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Home My WebLink AboutGillette, George - 91324C#F-]New U]CAMA ElDREDGE& FILL N9 91324 A B CCU D Previous permit -- GENERAL PERMIT 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: 15A NCAC ❑ Rules attached. Q General Permit Rules available at the following link: www.deq nc gov/CAMArules Applicant Name Address City State ZIP Phone #(_) Email % . L GWI Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS AEC(s): ❑OEA ❑IHA ❑UW SPIMA ❑PWS ORIN: yes(o PNA: yes/no Type of Project/ Activity Shoreline Length Authorized Agent Project Location (County): Street Address/State Road/Lot #(s) Subdivision -' City , Adj. Wtr. Body Closest Mal. Wtr. Body (Scale:,,VTS ) Access Length `_ Pier (dock)length Fixed Platform(s) — L _ -- _. r'___._ G , ✓_ V _ g 44 -_ r• Floating Platform(s) � Finger pier(s) e_ Total Platform area Groin len6t / h Jt -I 0ulkyea /Ri ra length ...� P P 6t Avg distance offshore No Breakwater/Sill Max distance/ length N Basin, channel — Cubic yards Boat ramp_ Boathouse/ Boatlift - Beach Bulldozing __ Other -� t--- l J- ` ' i -- t - I - - li b j� I II `� _ L. �'JL _ T -r' _ � _ � I '_ ( I SAV observed: yes no i Moratorium: n/a yes no t Site Photos: yes no Riparian Waiver Attached: yes no L I _I _ T_ J. A building permit/zoning permit may be required by: t t y Permit Conditions I . /✓l ,� �� ,t,,, 1.�.�J �,� D,TAR/PAM/NEUSE/BUFFER(circle one) . ){. •:� FV )�f it r'h� :>,� ,l hcc lt�'�l �'✓��'Ii <',J ❑ See note on back regarding River Basin rules i ❑ See additional notes/conditions on back IAM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECTAND REVIEWED COMPLIANCE STATEMENT (Please Initial) /f'7 Agent or Applicant PRINTED Name Permit Officer's PRINTED Name "l 1n Signature "Please read compliance statement on back of permit••, Application Feels) Check Jt/Money Order Signature Issuing Date Expiration Date ACOM71, ❑CAMA El DREDGE & FILL N9 91324 A B (c) D GENERALPERMIT 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: I SA NCAC ' ❑ Rules attached. N General Permit Rules available at the following link: wwmd .nc. ov CAMArules Applicant Name _ Address City Phone # (_ ) Email State Project Location (County): Street Address/State Road/Lot #(s) Subdivision City F ; T- zip Affected ❑ CW 0 EW ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body ',t ; (fiat/man/unk) AEC(s): ❑IDEA ❑IHA ❑UW ❑SPIMA ❑PWS Closest Maj. Win Body /✓ V. ORW: yes PNA: yes0o) Type of Project/ Activity Shoreline Lenath (Scale:^/ % S ) Access Length Pier (dock) length Fixed Platform(s) . 0 nn:i . :■■ Floating Platform(s) Finger pler(s) ■. r _ ,_ ■ ■:�i ii:��:non■ ■�■�■�� i A building permit/zoning permit may be required by: - Permit Conditions ' M,TAR/PAM/NEUSE/BUFFER (circle one) 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) J Agent or Applicimt PRINTED Name Per r mit Officer's PRINTED Name , j Signature -*Please read compliance statement on back of permit*• Signature Application Feels) Check N/Money Order Issuing Date Expiration Date J tz Ale'z+ `Ter r'j 6, 4C i 4K5i . f4c. usuk 252- 361-b76( 0 � o VSvoc�.h SCdicJ2� i. Cvv�SfirvG �k:py J 3AOIU 83AP9 9 U l` f t . l f t F M N.C. DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONlWAIVER FORM CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERY (Top portion to be completed by owner or their agent) Name of Property Owner: CieQv-qe r J L f-fi L Address of Property: 33 !aszj'ti , )tD,.i r a�a0 �O' J7 N Mailing Address of Owner 65S (3ria�nccL 9,211k, , acILL Z 5`�O Owner's email: do, a Owner's Phone#: _ 910 - 3 ZI- 4d g(D Agent's Name: c i r,P I /IS, (( I, W- Agent Phone#: Agent's Email: 0 r Ne, tTc_I e-r✓y 61 a ry a i, I .. ^ . 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 ha4e 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 contact at (252) 515-5400. No response is considered the same as no objection if you have been noyW by Certified Mail. WAIVER SECTION I understand that any proposed pier, dock, mooring pilings, boat ramp, br ater, boathouse, lift, or groin must be set back a minimum distance of 15' from my area of ' ran access unless waived by me ph: -I t apply to bulkheads or riprap revetments). (If ish to waive the setback, you must sign thete blank below.) I waive some/all of the 15' ack Signature of Adjacent Riparian Property Owner -OI dto waive the 15' setback requirement (initial the blank) Signature of Adjacent Riparian Property Owner: Typed/Printed name of ARPO:.. IV\ . j .( /N�, Mailing Address of ARPO: rW� 0J&03 l . T �� ARPO's email:f io "nn g h a+i' cA PO's Phone#: Izz-A _C2, 011- d>l0S O Date: *waiver is valid for up to one year from ARPO's Signature' Revised May 2021 N.C. DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONlWAIVER FORM CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY (Top portion to be completed by owner or their agent) Name of Property Owner: c1 c, 09 e C r_ L Address of Property: 133 R")e"- �'tuc.i acu✓{orl J�tu Mailing Address of Owner: 653 Bria,nCck R04 , 3ae L5,P t 0c U c- Kc 0 S5'-p Owner's email: doh r_ Owner's Phone#: 910 — g 7_4' r { 4-U- Agent's Name: crap 6�!//-i ( (_fir 4-a— Agent's Email:, tI(C&g_ri'-r✓j CO Agent Phone#: 25 2-- 36 I-O 78 ) 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 contact at (252) 515-5400. No response is considered the same as no objection if you have been not' by Certified Mail. WAIVER SECTION I understand that any proposed pier, dock, mooring pilings, boat ramp, br ater, boathouse, lift, or groin must be set back a minimum distance of 15' from my area of ' nan access unless waived by me (this does not apply to bulkheads or riprap revetments). (If sh to waive the setback, you must sign the appropriate blank below.) 100 wish to waive some/all of the 1 Sew Signature of Adjacent Riparian Property Owner to waive the 15' setback requirement (initial the blank) Signature of Adjacent Riparian Property Owner: Typed/Printed name of ARPO: !—rC.l "�C'( C wv O✓V Mailing Address of ARPO: % t3% 50L A 7k\Ju✓ �DAI ✓e, ARPO's email: ARPO's Phone#: � 5 2 FiW O! S`0 Date: O 4.2 3'waiver is valid for up to one year from ARPO's Signature' Revised May 2021 AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: Mailing Address: Phone Number: Email Address: 1 certify that I have authorized 50n Agent / Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: vcrat„. _'SC a urn P- 133 S, R,yev A ui+tu I pan 1s at my property located at I33 �� (, 12, e (fir.✓ e in Cw4e.y-rCounty. 1 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: — V Sgnature ('Lb%2 a- a W & i jam( e Print or Type Narne 1�tJ t12.✓ Title S i " / 2o2 Date This certification is valid through