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HomeMy WebLinkAbout89849A - Jones, M.❑CAMA ❑ DREDGE & FILL N9 89849 a, B C D Previous permit GENERAL 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 I ❑ Rules attached. ] General Permit Rules available at the following link: wwwdeq.nagov/CAMArules Applicant Name _ Address City Phone # ( ) Email ! State P Authorized Agent Project Location (County): Street Address/State Road/Lot #(s) _ Subdivision "'0, City i. Affected ❑ CW 0 EW ❑ PTA ❑ ES ❑ PTs Adj. Wtr. Body I r' t,: . (fiatJman/unk) AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS 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 Groin length/# Bulkhead/ Riprap length Avg distance offshore _ Breakwater/Sill Max distance/ length _ Basin, channel Cubic yards Boat ramp Boathouse/ Boatlift Beach Bulldozing Other J� J_ SAV observed: yes no I Moratorium: n/a yes no 1 Site Photos: yes no-� Riparian Waiver Attached: yes no _ A building permit/zoning permit may be required by: 0 A\`, Permit Conditions (Scale: I) ❑ 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) Y, Agent or Applicant PRINTED Name Permit Officer's PRINTED Name Signature•*Please read compliance statement on back of permit" Signature Application Feels) Check #/Money Order Issuing Date Expiration Date IUv �Yti� IUyo N.C. DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONfWAIVER FORM CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY (Top portion to be completed by owner or their agent) Name of Property Owner: Y19 R Y'c C bizz'T T kNG�s Address of Property: R Mailing Address of Owner: me — Owner's email: C I VO C o r'YI Owner's Phone#: Sqz, oS -q1-3 � / • Agent's Name N A Agent Phone#:Al L,}- Agent's Email: L ADJACENTRIPARIANPROPERTY OWNER'S CERTIFICATION_ (Bottom portion to be completed by the Adiacent 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. 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 (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 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.)=(�L/!//J/! I DO wish to waive some/all of the 15' setback - c FI i� Signature Aiijecent iparia Property Owner -OR- I DO NOT wish to waive the 15' setback requirement (initial the blank) Signature of Adjacent Riparian Property Owner. V � Typed/Printed name of ARPO: %,r/y,o r i%WeA1 :44 +1 Ae64P✓.v17 X ILL Mailing Address of ARPO: P,0 , 8" aj (P J f ARPO'semail: (/�LJ�S� y�tnr<iuvKAARPO'sPhone#: '757 4J) 1a37 Date: 9/s13Po13_*waiver Is valid for up to one year from ARPO's Signature' Revised August 2022 Sa.,th ,h �Li90 N.C. DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY 5 (Top portion to be completed by owner or their agent) 0:54V Name of Property Owner: hr1 A Q Cr A R EI J J N E SQ Address of Property: jS"UV &&6�7 .Dr-L. WC tN^^l i �_ Z 79y? Mailing Address of Owner: S[Z.*K_e11 GL� 'et b4✓� Owner's email: M '� A A/E-5 /do EJ Owners Phone#: S `/ U `j 0 S aJ /3`f Agent's Name: Agent Phone#: A Agent's Email: ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION {Bottom portion to be comptetettbythe Adjacent Property Owner) I 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 NOT have objections to this proposal, I DO have objections to this proposal. it you nave objections to what /s being proposed, you must notify the N.G. Division of coastal Management (DCM) in writing within 10 days of receipt of this notice. Correspondence should be malted 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 15' from my area of Hpadan access unless waived by me (this does not apply to bulkheads or riorao 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) Signature of Adjacent Riparian Property Owner: SSetr Typed/Printed name of ARPO: I AgELf I VOVP�j 1LPGIL by �/Iy' / r� Mailing Address ofARPO: 537nn0 QI')OA14L- ! Or�o��� V14 %3502. wu ARPO's email:i(1I�ij D AOV2V0YU A IOARPO' Phone#: r% 52� � r? I - 3 / 00 Date: H ( I i uit -waiver is valid for up to one year from ARPO's Signature' Revised August 2022 ■ Complete Items t, 2, and 3. A. Signature J Print your name and address on the reverse �. Agent y X �c so that we can return the card to you. RWdm ■ Attach this card to the back of the mallpiece, B. Received by (Printed Name) J C. We of Deli or on the front if space permits. r- tn" 7. Article Addressed to: _ D. Is cieilveryaddress di0arent horn item 7 es X ca r� `9'/`��%— It YES, enter delivery address below: R No 3YY9 N. Mil; y Nwy poi jal4e, vA z35i8 3. 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Article Addressed td. to 40&x1a r z/to Win ft / P. 11 1 y-r, D. le address rifterd from Ram l? ❑ Yes If YES, enter delivery acidness below: R No Wa)v�Lt/ee V SSg� 3, SultSig Type IIIIIIIIIIIII�IIII IIIIIIIIN�INIII IIIHIH ❑ "fi signstore ❑ ed Restricted Delivery 9590 9402 7482 2055 9395 61 Certified Man a oe Mal t DoMmy 7022 0410 0000 5532 3653 PS Form 3811, July 2020 PSN 7530-02-000-9059 0 ❑ Rbrtty Mall Expense ❑ Registered Md- ❑ Redateratl o ry Mall ReanldeO ❑ Slgnatun Conimason1- ❑ Sgnature Conhmatbn R*Wctsd Deliwry Domestic Return I / $ � 09ra pole located 7PmIII lilt m 2:out from V n» musk -m arrow MPAM _r � w�! T|MMONSGROUP ;{»m&_PLAN FOR -VJM_s NC"' LLCg� — �, i ,,`., j,I �+ it �;'.t ,:,; y �� .i 1� '�";,,,j, :,P