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Home My WebLink About89915A - Kissell+Ate'``r',fL ❑CAMA ❑ DREDGE & FILL GENERAL PERMIT ,AN9 89915 ; X B C1 Previous permit Date previous permit issued EJNew ❑ 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: vvww.deq.nc.gov/CAMAruIes Applicant Name I Authorized Agent Address Project Location (County): City State ZIP Street Address/State Road/Lot #(s) Phone # (_) Email Subdivision City ZIP Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Ad!. Wtr. Body (nat/man/unk) AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PINS Closest Mal. Wtr. Body ORW: yes/no PNA: yes/no Type of Project/ Activity Shoreline Length, Access Length Pier (dock) length Fixed Platform(s). Floating Platform(s) Finger pier(s) Total Platform area t Groin length/# Bulkhead/ Riprap length Avg distance offshore Breakwater/Sill Max distance/ length Basin, channel Cubic yards Boat ramp Boathouse/ Boatlift Beach Bulldozing Other SAV observed: yes no Moratorium: n/a_ yes no t^. Site Photos: -'-- Riparian Waiver Attached: yes no 1 A building permit/zoning permit may be required by: Permit Conditions (Scale: ) ❑ 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** Signature Application Feels) Check q/Money Order Issuing Date Expiration Date 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: s 4ey-Q f A (((� &! 2 Address of Property: 31 O w� `(h✓u t0�� p�L 'F�TDri - r Ut �7� 3 2— MailingAddress of Owner: �J5 t W r Vg;� lf/ f Z3�5 S Owner's email.4((WiQlAPAY40W`f0-OCj wner'sPhoc� Agent's Name: Agent's Email: Agent ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION (Bottom portion to be completed by the Adjacent Property Owner) I hereby certify that I awn 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. 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 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 ben 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' Ai e-I' -- of Adjacent Riparian Property Owner -O R- I do not wish to waive the 15' setback requirement (initial the blank) J U L 19 2023 xSignature of Adjacent Riparian Property Typed/Printed name ofARPO: DCM—Ec' Mailing Address of ARPO: ARPO's email: ARPO's Phone#: Date: _ "waiver is valid for up to one year from ARPO's Signature* Revised July 2021 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: `3I"V{.te '}y 1 I (C ,e_ i\ Address of Property: Mailing Address of Owner: Vit�rnict(ICc�vt fSSorj(�sma Owner's email: Agent's Name: Agent's Email: Wl L- (1 l)%, )(4 Z3�/� S Owner's Phone#: 7 5 7' 6 I S -U5 S— Agent ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION (Bottom portion to be completed by the Adjacent Property Owner) 1 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 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 t _ ure of Adja Signatcent Riparian PropertyOwner g� �^; 4 ; -OR- 1-`aE t I do not wish to waive the 15' setback requirement (initial the blank) M—(�sj . JUL 19 2023 Signature of Adjacent Riparian Property Owner: _`YNY Typed/Printed name of ARPO: M r L D? t D L. l+o w as L L _ Mailing Address of ARPO: P O. 134 g 6a Ty M4t M N C_ ,Z 7 9 W a ARPO's email: ARPO's Phone#:(X53 Date: (o — / O— .7, 3 "waiver is valid for up to one year from ARPO's Signature' Revised July 2021 �- R @m., ... , r ram. J U L 1 y 2523 DCM 'E- • Y j( � a I. it ht i • Y y n � • Y � Y e e , R � ` I I G �i 1y • ' 5 �°, � •' t i �� ., � It i'A ��I 1��1•. , �� .. .. �7 �� 8Y '�- q � � J • � � 'fj ih"' - � " z ds ylR � •�t aa e �ry�N �•r `� ' to RY S ° R Td R e Y` i3" • {{11 F IL � , 1 7 ry; i s