89967A - Appell

CAMA IY] DREDGE & FILL
GENERAL PERMIT
N9 89967 ~ s
Previous permit V
Date previous permit issued ______ _
[] New O Modification O Complete Reissue D 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 I f I I I ( 0 Rules attached. 1£] General Permit Rules available at the following link: www.de(l.nc.gov/CAMArules
Applicant Name ---"'--'----------"---''------'---'-c'-----
Address -~~---------'~~~'--~---~------
City \'I, \ (
Affected Dew □Ew □PTA □ES [JPTS
AEC(s): □oEA 01HA Ouw □sPIMA 0Pws
ORW : yes/~o PNA : yes/n,q;
Authorized Agent --~~·~-~)-"'-~~-'~<_J __ ~~--~---4---
Project Location (County): -----'(~}' __ ., __ f"\ ___________ _
Street Address/State Road/Lot #(s) _/~,_f __ #_,1...~'_Q ________ _
IJ".) ~1
1: r I Po,rd
Adj . Wtr. Body (\ lb '
Closest Maj . Wtr. Body f\!b<
r,-). ~hat/man/unk) ---,.
. (A.( ,J
Type of Project/ Activity _________ c ______ N __ 1_.) ____ t:_~_l _O ___ .J.._ _______ ,_-;--__ (_-_J •_1_1~---
Shoreline Length ___ 1_0_G ___ _
Access Length ________ _
Pier (dock) length _______ _
Fixed Platform(s) _______ _
Floating Platform(s) ______ _
Finger pier(s) ________ _
Total Platform area ______ _
Groin length/# ________ _
Bu & / Riprap length (, (j _,., 1 <
Avg distance offshore _____ _
Breakwater/Sill _______ _
Max distance/ length __ Z.. __ 1 __ _
Basin, channel ________ _
Cubic yards _________ _
Boat ramp _________ _
Boathouse/ Boatlift ______ _
Beach Bulldozing ..,..f ~f.:
Other __________ _
SAV observed: yes \ no
~1
Moratorium: n/a_ yes no
t Site Photos : yes no
Riparian Waiver Attached: yes no
t
t
A building permit/zoning permit may be required by : __ ('_~f'------~---,---------
Permit Conditions ______________________________ _
(Scale: 1
□ TAR/PAM/NEUSE/BUFFER (circle one)
D See note on back regarding River Basin rules
D 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) ---'f'-/----'Jf::;}""1/=------( ,{ t, 11 J ~t~ ,,
Agent or Applicant PRINTED Name .
I ,i;,J 1 1/
Signature **Please read compliance statement on back of permit**
r,
Application Fee(s) Check #/Money Order
Permit Office'r's
Signature #
' )
Issuing Date Expiration Date
AGENT AUTHORIZATION FORM FOR PERMtT APPLICATIO NS
Name ct Prope Owner Applying for Permit
Mailing adoress ·
Telephone Number:
to a I on m behalf or r .a purpose of applying and obtaining all CAMA PBrm1 s
necessary or the proposed development of __ eu_ ..... l _Jt ..... he .... · ..... od_,, _______ _
This certifica ton is valid through ________________ {date)
61gnGt1.1re
r,ue co owner or
RECEIVE D
'" Dae
AU6 t 4 2023
Telephone Number DCM-EC
RECEIVED
AUG 1.4 2023
DCM-EC
N.C. DIVISION OF COASTA MANAGEMENT
ADJACENT RlPARIAN ;PROPERTY OWNE NOTIFICATION/WAIVER FORM
CERTfFIED MAIL · RETURN RECEIPT RE UESTED or HAND DELIVERY
(Top portion. to be complete ner or their agent)
Name of Property Owner: _~.;:_r ::.::r,::.,;· . ...::'}a:;;...;:_,/..,,,C_f _-t=--··-'--"---"-'==+;;;.._-"-r-+-=->.,__,_ ___ _
Address of Property : • ) t= tie tr; 1 {I'
Mailing Address of Owner: I DL/t ··, ..,. lJL. CrJulf.;
Owner's email:,-LL!o:.l<.L'-'-""'-'-'--4=="~~~-==--:.,. : L C, -7t/)-r23b
Agent's Name : •• :> ) ).) · l .Opl r . Phone#: Z_52 l/Z,Lt,• 3/f,.5_$, __
t }L [jL I -i...._/ / ,.,, l J,; /)/' v'l Agent 's Email: o{)c ct,] · Y.Jl _ Y ! -\.! &JU,. r-· . t v '1 N
.J
ADJACENT Rl~ARIAN · ' TION
Bottom rtion tb be c Owner
I hereby certify that I own property adjacent to the above refer need property. The individual applying for this
permit has described to me , as shown on the attached dra ing, the development they are proposing. !:,_
d scri tion or drawin . wtth dimensic!ms must be rovided this letter.
_x I DO NOT have objections to t his proposal. --+-I DO have objections to this proposal.
If you have objections to what,~ being proposed, you must notify the N.C. Division of Coastal
Management (DCM) in writing within 10-days of receipt f this notice. Correspondence should be
mailed to 401 S. Griffin St., Ste. 30(), Elizabeth City, NC, 27909. DCM representatives can also be
contacted a.t (252} 264-3901. No refiponse is considered e same as no objection if you have been
notifled by Certified Mail.
WAIVER SECT!
I understand that any proposed pier, dock, mooring pilings, b at ramp, break.Water. boathouse. lift, or
grorn must be set back a minimum distance of 15' from my a a of r iparian access unless waived by me
(this does not apply to bulk.heads or ciprap revetments). {lfyo wish to waive the setback . you must sign
t he appropriate blank below.)
I DO wish to waive some/all of the 15' setback
-OR-
I do not wish to waive the 15' setback requirement (initial the lank) _____ _
Signature of Adiacent R iparian Property Owner: _____________ _
::,:::::::.:·:::.:Po /l~be~~~";it;; n,~~:£:1eM vvm_
ARPO 'semail:C.f,..,.-,sfrcm6niif;f;>1~'1AR~'sPh e#: 252 312 55'2.G
Date: 7 /( 3 ljS *waiver is valid for uo to on vear from ARPO's SianaturA•
RECEIVED
AUG 1 4 2023
DCM-EC
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: .-Rma..Jcf + -}b;,V)U.,I 0-A-p p.e,, t {
Address of Property: 1 J 5 tl-en'toC) e ✓ ·ye 1 "l + 1') v f3:j.g.N\ -1o n NC
Mailing Address of Owner: IDL/LJD f' 01, \~~li()td DY--l?Ctl tnV)/ fl~ C¥lulJS
Owner's eman :D(lln1omi=o-ni3qr{'C\.d g~X's Phone#: Ctol-7 D 1-r23b
Agent's Narne:~YulUn5 LOrcf:tevet~p )'(°(jA gen t Phone#: ZS2 LJZ✓Li 31.t;S~-
Agent's Ema il: 8heLloLJ bid I v1C((J t)(lfJ()O}: -(t)~
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 t his
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 [phone]. 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
-OR-
I do not wish to wa ive the 15' setback requirement (initial the blank} _____ _
Signature of Adjacent Riparian Property Owner: ____________ _
Typed/Printed name of ARPO: _'_-~_t_,,_UC_<_"fe __ ._C_K _____________ _
Mailing Address of ARPO: _____________________ _
ARPO's email: bnroecktyD:£ ·COO l ARPO's Phone#{ZS2 ) 3'.-LfQ -2 651
______ Da_t_e_: _D_7_/_\L:5 __ .... / .... 2J> ........ ---....-•w_a_i_ve_r_i_s _v_al_id _f_?r _u_o !o one vear from ARPO's Sianatura*