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Home My WebLink AboutKoutlus, Theodore - 91408C❑DREDGE & FILL N9 91408 A B C D GENERAL PERMIT Previous previous . Date previous permit issued i ,: . �'i I Z ❑New ❑Modification b 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 Applicant Name Address City State Phone # ( ) ❑ Rules attached. ❑ General Permit Rules available at the following link: www.deq.nceov/CAMArules ra : .i ./ ' Authorized Agent Project Location (County): ll Street Address/State Road/Lot#(s) Zl� P)r¢.\ ,�f�,-,o Subdivision - - City /-j (rMf , (_ `>P Gs r�� ZIP Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body jcs/ ��'0 �-c (6 11-L 1. �vt�k ) (nat/man/unk) i AEC(s): ❑\ OEA ❑ IHA 11 ❑ UW ❑ SPIMA ❑ PWS Closest Maj. WI Body .ec) ORW: yes/po 1 PNA: yes/no Type of Project/ Activity DrWQZc -` _l k, i e c( dorL f /{ iF Y (Sca1e:A):(3 ) Shoreline Length Access Length Pier (dock) • k � length '; g r -T {+ - - � � - Fixed Platform(s)�_ T- -- �-- - -I-- Floating Platform(s) c- - - Finger piers) Total Platform area Groin length/q _.- Bulkhead/ head/Riprapleng[h Avg distance offshore Breakwater/Sill -- �- -- - --i - Max distance/ length - -'- 1- - - - - --- - Basin, channel- Cubicyards _[- ' Boat ramp- Boathouse/ Boatlik I- i Beach Bulldozing Other -- - j - SAV observed: yes no Moratorium: n/a yes no '-?-- - Site Photos: yes no .__ - Riparian Waiver Attached: yes no p g permit may be required by -^ A buildingpermit/zoning �- -� -'_ - - II-- _.; v -_,._ _....._'._ -C__. _ _ _ �_ I [^ ) Permit Conditions __'�' "IA 0040(%f'c41} Cam. rz�(e� U Iv RULES AND CONDITH Agent or Applicant PRINTED Name Signature'*Please read compliance stat4ment on back of permit" 2L Application Fee(s) Check tf/Money Order ❑ TAR/PAM/NEUSE/BUFFER (circle one) ❑ See note on back regarding River Basin rules ❑ See additional notes/conditions on back STATEMENT. Permit Officer's PRINTED Name Signature Issuing Date (Please Initial) Expiration Date #F-]New OCAMA ElDREDGE & FILL N9 914OH A B C D GENERAL PERMIT Previ Date °sperm``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: wwwdeq nc gov/CAMArules Applicant Name Address City Phone # (_ ) State ZIP Authorized Agent Project Location (County): (-,-r^-<-' Street Address/State Road/Lot#(s) Email Subdivision City hof o+ol.+ -------ZIP ❑ ❑ Affected CW EW _❑PTA -❑ES ❑` PTS Adj. Wtr. Body - JO,�.c� f/z ro(4 `.-,n[--C C / (naUman/unk) AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body r10 • .'£- d.rt.w ORW: yes/no � PNA: yes/no Type of Project/ Activity (Scale:A)( ) Access Length Pier (dock) length _,' [c' Fixed Platform(s) + --f-- ; __ r ( ( - - i� Ir-- �- ! Floating Platform(s)�t- Finger piers) TotalPlattormarea N _ - - - Groin length/p Bulkhead/Riprap length Avg distance offshore s Breakwater/Sill - Max distance/ length Basin, Channel - -�-- ' i � i -_... i Cubic yards Boat ramp -.. -_I_— ,_.. _.__ _..— Boathouse/.Boatlift It./ Beach Bulldozing -" Other - - i — SAV observed: yes n Moratorium: n/a yes n i— Site Photos: yes no ! Riparian Waiver Attached: yes no - ! i - ' j A building permit/zoning permit may be required by A !+i.t Permit Conditions 'l i i ilk,': •! f, �t A/' �•' f *e ( '+ i z G - .- ❑ TAWPAM/NEUSE/BUFFER (circle one) 'r ��) (• 1./ ❑ See note on back regarding River Basin rules APPLY TO THIS Agent or Applicant PRINTED Name t' Signature '• Please read compliance stat ment on back of permit** Application Fee(s) Check p/Money Order ❑ See additional notes/conditions on back MT. (Please Initial) ,,, I I Permit Officer's PRINT Name , _ Signature i i I( Issuing Date Expiration Date �4A�.x�a'��.a�ayx��S.��:a{{u��Ji+Ft��,y.......�y ��w�f F�i��VC►L YW*ssn t 1FsTt }r rt+atfi to tv txstiYrlokel tsp rr rirt r i3r'tw��r at ia"iA) dh li'� IX'. t 2 f t� d5he 4rdA 1 �31�` ._.. _. AD ACjNTIAlpAn tM pRopERTV4VdPtER'lCERT'FMTI" noaH -'::w to lwF_.€ k.Y #yCscaaN p matt edWAVII?9'tm jYNS`'Atl to*t. :. 0(An*AY.: T$tA wdvoidoufn ftwIh3 iX._ , Y 1 »tall #k tTYak ..WQox4i2vx*Ano 00 UOT haw &Obdkrft W iht* ta'tN OPI. ,. ,,,' 00 the - a to �i5 iXiK�ABi. Vl �,. �.m__._. ru F a't �sp +s� rriia ie Abe rp i a i c r$! { Art WM'p ro days nt tecW ot trril tjoace, Coff fxmwAosctt should be �hi�id't4 att>CRrarerAs�., MkeralfreaUaFdy. N�76S6f. ttCdtt+tgawawtaattarta R'st' #t€ts btt�ort4t�.'vi at {tsp "84m, NO o is PxWetltJr m d um Mato w no oBy# _. Mtaxt hvw been 19~ by r WAIVER SECRON ' lodwstoW MW any deck. RwKdVg p:ka°xgs, ttult ramp twuskvvainr, twatltow, s, YT', of WOK MW be TO fWA a nnitnim diW*%o M I V t'ten ary nrnrr rti I4raetao artwss unless waivo by mw q'n lA lY tx lit #ngx #e hC#Ytra ) fl' yL« y ,h 10 W (be s0bfstk, YIN }/ {/ () tl L�41 Mke'h t+A w i 4%xY%td'i"4tJ#'iwri /,✓_f i db FXR wm b wawv the I V nrl- 00014 coml weariAro suw atvradA4iWw# f'fWdy ww�w_ .. fiesta: _v`,nra.7rea it VOW #or a 'o P hri¢ Pat tto'rA a6ii'di'rt %qm" ltTYBv'.'r"`t 7t AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: N-0 1 (?� Mailing Address: C q & D�ar_� Phone Number: �x C, 61 Email Address: �Cgy )A�e ( n,V� Cry I , f_c.^� I certify that I have authorized , Agent / Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following prop sed development: at e A\i� �t y", at my property located at �'l in` %%fr (- A't -`.e � County. r Ca n 1, t �.k, vc. �,. iJ C. DKS 11 l furthermore certify that l 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 �C, ( 1 Signature Print or Type Name Title ) 1 1 / TOT-3 Date This certification is valid through +1jw ❑,LAMA 0 DREDGE & FILL N9 87326 A B C D GENERAL PERMIT Previous permit { Date previous permit issued r New []Modification ❑ Complete Reissue ❑ Partial Reissue As authorized, by the. State of North Carolina, Deparfineint of Environmental Quality and the Coastal Resources Commission In an area of environmental concern pursuant to: I 15A NCAC ❑ Rules attached. ❑ General Permit Rules available at the following link: www.dea nc.govJCAMArules I Applicant Name Authorized Agent i Address'_.' < Protect Location(County): -._... r City State ZIP Street Address/State Road/Lot#(s) Phone#(._)'� Email --- '" Subdivision I --- ' i City ' r ZIP Affected ❑ CW ❑ EW L-1 PTA ❑ ES ❑ PTS Adj. Wtr. Body (nat/man/unk) AEC(s): ❑OEA ❑INA ❑UW "❑SPIMA ❑PWS Closest Mal. Wm. Body ORW: yes/no PNA: yes/no Type of Project/ Activity , (Scale: Shoreline Length Access Length�.- Pier (dock) length Fixed Platfornrl(s) f rt Floating Platform(s) Finger pier(s) - Total Platform area Groin length/9 - - , Bylkhead/ Riprap length Avg distance offshore Breakwater/Sill Max distance/length " Basin, channel Cubicyards I Boat ramp .... Boathouse/ (3batlift Reach Bulldozing i Other SAV observed: yes no Moratorium: n/a yes no Site Photos: yes no '.. - RiparianWaiverAttached: yes no A building permit/zoning permit maybe required by: ❑ TAWPAM/NEUSE/BUFfER (circle one) Permit Conditions " _ _ ❑ See note on back regarding River Basin rules r —'---"-"--' —"- - - ❑ See additional notes/conditions on back I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPt1ANCE STATEMENT. (Please Initial) Agent or Applicant PRINTED Name Permit Officer's PRINTED Name Signature '*Please read compliance statement on back of permit` Signature Application Feels) Check H/Money Order Issuing Date Expiration Date Statement of Compliance and Consistency This permit is subject to compliance with this application and permit conditions. Any violation of these terms may subject the permittee to a fine or criminal or civil action; and may cause the permit to become null and void. This permit must be on the project site and accessible to the permit officer when the project is inspected for compliance. The applicant certifies by signing this permit that: 1) prior to undertaking any activities authorized by this permit, the applicant will confer with appropriate local authorities to confirm that this project is consistent with the local land use plan and all local ordinances, and 2) a written statement from the adjacent riparian property owner(s) has been obtained, or proof of delivery of certified mail notification of the adjacent riparian property owner(s). The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available information and belief, certify that this project is consistent with the North Carolina Coastal Management Program, River Basin Rules Applicable To Your Project: L 1 Tar - Pamlico River Basin Buffer Rules u Neuse River Basin Buffer Rules If indicated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules for the River Basin checked above due to its location within that River Basin. These buffer rides are enforced by the NC Division of Water Resources, if you have any questions, please contact the Division of Water Resources at the Washington Regional Office (252-946-6481) or the Wilmington Regional Office (910-796-7215). Notes/Additional Permit Conditions: Please ensure all debris associated with the removal or construction of the permitted development is contained within the authorized project area and disposed of in an appropriate upland location. Division -of Coastal Management offices Morehead City Headquarters 400 Commerce Ave Morehead City, NC 28557 252-808-2808/1-888-4RCOAST Fax: 252-2473330 (Serves: Carteret, Craven -- south of the Neuse River, Onslow counties) Elizabeth City District 401 S. Griffin 5t, Ste. 300 Elizabeth City, NC 27909 252-264-3901 (Serves: Berrie, Camden, Chowan, Currituck, Dare, Gates, Hertford, Pasquotank and Perqulmans Counties) Washington District 943 Washington Square Mall Washington, NC 27889 252-946-6481 Fax: 252-948-0478 (Serves: Beaufort, Craven — north of the Neuse River, Hyde, Pamlico, Tyrrell and Washington Counties) Wilmington District 127 Cardinal Drive Fxt. Wilmington, NC 28405-3845 910-796-721.5 Fax: 910-395-3964 (Serves: Brunswick, New Hanover and render Counties) http /,'laartal nrdrrnrorf;{w�hJcnildt:n':-home e=�tseae�at/zori ❑LAMA d DREDGE & FILL No 87326 A B C D PreviGENERAL PERMIT Date Devios permit Date previous permit Issued New ❑Modification ❑Complete Reissue ❑Partial Reissue As authorizedy the State of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to; ISA NCAC ❑ Rules attached. ❑ General Permit Rules available at the following link: wvrwdeq nc eovICAMArules Applicant Name Authorized Agent Address city Siatef Phone # ZIP Project Location (County): Street Address/State Road/Lot #(s) P Subdivision i r City ZIP I Affected ❑eW ❑ EW ❑ PTA ❑ Es ❑ PTS Adj. Wtr. Body (nat/man/unk) f AEC(s): ❑OEA ❑IHA ❑UW ❑SPIMA ❑PWS Closest Mal. Wtr. Body ORW: yes/no PNA: yes/no Type of Project/ Activity (Scale: ) Shoreline Length _ Access Length ..... _. Pier (dock) length Fixed PlaHorm(s), r Floating Platform(s) Finger pler(s) .. Total Platform area Groin length/4 " Bulkhead/Riprap length Avg distance offshore Breakwater/Sill Max distance/length .. Basin, channel Cubic yards ..,! . .. Boat ramp Boathouse/ Boathft I Beach Bulldozing. Other SAV observed; yes no Moratorium: n/a yes no f I y 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 Agent or Applicant PRINTED Name Signature --Please read compliance statement on back of permit*' Application Feels) Check N/Money Order (Please Initial) Permit Officer's PRINTED Name Signature j Issuing Date. ; -} - Expiration Date Statement of Compliance and Consistency This permit is subject to compliance with this application and permit conditions. Any violation of these terms may subject the permittee to a fine or criminal or civil action; and may cause the permit to become null and void. This permit must be on the project site and accessible to the permit officer when the project is inspected for compliance. The applicant certifies by signing this permit that; 1) prior to undertaking any activities authorized by this permit, the applicant will confer with appropriate local authorities to confirm that this project is consistent with the local land use plan and all local ordinances, and 2) a written statement from the adjacent riparian property owner(s) has been obtained, or proof of delivery of certified mail notification of the adjacent riparian property owner(s). The State of North Carolina and the Division of Coastal Management; in issuing this permit under the best available information and belief, certify that this project is consistent with the North Carolina Coastal Management Program. River Basin Rules Applicable To Your Project: 11 Tar - Pamlico River Basin Buffer Rules Neuse River Basin Buffer Rules If indicated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules for the River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the NC Division of Water Resources, If you have any questions, please contact the Division of Water Resources at the Washington Regional Office (252-946-6481) or the Wilmington Regional Office (910-796-7215). Notes/Additional Permit Conditions: Please ensure all debris associated with the removal or construction of the permitted development is contained within the authorized project area and disposed of in an appropriate upland location. pfvision of Coastal Manaeement Offices Morehead City Headquarters 400 Commerce Ave Morehead City, NC 28557 252-808-2808/ 1-888-4RCOAST Fax: 252-247-3330 (Serves: Carteret, Craven - south of the Neuse River, Onslow Counties) Elizabeth City District 401 S. Griffin St. Ste. 300 Elizabeth City, NC 27909 252-264-3901 (Serves: Berne, Camden, Chowan, Currituck, Dare, Gates, Hertford, Pasquotank and Perquimans Counties) Washington District 943 Washington Square Mall Washington, NC 27889 252-946-6481 Fax:252-948-0478 (Serves: Beaufort, Craven - north of the Neuse River, Hyde, Pamlico, Tyrrell and Washington Counties) Wilmington District 127 Cardinal Drive Ext, Wilmington, NC 28405-3845 910-796-7215 Fax:910.395-3964 (Serves: Brunswick, New. Hanover and Fender Counties) http://portal. ncde n r.org/web/cm/dcm-home Revised 6/01/2021 AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: i e Mailing Address: G I / Phone Number: Email Address: I certify that I have authorized eA— Agent! Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: (\ e J 5&,,,7a 11 Cock ) at my property located at Z 17 ��' eA �r in (-1kreA— County. I furthermore certify that 1 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: Signat Print or Type Name Title oil 1S l42L Date 7 RECEIVED This certification is valid through 03 Y: i? L)GM-Mt•wil CITY \l c0) N.C. DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONMIAIVER FORM CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERY (Top portion to be completed by owner or their agent) Name of Property Owner: l tC�-1 f 10 5 Address of Property: Z (% Mailing Address of Owner Owner's email: S 0 4 d a �" �s`/ % Owner's Phone#: Agent's Name: f1.CL:j P'/ Agent Phone#: ZSZ u22-�Yo j Agent's Email: ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION (Bottom portion to be completed by the Adiacent 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. If you have objections to what is being proposed, you musr norrry me rv.�. urnarurr or wuarar 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 revetmen ). (If you Nish to waive the setback, you must sign the appropriate blank below.) p\\ I DO wish to waive some/all of the 15' setback Adjacent Riparian Property Owner No I do not wish to waive the 15' setback requirement (initial the blank) Signature of Adjacent Riparian Property Owner: TypedIPrinted name of ARPO: Cal C . A ((P Mailing A dress of ARPO: I LAlne1-ioejC C/hti,1�J , k (�t A O LblG ✓alt, yLARPO's Phone#: I / ✓ o o/ AR O's email: Date: -L Lti _'waiver is valid for up to one year from ARPO's Signature' Revised MOO-IVI=r, MAP v 0 111612 DCM-MiriLl CITY 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: q ed Address of Property: i t i Pscd Dr- A+(# lk- 3 -9 - Mailing Address of Owner: % l 1 31,,K 0L Owner's email: Agent's Name: sn. C14-1 11&-- :1 Agent's Email: rti;GAy 2-1 Owner's Phone#: Sol - col. &S`19 Agent Phone#: Z5 1--6J Z Z - 4)�l03 Lv^ ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION (Bottom portion to be completed by the Adiacent 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 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. 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 ,/// _ Slgnatu 4f A djacetif Riofi6n Prop rty Owner -OR- I do not wish to waive the 15' setback requirement (initial the blank) Signature of Adjacent Riparian Property Owner: r� Typed/Printed name of ARPO: R ( k Mailing Address ofARPO: C>'') UAAQtbrIS(%(C', ),S ARPO's email• �: \ \ \ a _tti . r �9, ARPO's Phone#: 1C4 Date: *waiver is valid for up to one year from ARPO's Signature* Revised May U2n2 f)CCM-MIHO CITY Oy- Ocwl-� nir , CITY