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Home My WebLink AboutFulcher, Timothy - 88972Ck�[]CAMA [IDREDGE & FILL N9 88972 A B C D GENERAL PERMIT Previous permit 41 Date previous permit issued QNew ❑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 I � I - i >J_ i ❑Rules attached. General Permit Rules available at the following link: www.dea.nc eov/CAMArules Applicant Name v V) i t 1.C Authorized Agent -f-_V I C VC[ LC Address Project Location (County): i rs Y i-C City State °. I < ZIP Street Address/State Road/Lot #(s) Phone # Email City ZIP t Affected ❑ CW ❑ E W ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body (nat/man/unk) AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body I, �' Y C (,�. : �. ORW:'yes/no PNA: yes/no Type of Project/ Activity I (scaler., lk- ) Access Length - - - -_I--- - Pier (dock)length .% _r - I I Fixed Platform(s) :' I I I -- Floating Platform(s) (a Finger piers) Total Platform area _ Groin length/# TI Bulkhead/ Riprap length I ---- ----�- -- --� -� Avg distance offshore t--- - - -� --- - L I - Breakwater/Sill - �- / Max distance/length- Basin, channel 4- Cubic yards Boatramp Boathouse/Boatlift Beach Bulldozing I --- - Other ^- ` 3 SAV observed: yes no - I - 1 -- - -i- - -� -S - - -- - Moratorium: n/a yes no _ --- Site Photos: yes no Riparian Waiver Attached: ,yes no -A CW11"., i._.1_. __ F• C I C '! A building permit/zoning permit may be required by: Permit Conditions hCll� d7t VIl[R!�❑TAR/PAM/NEUSE/BUFFER(circleone) �:.1 ,. ':` �. ! r� 1- ❑ 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 Aliplication Feels) Check#/Money Order Issuing Date Expiration Date &"Our" DLAMA ❑ DREDGE & FILL ND 88972 A B (C D Previous permit GENERAL 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: I SA NCAC ' i- r i I > ( f ❑ Rules attached. 0 General Permit Rules available at the following link: www.deq.nc.gov/CAMArules Applicant Name Address City State P�-`� C ZIP Phone # (_ ) Authorized Agent Project Location (County): Street Address/State Road/Lot #(s) City Affected ❑ CW HEW 0 PTA ❑ ES ❑ PTS Adj. Wtr. Body i (nat(man/unk) AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PINS Closest Maj. Wen Body ORW:Tyes/no PNA: yes/06) Type of Project/ Activity i „r ; a cj (Scale:.' 1 Access Length (dock) length I■■Pier ® ..C.� ■ .0 .� ■■■ ■ ON IN 00 as ME IN on '.C■:■� :m:m Total Platform area Bulkhead/ Rprap length Avg distance offshore Max distance/ length Basin, channel o .. Boathouse/ Boatlift■ Beach Bulldozing�r g ■ ■H ® ■■��■■aiiM■■■■�■■■� ■ ■■ I■■■■■■ ■ �■ ■i1 � ■N■■■� ■ ■■ ■■■ �■■� INN® ■■■■■■■■■■■■ I■r■■■■■■■■■ A building permit/zoning permit may be required by: TAR/PAM/NEUSE/BUFFER (circle one) Permit Conditions 1 (�!1 � I Ij '' /. [" i !� ❑ 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 Feels) Check #/Money Order Signature Issuing Date Expiration Date I F�pgD� 0 1A r RECEIVED 2 20D 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 portiontobe completed by owner `orr their agent) /I Name of Property Owner: / / ram' " �nTN `� [�((/ 4 c /V G� / '- Address of Property: or .J /C. i% S % 1`yT1r/. 4a*u N� / I n i i oee.KF, Mailing Address of Owner: 01 U (/ ) (/I a) 1V 171 U12 tC'4/ j6/1/Ov,/ynv Owner's email:' 1 Muni e61W'Owtner s Phone#: f,L � !✓ ds Z 1 a �y Agent's Name: 04ZI C J &t<6 - AgentPhonet. c/qS-A'll79'd Agent's Email: Dl ar- 121 IJ a&- t- @ ///��L I el"Q 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 wnat is being proposes, you musr noury me mi'. urwsrun ur i uasral 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 Signs 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: Typed/Printed name of ARPO: ) .Y]/l I c: " Yrn IovVe/' AIL-- Mailing Address of ARPO: �b �� &��Z1 GJi/r // B � ILL ARPO's email: Yllutio 2,52(evFL. ._Gqn ARPO's Phone#: 2.52— r7?S.rN 3Q' s_ Date: .5 fz - 2*waiver is valid for up to one year from ARPO's Signature* ,nV 12 2023 DCM-MHD CITY Name of Property Owner Requesting Permit: / ^t Mailing Address: Phone Number: Email Address: I certify that I have authorized (h j 5�_)-� , n} 1 c �-I 1 / Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: %fca'CL at my property located at ids, s% / in Cc Le-) County. I 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: Signature Print or Type Name Cl��nt" Title Date RECEIVED r"cv 12 2023 I1 I : I ,I This certification is valid through DCM-MHD CITY A�Nceuzu Name o/ Prepelly OwnO( ltoquoeana Parmll: �- Mn111n1, Addrusa: / r _ 111 N.C. InVIS10N OF COASTAL MANAGEMENT Anr liGEt i %D IIr1All tAN.IROPERty I'l1NN 13feG ll'TNER t3GSly -.T` •097 �NPNAIVER FOR �t��) = }'LVLRY ( lot) nortlon to be completed by owner or [half agent) ,. CNG= Namr or PNPwIy Ownar: Address of Prvpurty - N - AX,4, r�PsS Moiling Address Or Owner OwneYs t crnail:l_'tA�!�DlilY ptrfl'l/!' t / PiGnfiu' -ft no's Phone#: Agent's Narite: _� _� 'ft Cf _J"� Agent Phonch. Agent's Email: ��/11-r ✓�I �'.UJ�L<r — �_�.1L1�Y'i LQ�-`-' ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION (Bottom portion to be completed by the Adlaconl Proeenv Ow Adlaconl Proaenv 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 descri ti or drawin h dimensions must be provided with this letter. 1 DO NOT have objections to this proposal. I Do have objections to this proposal. It you nave obecuons to wrier is netng proposed, you must noury me N.U. u/vlslon or Uoascar 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 Celi fled 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 siOn the appropriate blank below.) I DO wish to waive om /all of the 15' setback -OR- Signature of Adjacent Riparian Property Owne UT do not wish to waive the 15'setback requirement (initial the blank) Signature of Adjacent Riparian Property Owner: TypedjPrinted name of ARPO: failing Address of tP0's email: 9: 11-,31 'waiver is valid for up to one year from ARPO's Signature* RECEIVED MAY 12 2023 DCM-MHD CITY NC a7loo'.. Revised May 2021