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Home My WebLink About89732A - Wojeck4 "r" C3CAMA ❑' DREDGE & FILL �N9 89734 A B C D GENERAL PERMIT Date Previous previous Date previous permit issued FINew [:]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 ()_ llA_ , 1, ) CZ7 ❑ Rules attached. ay' General Permit Rules available at the following link: www.de .nc.pov/CAMArvles t Applicant Name S F_': i•�GVI s iAJ Cz t C•'- c }:. Address .,. i<.) 1'i.C? vV1 t ✓lG}-'tI': bl 1 1"" 7 l/'S=. city I�zip 2''3 Phone # ( _n '- 1 9 Z6 I r Email &J 601(6 i1 ECG'• C'!>ty% Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS AEC(s): ❑OEA ❑IHA ❑UW ❑SPIMA ❑PWS ORW: yes/no PNA: yes/no Type of Project/ Activity Authorized Agent A 1,1 0 bLI Jf '-� : , .1Jt _ /" aT- l Inc, , Project Location (County): _� �LJ,%TV, I `!.LJC L Street Address/State Road/Lot #(s) V7) � i [... 11 CU. )+ Subdivision t%P_J.II �•f-`">`. city C i, /r 7 , -K),-_ t- zip Adj. Wtr. Body Closest Maj. Wtr. Body —� I• (Scale: Shoreline Length _ _ Access Length _=�.. �__ I Pier dock 1 len h t � •�i Fixed Platformgs -- f Floating Platform(s) Finger piers)f—I ' I- _t.. _ -I— I ! Total Platform area Groin length/q - �BulkheaJ)/Riprap length ! ✓ 1 -- _-- --r-- Avg distance distance offshore Breakwater/Sill i Max distance/length '.:LJ i Ot-9- Basin, channel kd Cubic yards Boat ramp I \ Boathouse/ Boatlift Beach Bulldozing Other I i I i I SAV observed: yes no Moratorium: n/a yes no Site Photos: ` yes no Riparian Waiver Waiver Attached: yes. no�iZ2 I A building permit/zoning permit may be required by: —1) C V, 1 "ri 1 i i' �' C'.i) I, 1 d \ % Permit Conditions ij. \i t_• 011-1.1I D4 (!:S7 cq, 1 y I r ❑ TAR/PAM/NEUSE/BUFFER (circle one) ❑ See note on back regarding River Basin rules ❑ See additional notes/conditions on back J 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 readcompliance statement on back of permit** Signature Application Feels) Check k/Money Order Issuing Date - Expiration Date AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATIONawZ J U N 0 2 2023 Name of Property Owner Requesting Permit: '�-TE�rrew in)07E-C �- Mailing Address: fig' (ZCmj"—,oN puye- DCM-EC C466 -tPi✓AICY t V q ��22 Phone Number: -3-5T qys l 9Qii� Email Address: S %Ls PFt f . w ojtr-C k.. °� tii14 f-lc<3 , G o-nn I certify that I have authorized S z - y5'7 -g7 a ? Agent / Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: at my property located at 38 E• CatVA5aFvCK--, (,ye l-TuCIC in CV tin rTv (.k 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: Signature Print or Type Name Title ( / L / 2023 Date This certification is valid through / �-- / 2 1 2 7 RECEIVED N.C. DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONMAIVER FORM )UN 0 2 2023 CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERY (Top portion to be completed by owner or their agent) DCM-EC Name of Property Owner: Address of Property: I :) Mailing Address ofOwner:71�'o� rvtl�fln 17� `(lec `� V c" Owner's email: Ste_ -C rN (6LQ.)(K, V&I&Owner's Phone#: 76i •—C1 t� � J Agent's Name: Al �V (_OG,SA` J✓iaflti Agent Phone#: ��D Ld� �an4q r ti, Agent's Email: C--Lo'%�-e�'kN^na ci% ,( 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 _._- w.....,. ;A -,a with t hie lofior 1 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 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 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.) ✓ p /, I DO wish to waive some/all of the 15' setback Signature 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: /" «�l �� G• �G /nc Mailing Address of ARPO: / h Y 6&5 ,��, / rVl t Co /mot( nr3 ARPO's Phone#: �J4� �� if 8V6) ARPO's email: Date: j - 2(2vt 3 *waiver is valid for up to one year from ARPO's Signature* Revised July 2021 N.C. DIVISION OF COASTAL MANAGEMENT RECEIVED ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY JUN 0 2 2023 (Top portion to be completed. 1by, owner or their agent) OIF-IC Name of Property Owner: Address of Property: Mailing Address of Owner: G, r(��- ^ vr^ rC!`<CM q Owner's email: nn e�-e' AI O �CkP' I- MS Phone#: ��j %— Agent's Name: CODI Agent Phone#: a 1'�rJ7 —tom 7 Agent's Email C!�(� (Y�OJ i nt Cr,nst./��1s�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 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. DO NOT have objections to this proposal. 1 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 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 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 I do not wish to waive the 15' setback requirement (initial the blank) Signature of Adjacent Riparian Property Owners_ Typed/Printed name of ARPO: v"4 J Mailing Address of ARPO: lqd ARPO's email: hSSi UE@ �/� � ARPO's Phone#: 7 f 7' 376- 3173 Date: � 3 *waiver is valid for up to one year from ARPO's Signature* Revised July 2021 FA \ • Ri- rrr