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Home My WebLink AboutHall, James Shelton 91110CCOATTq/!/,yc❑CAMA ❑ DREDGE & FILL Na 91110 A B C D GENERAL PERMIT Previous permit y 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 Authorized Agent Address Project Location (County): City State ZIP Street Address/State Road/Lot #(s) Phone # (_ ) Email Affected ❑ CW AEC(s): ❑ OEA ORW: yes/no ❑EW ❑PTA ❑ IHA ❑ UW 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 `m j Moratorium: n/a yes no Site Photos: yes no ?._...-- ......................€....... Riparian Waiver Attached: yes no A building permit/zoning permit may be required by: ` ❑ TAR/PAM/NEUSE/BUFFER (circle one) Permit Conditions ❑ See note on back regarding River Basin rules ❑ See additional notes/conditions on back ❑ ES ❑ PTS ❑ SPIMA ❑ PWS Subdivision City ZIP Adj. Wtr. Body (nat/man/unk) Closest Maj. Wtr. Body 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 �F`°"Sr4 ❑CAMA ❑ DREDGE & FILL N9 91110 A B C D �o 11 = GENERAL PERMIT Previous permit 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 Authorized Agent Project Location (County): Street Address/State Road/Lot #(s) Subdivision City 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 i Shoreline Length Access Length Pier (dock) length Fixed Platform(s) 1 Floating Platform(s) i Finger pier(s) Total Platform area i Groin length/# ) Bulkhead/ Riprap length Avg distance offshore Breakwater/Sill Max distance/ length Basin, channel Cubic yards Boat ramp Boathouse/ Boatlift 1 Beach Bulldozing Other SAV observed: yes no � Moratorium: n/a yes no Site Photos: yes no 1 Riparian Waiver Attached: yes no „, i , L ) A building permit/zoning permit may be required by: Permit Conditions (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" Signature Application Fee(s) Check #/Money Order Issuing Date Expiration Date 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. v�`e5 54a�>J + �" v�, Address of Property: ASS Y"11-L- l,"-Olocl -PDL F-D Mailing Address of Owner: 5At'YV?e Owner's email: 6c0bAr5l0keL-T00 &�MArtt. • t.,cw% Agent's Name A `Q d 1�41L-Ly Owner's Phone# 252 —�ro1-8144 Agent Phone#: Agent's Email: 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) 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 Adjacen iparian Property Owner -O 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: 1 Mailing Address of ARPO: Li 7 ARPO's email: Y'°xGGiVZ14 •Gpch ARPO's Phone#: �S� gc7$' 7 �Z Date: Z0Z2?>FD7 _-waiver is valid for up to one year from ARPO's Signature' Revised May 2021 HO N.C. DIVISION OF COASTAL MANAGEMENT . ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION WAIVER FORM CERTIFIEQ NpAiL. - RETURN RECEIPT #R,ER_t1FSTEa_ ,or HAND DEL VE Y (Tap portion to be completed by ovvner or their agent)- operOvr: w�+ene at ' Address of Property; ' v (Vk I t: 4 y✓ ° ; t �- Flailing Address of Owner; 1t i i Owners email: , I , Agent's Name: i4 �s Agent Phone#: Agent's Email: ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION (Bottom Portion to be completed by the Adjacent Property Owner} ' I hereby certify that l 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 totter. -' 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 90 days of receipt of this notice. Correspondence should be matted to 400 Cornmerce 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 <n. �A Signature of -Adjacent Riparian Property Owner -OR- do not wish to waive the 15' setback requirement (initial the blank) Signature of Adjacent Riparian Property Owner: yped/Printed name of ARPO: Malting Address of ARPO: t.'t ILL IL sC i e1 i-r,c k1c�� 1a lrcYc�r,�c i I ccrv. C- • q I� 13-1, T ARPO's emall: ARPO's Phone#: N ; tic Lr2-} 21�2G_ Z3 *waiver Is valid for up to one year from ARPO's Signature* �, Revised May 2021 LAPT- 1-ALAM cq=: n.. PIA MON" low 04 J j. dPo IvWle - T- Al 4b a.. LL �4 Oki T4 CA H -�7