89815A - Lanman

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~ottoAST.ft~~CAMA □ DREDGE & FILL
{ J GENERAL PERMIT
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[9 New D Modification D Complete Reissue D Partial Reissue
N9·89815
Previous permit 1 ( ~ 5
Date previous permit issued
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 , \ "? .,, ,.,> D Rules attached . ~ General Permit Rules available at the following link: www.de(l.nc .gov/CAMArules
Applicant Name £ a C t O "\
Address _ _ul Z=-_'.3~-;;&,~-;!..--..!..r ____::Q,,:,!,_!,.\,~~'......L...!.'.....li_<,~_;ulc.::,__~~L--4-...!,.!....=:__
-·, u""""' City w r \ -~F-r:\-+-J.J-""-'--ZIP--'"--'-'=-=-=--'-'
Phone # (
Email _______________________ _
Affected □ CW
AEC(s): □ OEA
ORW :yes/G
[9e w
□1HA
Shoreline Length _1"=-=--------
Access Length _______ _
Pier (dock) length--~~---
Fixed Platform(s) ---+-----
Total Platform area----~-
Groin length/# ______ ,.___
Bulkhead/ Riprap length -----+--
Avg distance offshore ___ ...._ __
Breakwater/Sill ____ __,,_ __ _
Max distance/ length --+----
Basin, cha nn el ___ ___,......_ __ _
Cubic yards------+----
Boat ramp ________ _
Boathouse/ Boatlift ---+-----
Beach Bulldozing ___ ...c.;.._\ __ _
(5v~4~~-~~~=;....---...,,,
SAV observed : ye s no
Moratorium: n a, yes no
Site Photos: yes no
Riparian Waiver Attached :
~TA
Ouw
□Es
□sPIMA
OPTS
0Pws
Authorized Agent --'~'=-''---'--'-'-'----'-~"----'...._._,_____;"--"--'-',.4-........,__._ __ _
Project Location (County): _..:'.jt:'.:U~~~~~e:~~...±~Lr:::e~-
t-
...
yes e_o )
A building permit/zon ing permit may be required by : --'-..;,:.c=""-J ..c.h_,_.....,e,.._. . ._f.__n...,....:.:..::...:_=---------□ TAR/PAM/NEUSE/BUFFER (circle one)
D See note on back regarding River Basin rules
• Permit Conditions _____________________________ _
D See additio nal notes/conditions on back
I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial) I,
}\ 'h c l , J
Agent or Appl icant PRINTED Name
Signature **Plea se read comp li ance statement on bac k of permit••
t,.v_ S ::t:'9 ,,,,
Signature
J
I:!. I I -?i
Application Fee(s) Check #/Money Order Issuing Date Expiration Date
MINI NfIHOBRtDII fP8 CAIIA.PIBl[{N?PMCATIQN
Named Property Owner Requa1lll1g Pannll: Pxu:t l Q O ma..n
'~ 33 Co oto Ats b I,x. s; \ \kc V©t) mD Qo9o5
Phone Nllnber: :3o) -%0 ln -ocd)
Emlll Addi-=
N ~ W"Y"\.,. --"~ I certlfylhatl haw aulhmtmd __ e, __ ,_ • l.«.A,...;I~~'-~~------
Aglnt/CGI
to act an my behalf, for the purpoee d applytl111 for and oblalrdng al CAMA permlta
nemaaary far the t'ollowlna propoeed dewlapmeut: a dJ~ :'.b QfW
. moon~ Qc,)12> :{ yv--oo( (\['.) \ po\e..,
atmypropertylocalldat \'53(, l)U dLRA · UJ(L N~ .
In Q~e, ~-
I f&nhermote Olf'fly lhllt I am lllllt,o,ta,d fo grant end do In fad grant ,,,,,,,.,.,,, lo
Dlvltllotl ~ Coeetal.,.,.,.,,.,,,.,.,,,,,. ,. LIJCIII Penni OIDr.-1111d """'.,. fo .,,,.,.
on the llotemenlloned,.,,. In oonnsdlon 1111h .....,,, tbrml/on ,alat.ct to this
,,.,,,,. applfcllMon. '
Thlo ......... 111111d lmlUGh ~ . __;;>
lltNillt!d Nar. 2016
N.C. DMSION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL . RETURN RECEIPT REQUESTED or HANO DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner: fur.\-lLLn. rnCL,f\
Address of Property: \ 63le D LtQ_)(.Q,-\,, V U tk
Mamng Address o10wner. iCB 3 C:.a.Drn dis h 'Dv-: S,;' I Ver ~ fYl £ '105
Owner's email:---------Owner's Phone#: 3ol .. EQlo "
Agent's Name: N €::= rnQ...O..o :'.e Agent Phone#: ~5~ -~~ -3.o g ~
Agent's Email) u..\,·-e..@.n e.., O)Qd::) h-e. c.onS+-c L.\O ~
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
<Bottom portion to bf completed by the Adiacent Property Owner}
I hereby certify that I own property adjacent to the above referenced property. The individual applying for th is
permit has described to me, as shown on the attached drawing, the development they are proposing. A
d~~~~~~~~~~~~~~~~~~~le~tt~e. =::r: -:: ~,,...,._ -e,w m oon n0-\ (SO\eS C O v ,J-._
have objections to "this proposal.
If you have objection• to what ls being propoaed, you must notify the N.C. Division of Coastal
Management (DCII) in writing within 10 days of receipt of this notice. Correspondence should be
malled to 401 S. Griffin St, Ste. 300, Elizabeth City, NC, 27909. DCM rept'Hentatlves can also be
oontaotod at (252) 2U.200f. No ,uponN is eon•ldorod tho Hmo u no objection If you havo boon
notified by Certified Mall.
WAIVER SECTION (Chpoff only one)
I understand that any proposed pier, dock, mooring plllngs, 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
fth js does not apptv to bulkheads or norao 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
•OR·
I DO NOT wish to waive the 15' setback requirement (initial the blank) ____ _
Typed/Printed name of ARPO: ~
Malllng Address of ARPO: ..::r;::-~d ~ ~ t! d //
ARPO's.eman~&m/~ ttLL ,c ~e#: 9/d d ¥,/?,,::? ~,:P°
/
Date: Z/2~, /4 ,:::31 3 "'waiver Is valid for up to one year from ARPO's Signature*
Revised August 2022
8/17/23, 4:02 PM USPS .com® -USPS Tracking® Results
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Tracking Number: Remove X
70220410000055307998
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Latest Update
"Tl You r item was del ivered to an individ ual at the address at 12:12 pm o n J uly 8 , 2023 in ro
(1)
KITTY HAWK , NC 27949. o..
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7-'
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• Delivered
•
Delivered, Left with Individual
KITTY HAWK, NC 27949
July 8 , 2023 , 12:12 pm
Departed USPS Regional Facility
ROCKY MOUNT NC DISTRIBUTION CENTER
July 8 , 2023 , 4:27 am
• Arrived at USPS Regional Facility
ROCKY MOUNT NC DISTRIBUTION CENTER
July 7, 2023 , 1 :59 pm
i Departed USPS Regional Facility
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SENDER: COMPLETE TH/S SECTION
■ complete ltem_s.3, 2,. and 3. ,
, ■ Print your ~-end addl'888 on the reverse
so that we ~·tatum the card to you.
■ Attach thls ·eari:I to the back of the mallplece
or on the front If space permits. '
1. Miele Addressed to:
; PS Form 3811 , July 2020 PSN 7530-02-000-9053
SENDER: COMPLETE THIS SETT/ON
■ Complete Items 1, 2, and 3.
■ Print your name and address on the reverse
so that we can retum the card to you.
■ Attach this card to the back of the mailpiece,
or on the front If space permits.
: PS Form 3811, July 2020 PSN 7530-02-000-9053
' .
D. la delivery addlwe <ll'lenlnt from Item 1? □ Vea
If YES, enter delivery addr8N below: □ No
Domestic -Return Reoelpt
o. Is d'dferant from Item 17
If YES, enter delivery addrN8 beloW:
Domestic Return Receipt
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