabeth City, NC, 27909. DCM representatives can also be contacted at (252) 264-3901. 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 15from 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' setba ��7( Signature of Adjacent Riparian Property Owner -OR- I do not wish to waive the 15' setback requirement (initial the blank) 4 Signature of Adjacent Riparian Property Owner: Typed/Printed name of ARPO: Mailing Address of ARPO: ARPO's email: ARPO's Phone#: Date: -waiver is valid for up to one year from ARPO's Signature* Revised July 2021 N� ,4d�Us�rnan �' P/.o Gcn.'t Bl" C(nr s4�� L��S►�-e� (KC) s ,^"p 3o^ a b oEIVED No V 2 2 2022 DCM-EC sfi► .NOW �:1