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Home My WebLink About89717A - PolkC�ICAMA ❑ DREDGE & FILL N° 89717 45) B C D ;a° GENERAL PERMIT Previous permit Date previous permit issued New ❑ 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 '4u' %ate ❑ Rules attached. X I General Permit Rules available at the following link: www.deq.nc.gov/CAMArules Applicant Name ga r br• rc, Address f 3c�$ ('sfOo!dbnq br City f'olsrWl'i,.,,. State Nt,. zip d-A-44B Phone #(IT04) 33S- 500(0 Authorized Agent 1] c 1& Project Location (County): Du C 2 Street AddreWState Road/Lot#(s) 110 Sc,)aJ,bo.z or, Email Poly, low P4: lin"�l , Cw Subdivision Co I .nti � �-' - r 6o City Co 1"n!l fw ZIP ],`}q L4 43 Affected ❑ CW NEW ® PTA ❑ ES ❑ pTS Adj. Wtr. Body l..a n L k (nat(!1g)nk) AEC(s): ❑0EA ❑IHA ❑UW ❑lSPIMA ❑PWS Closest Maj. Wtr. Body_ gcr^arle So.�..d ORW: yes PNA: yes Type of Project/T `Activity-� _�v,Ir �}= X )3'X(• 14 7rlr. ,,l�r Ply}(ur , ha} Rn bL)\Yh;oA d',1 N')cafl tt (Scale: W X.S, Shoreline Length t 53' Access Length Pier (dock length ' ed Platto 13� XL X 14 Floating Platform(s) Finger pier(s) Total Platform area Groin length/# Bulkhead/ Riprap length Avg distance offshore Breakwater/Sill Max distance/ length Basin, channel Cubic yards Boat ramp Boathouse/ Boatlift Beach Bulldozing Other En !Ss«r1.41 ola+fror•r� G SAV observed: yes V Moratorium: CV yes no Site Photos: <f��no � Riparian Waiver Attached: yes C:y✓ r� A building permit/zoning permit may be required by: f�a r e— 0. i Permit Conditions CRC RULES AND CrA t1CA, Itr � E* Flom AVI m , \I I Permit ❑ TAR/PAM/NEUSE/BUFFER (circle one) ❑ See note on back regarding River Basin rules ❑ See additional notes/conditions on back ICI (Please Initial) Si6505—re r'Plt ase rdaTcompliance statement on back of permit'* Sigbature� ` L� o .00 - Icn as-t3 iefta� aoa-'s �Uaua4 Application Feels) �,p N. tac\—{.ti d{ Che�k#/Money Order Issuing Date Expiration Date e&C]CAMA El DREDGE &FILL ' N9 89717 A B C D N GENERAL PERMIT Previous permit Date previous permit issued New ❑ 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: wv5vd nc pov/CAMArules Applicant Name City State ZIP Phone # ( ) Email Affected ❑ CW ❑ EW ❑ PTA AEC(s): ❑ OEA ❑ IHA ❑ UW ORW: yes/no PNA: yes/nb Type of Project/ Activity c Malian.ee k Authorized Agent Project Location (County): Street Address/State Road/Lot #(s) f-o a { Subdivision City Co V _ . ❑ ES ❑ PTS Adj. Wtr. Body C c ru (nattman/dnk) ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body 11,, (Scale: W A- S ) Access Length Pier (dock) length Fixed Platform(s) ■■ . . .�■. ■ :.:.. Floating Platform(s) ME .�..;;: 11Z ::C;CE:C so ::: NOR" N: �'1Avg 0 mom Total Platform area Groin length/# Bulkhead/ Riprap le distance offshor ME MEMO IF 0 •� • :. . ��!� . �. .. �SWOM ■.i.■■ :IN:: i C�:® :::E: Boat ramp.��..: Boathouse/:. : �.■■■. NO:. ■....� ■�.:..■■■■EN EMEE Other N:. m . SAV observed: yes noONN11.1111MEM Moratorium: n/a yes no Site Photos: yes no,! TiriariaTAFalver4xachecl: yes no .■�.o ON ■E:■....NONE ■ NONE ■■E■o MEN■NE■ONEEN mom O N A building permit/zoning permit may be required by: ❑ TAR/PAM/NEUSE/BUFFER (circle one) ❑ See note on back regarding River Basin rules ❑ See additional notes/conditions on back 1 AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial) Agent or Applicant PRINTED Name Signature **Please read compliance statement on back of permit" Application Feels) Check H/Money Order Permit Officer's PRINTED Name Signature Issuing Date Expiration Date p�agn EnVOIOP' o: 269 � � ., w' � N\;.r.\�=.�. .rr.�r.-•-,--:.jam w game Of property Oww Rey MWWV B taKb wv a IN Ins Address: Sao Q�road► Cciiha�ttx� Phone Numtlet: &mn Address: �01 ' bvd L MfWy eW L have Wt (kOd QA E Aparxicaaaaa to sa on my behaLt, for the purpose of appyirl9 tot and abtsmft an LAMA permits nocemmrYfor the toY Oft proposed deveMxymtt: 1K Wcaa .� at my pup" boated gt.a.W In a.>rg, ce\,nry. hgdlerrnore cw* drat i am audwked to grar►r: mW do in tact grant parrrl"on Division d taoastai Merle wmw 86K the t.00ai Par O OffberSW ,eAra 1 to W an dra &#orarnend Pod bfxt in om motion wM evaAOft _ pennitappAcadon• — property Dorm Ydorrr oom oe.msa w e VAAM PA Barbara Polk Print or Type Nome TO 9n /zo23 1 Dale This m"C"m Is vem thtwo r m /V New Bulkhead +- 50' Zin front of existing .................................................. ca %Exisfing bulkhead — co O On Polk 204 Broadway dir 4) to Colington NC 27948 CN L Existing Dock N And Boatlift Af >, New Finger pier (a ca Polk 130 Broadway dr Colington NC 27948 Go CM N.C. DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONAMAIVER FORM CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY (Top portion to be completed by owner or their agent) Name of Property Owner. &,1W xa Pay, Address of Property_ 130 Q-1fQQ An U Q,,r Mailing Address of turner. owners email:Dowlow magi Ltxt-lDwmer's Phoned°: a - 3-�5 50CLO Agent's Name: &ana gn M�it.Vt l I Agent Phone 25 7 a� 5-7 1 t i Agents Emall:l We 917CAr C%-tld 32q C"" - ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION (,Bottom portion to be eomplstsd by the Adiacem PropertyOwnor) I hereby certify, that I own property adjacent to the above referenced property. The individual applying tar this permit has described to me, as shown on the attached drawing, the development they are proposing. A NOT have objections to this proposal. I DO have ObjediOns to this proposal. ff you Kaye ob)acdons to what is being proposed, you must notary me rix. umsron or t:oasun Management (OCM) in writing within 10 days of receipt of this notice. Correspondence should be mailed to 401 S. Gi fn St, Ste. 300, Whobath City, NC, 27909. DCU representatives can also be contacted at (252) 204-SM. MD response is considered the same as no objection M you have been notified by CardNed Mat WAIVER SECTION JChoosa only oral I understand that any proposed pier, dock, mooring pilings, boat ramp, bmakwater. boathouse. lit or groin must be set back a minimum distance of 16 from my area of riparian acoess unless waived by me (this does not apply to t gH02ads or riprap revelments). (if you wish to waive the sedmmk you must sin the appropriate blank below.) I DO wish to waive somelall 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 Props Owner: Typed/Printed name of ARPO: "fit" Mailing Address of ARPO: _ �&S/ n wgp 11 ARPO's email: b e' Ill ARPO's Phonefl: / �7 Date: °'waiver is valid for up to one year from ARPO's Signature• ty7p1/iCP/t yl.muel /1//1n 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: K)CLY�)f Ck Address of Property: Mailing Address of owner: Owner's email:l}C`�,'DW 't'4 k CW`Owner's Phone#: i�q •• ff)L�otL1 Agent's Name: VY LLi`d M t!�1 Lh1 t I Agent Phone#: 6� _1-) q Agent's Email: l'vv cCq'-ctr ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION (Bottom portion to be completed by the Adjacent Probe Lrty 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 I DO NOT have objections to this proposal. I DO have objections to this proposal. you nave objections to what is being proposed, you must nofify the N.C. Dfyislon 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 noiffled by Certified Mail. WAIVER SECTION (Choose on{v 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 15' from my area of riparian access unless waived by me (this does not aopty to bulkheads or riprap revetments). (if you wish to waive the setback, you must sign the appropriate blank below.) I DO wish to waive sometall of the 15' setback Signature of Adjacent Rip -OR- operty Owner I DO NOT wish to waive the 15' setback requirement (initial the blank)Qd?--) Signature of Adjacent Riparian Property Owner: TypedlPrinted name of ARPO: ^{ ( r� JQ �I } a74�� base Mailing Address of ARPO: CX�'�{j (`Qgoj, W � r ARPO's email: �n�► a C'n ARPO's Phone#: ? - q 13 Data. -'waiver is valid for up to one year from ARPO's Signature' {'_Ay\aA li x,,�P"S x4-%5 e_ Revised August 2022