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Home My WebLink About89637A - Choffeld Holton, LLCte"r° ❑CAMA 0 DREDGE & FILL NU 89637 A B C D a GENERAL PERMIT Previous permit a Date previous permit issued ElNew ❑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 # ( ) Email ZIP Authorized Agent Project Location (County): Street Address/State Road/Lot Subdivision City Affected ❑ cW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Win Body (nat/man/unk) AEC(s): ❑OEA ❑IRA ❑UW ❑SPIMA ❑PWS Closest Mal. Wtr. Body ORW: yes/no PNA: yes/no Type of Project/ Activity (Scale: ) Shoreline Length .H. �C■...■.ME ■■......�■i�■. EMSHH■■®■■ ■■■■0H■■■■0ME H :■ u lull ME Ems M No � ■ e® e�■�. ■ ■ ■ �H...■H..::�.�.�;ME ■■�. H..H ONE ■1 H ■■. ■■ . MINE N ■:■■�■�■■�. ��..■i1i■■HMEN �.■■ ■■p■■■■H■■H■.■■HH■■■■■H■■■■■■■ ■WH' �■ ■ ■�■ ■■H■M H■■■��o A building permit/zoning permit may be required by: Permit Conditions ❑ 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** Application Feels) Check k/Money Order Signature Issuing Date Expiration Date None ofRWedy Owns Pemdt / / "N4f 11 llvzzO/ ! Ma" 5 0 1 5 80,'-n J 6d d i R t-- hL,,okn no„AP I/A ;) -� RHO mom Nuffow. r" Addresm n/2 t wry #mt t hW4e authodzed ZTtic6o o to ed on my t , fonds pupow of apOVM for and a as CAW pew , atmy popegty bcMed at lad R in ; ivw,, S Cou ly. furihmrmn►e reri+7y IW I am auUxWwd to gram and do in race grant pemdssfon to 1KammofGbaseal erdst4ihe.Lwdpemmt09iicerandfiateomfttow#er on the afiormnmdoned Lands in oomacgon w9h e>&ating Ir► bmgWim noted 6 this POMWS P • Sli�eiee WI) I+Z)I) RECEIVED hAWarlim PI, me 6�r FEB 2 0 2023 71b —I 1i d oa3 DCM-EC rx�e - N.C. DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY (Top portion to be completed by owner or their agent) Name of Property Owner. 1176t'1f'-^ 1-149110/i Address of Property: 13,Z ! rrL/ s✓gJyle—/ b/ 14e f I � N1C- oZ ! ! 7 Mailing Address of Owner �S ��r N nPiLLf`L' O/6 u �e, R(,i4 J —7 Owners email: / /% L-4 Owner's Phone#: rZ S'r) ` t i t'S -3 `/l/ Agent's Name:hCwl 1 r r 6ft 144 ..Tel C Agent Phone#. C - -�3 b3i3 Agent's Email: CC E%Cmn dxfr r /1 e g: /7`6' ! �— Met ! . C67 A" 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^roperty. 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. X 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 malted to 401 S. Griffin St, Ste. 300, Elizabeth City, NC, 27909. DCM representatives can also be contacted at (252) 264-3901. No response is considered the same as no objection # 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.) 1 DO wish to waive somefall of the 15' setback n� Signdt7reofAdjacent Ripdrian Property Owner -OR- I do not wish to waive the 16 setback requirement (initial the blank) Signature of Adjacent Riparian Property Owner: Typed/Printed name of ARPO: RECEIVED F E B 2 8 2923 Mailing Address of ARPO: D C M V 4 E C ARPO's email: ARPO's Phone#: Date . q! a 3 `waiver is valid for up to one year from ARPO's Signature` N.C. DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY (Top portion to be completed by owner or their agent) Name of Property Owner. // 'Gf/ �) /7y�TI�� I(/ / /' u Address of Property: �3Z R`�!/✓�/� �/ HLt/ify/GC hL Mailing Address of Owner. Owner's email: /`I �� Owners Phone#: ul d & jS _3 Agenfs Name: I— Agent Phone#- �✓ �� `� Agent's Email: ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION (Bottom portion to be completed by the Adjacent Property Owner) , .3.3ai 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_ Y JS 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 fire N.G. nnnsron or k:oastar Management (DCM) in writing within 10 days of receipt of this notice. Correspondence should be malted to 401 S. Griffin St, Ste. 300, Elizabeth City, NC, 27909. DCM representatives can also be contacted at (252) 264-3901. No response is considered the same as no objection M 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 16 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 most sign the appropriate blank below.) I DO wish to waive some/all of the 15' ��ack/ `. 42� gnature ofAdjacent iparian 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: Mailing Address of ARPO: ARPO's email: ARPO's Phone#: R,`� Date: ;, , 1 r c�"3 'waiver is valid for up to one year from ARPO's Signature` FEB 28211D DUVhI- r s —0 c�- a 21 A, 61'elk,ld • w ,Y ` � � r • l e �5 /it . u . 1 i?� �'.