HomeMy WebLinkAbout89746A - Spelman❑CAMA ❑ DREDGE & FILL �� N9 89746 A B
GENERAL PERMIT p,(v Previous permit
Date previous permit issued
❑New [Modification ❑Complete Reissue ❑Partial Reissue MO.J+C(A -1/2-TI 2_3
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: www.deq.ncgov/CAMArules
Applicant Name
City State ZIP
Phone#O
Email
Authorized Agent
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision
City
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body (nat/man/unk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body
ORW: yes/no PNA: yes/no
Type of Project/ Activity
Shoreline Length
Access Length
Pier (dock) length
Fixed Platform(s)
Floating Plafform(s)
Finger pier(s)
Total Platform area
Groin length/#
Bulkhead/ Riprap length
Av distance offshore
2�NOJE 2
BUI.KItE.4!
g
I �
Breakwater/Sill
11
r I
'
Max distance/ length
yl"�11�
y
' (V
asin, annel
r
(
.,
i '
Cubic yards
Boat ramp
Boathouse/ Boatlift
s.j�n
Beach Bulldozing
j "
t
-S
IWM JadzAT
Sill
SAV observed:
yes
no ,
Moratorium: n/a
Site Photos:
yes
yes
no
no + f—�JJ----T'-—.,
�
Riparian Waiver Attached:
yes
no
I ,
A building permit/zoning
permit may be required by:
Permit Conditions
a
(Scale: Ig )
A,-
'R�(xaA-9,oK Tc§ dc;
1� 1'—✓—v�l'�� � e j. d 1
❑ 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 U/Money Order
Signature
Issuing Date J Expiration Date
Vlela+e z /2 S /Z C12-S
i f
I
N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date
Name of Property Owner Applying for Permit:
APR t L- 4 (2o61 jj S p al-MA-rJ
Mailing Address:
)-6 9 tt4v,) elnL Z/9-�r
I certify that I have authorized (agent)
Lauren Berry Burch
to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) 1601-l<14E,0 -A -,�%Vy Z)pGk
/ L n1 v� �iR2/TlC 717
at (my property located at) /� 9 ���� a� ICKF
This certification is valid thru (date) Ub
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:
Address of Property: r 3q /t VZ)1_7e14L Lhlr CL
Mailing Address of Owner: /' /✓At»7G'�L c,,t,/ e,,A,e /Tac,_ Alc1-
Owner's email: roL.,, ner's Phone#:
Agent's Name (L `urelle-rk.h)I Agent Phone#: pit>i • `�` 3(`57�v
Agent's Email:
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adjacent Proporty 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
desgription or drawing with dimensions must be provided with this letter.
XI DO NOT have objections to this proposal. I DO have objections to this proposal.
it you nave opjections to wrier is nemg prupuaeu, yua umar •rvury o.a ..•----•^•
Management (DCM) In writing within t0 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 (Choose only on
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 rlyrap revelments). (If you wish to waive the setback, you must sign
the appropriate blank below.)
! DO wish to waive somelall of the 15' setback
r_
afure of 44mcebt 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: _
Mailing Address of ARPO:
,V9✓7%6H4 14, ev✓ ziT,1[K rJC a77,X?
ARPO's email: , �i�t �� i. Il�� artµ P QQ�tr�iyt ARPO's Phone#: N 5U5 - 3SO
Date: L� 0" _-waiver is valid for up to one year from ARPO's Signature'
Revised August 2022
N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Q RTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner: AllfR/k- Y1 lwkQJ✓✓ spe e-M At4
Address of Property: 13'7 n/f3ex'i't'/Tkr! t{G 17RJ-(/
Mailing Address of Owner %✓�rJ tiJAu%/c"Ht C 41f2 iZ/ 7-0C- G 27q�`�
Owner's email: ro binc s r Jmafi4fly j Owner's Phone#: tl �'��1-gy3r%
Agent's Name: - Agent Phone#: 3-,iq — 3s4t,
Agent's Email: i'jqPsmrLr'r/1 e.to c'rnbl,rg /r7a i I . Cn/r)
Z
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.
4,�` 4 1 DO NOT have objections to this proposal. 100 have objections to this proposal.
If you have objections to what is being proposed, you must notify me N.c. urvrsron or cpasrar
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 (Choose only one
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 must sign
the appropriate blank below.)
100 wish to waive some/ail of the 15' setback
ture 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:
Mailing Address of ARPO:
ARPO's emag: ')IC J ARPO's Phone# 157 LI b - fL73
Date: AR eci `� 'waiver is valid for up to one year from ARPO's Signature*
Revised August 2022