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Home My WebLink AboutJohnson, Robert - 88976C❑CAMA ❑ DREDGE & FILL N9 88976 A 13,C D 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: wwwc1eq.nc goy/CAMArules Applicant Name Authorized Agent 'd•`• I r l 1 Address Project Location(County): 1 Giry- State ZIP-i.,(t... Street Address/State Road/Lot #(s) Phone # ( ) Email Subdivision City C211 ua-g zip Affected ❑CW ❑EW PTA ❑ES ❑PTS Adj. Wtr. Body Iy\411\`<A CV+P�P! ',/(.(nayman/unk) AEC(s): ❑OEA ❑IHA ❑UW ❑SPIMA ❑PWS Closest Maj. Wtr. Body ^��i.�"! i Y-'t V°f-1 11'.+f ORW: yes/no PNA: yes/no Type of Project/ Activity I). kfi (Scale: j I A Shoreline Length Access Length Pier (dock)length � — Fixed Platforms)-� -� f - k— f - � -- - �— IOL Floating Platform(s) I 4A _ Fingerpier(s) I Total Platform area Groin length/tt Bulkhead/ Riprap length_kt Avg distance offshore-- Breakwater/Sill j I'C I 2 :(r I � I L -- —- - — __11— — r. - — Max distance/ length - —i-- -- — — — Basin, channel -- - — -- -- — Cubicyards Boat ramp - i � � -- i Boathouse/ Boatlift j "� I I Beach Bulldozing Other ) l ! 1 I I - X :.(J•"CC }— —%-� i .-X .'C , C Fr.Y t rr ;. j — <-� ,� t _ �7 <'.1:. , -L- - _ __ , { r" c. ^.. -� _ _ s'�- �,. . - — SAVobserved: -.t yes no Moratorium: n/a yes no 91 Site Photos: yef no 9 Riparian Waiver Attached:, yes no t"�, f l / A building permit/zoning permit may be required by: , O)C)02. (N. - Agent or Applicant PRI NTED Name Permit Officer's PRINTED Name ❑ TAR/PAM/NEUSE/BUFFER (circle one) ❑ See note on back regarding River Basin rules ❑ See additional notes/conditions on back (Please Initial) Signature "Please read compliance statement on back of permit" Application Feels) Check ll/Money Order Signature] Issuing Date Expiration Date •doutt'kNE]LAMA ElDREDGE & FILL &GENERAL PERMIT N9 88976 Previous permit Date previous permit issued A B C D 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 ❑ Rules attached. ❑"General Permit Rules available at the following link: www.deq.nc.gov/CAMArules Applicant Name Authorized Agent f\.i NBC coda. ly%,N Address Project Location (County): (:41XrV'V-Ctt City State ••. ��( ZIP � Street Address/State Road/Lot #(s) Vl('.'_ Phone #( ) Email <(•,t`:t Subdivision City i �:'-f-4n](` I ZIP ,.I ;_".- i (G' Affected 0 CW Q EW E PTA ❑ ES ❑ PTS Adj. Wtr. Body a1YtA,'('� [(nta man/unk) AEC(s): ❑ OEA ❑ IHA ❑ U W ❑ SPIMA ❑ PINS Closest Mal. Wtr. Body L ( N V_ N C If ORW: yes/no PNA: yes/no Type of Project/ Activity Shoreline Leneth t(F) (Scale: Access Length Pier (dock) length f Fixed Platform(s) I - I r t' \ Floating Platform(s) i / Finger pier(s) — —_ — 110 Total Platform area Groin length/g Bulkhead/ Riprap length Avg distance offshore Breakwater/Sill V— Max distance/ length I Basin, channel — —- — — - -- - -- — Cubic yards Boat ramp - Boathouse/ Boatlift ` Beach Bulldozingi Other t �.. _ J ` r ZT _ r -c r f, ( , s.. r` -. SAV observed: yes no '— Moratorium: n/a yes no Site Photos: yes no Riparian Waiver Attached: yes no Li A building permit/zoning permit may be required by: Permit Conditions. n ❑ 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 THATAPPLYTO 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•• r � / Application Feels) j Check p/Money Order Signature 11 1 Issuing Date Expiration Date AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: Mailing Address: Phone Number: ( C ) %/ V— Email Address: I certify that I have authorized to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: TDQ -tL at my property located at .333 1111. in vJ County. I furthermore certify that / 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: Signa r D £/zT f , ;*'L A45 0A) %Print or Type Name Title i oz3 Date This certification is valid through/07 f�Z MAY i � toz� DCM,-MHC CITY 3�1 N.C. DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONJWAIVER FORM CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERY (Top portion to be completed by owner or their agent) Name of Property Owner: /a r s ✓ /laal, ;TJ S Address of Property: A& %%%-s1, p zaz yj}g f /)(f Mailing Address of Owner: 5e-yt , A5 e v,<, Owner s email: nr eJo,s 5 e� eo i, r, Low Owner's Phone#: 2.627Z5'- �24�-T Agent's Name: j-,^ , Agent Phone#: V Y-7Z L/ - 99Z-3 D Agent's Email: ✓rl� Gllyac rl]� a ,r ;1. Co vh 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 forthis 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. it 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 943 Washington Square Mall, Washington, NC 27889. DCM representatives can also be contacted at (252) 946-6481. 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 Adjacent Riparian Property Owner No I do not wish to waive the 15' setback requirement (initial the blank) Signature of Adjacent Riparian Property Own( Typed/Printed name of ARPO:J/V"J l-S /V(1;M Pd1-3S J MAY ] 0 �nr 0CtVf•MiAD -I ry Mailing Address(( ofARPO: /]G Mnig5H 13R�'15fit- Ar, ARPO's email: ,11y) E ajo aS r'e e0' r/'AMO s Phone#: !j5r?- 7 h 0 - 2494 Date: f- -V ' 2 o 9-3 *waiver is valid for up to one year from ARPO's Signature* Revised July 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) Name of Property Owner: e Address of Property: .2 Mailing Address of Owner: ie �1/ z Owner's email: i=o=o , f ? (% L Agent'sName:ZC,5�e Agent Phone#: 2.572-e- 'ii/— `;� V Agent's Email: L Sallllf P-r 26e,274; ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION (Bottom Portion to be completed by the Adjacent Property Owner) (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. M 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 943 Washington Square Mall, Washington, NC 27889. DCM representatives can also be contacted at (252) 946-6481. No response is considered the same as no objection if you have been notified by Certified Mail. WAIVER SECTION Iunderstand 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.) n I DO wish to waive some/ail of the 15' setback i -OR- Srgnature of Adjacent Riparian Property Owner 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* MAY 10 7( Revised May 2021 G � � o MAY 10 202.3 D CITY FEE