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Home My WebLink About89871A - Vestal & Hensley❑CAMA ❑ DREDGE & FILL NI? 89871 A B C D fA GENERAL PERMIT Previous permit s0 [] 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: 15A NCAC ❑ Rules attached. ❑ General Permit Rules available at the following link: www.deo.nc.gov/CAMArules Applicant Name _ Address City Phone # ( ) Email I ZIP Authorized Agent Project Location (County): t Street Address/State Road/Lot #(s) Subdivision City Affected ❑ cW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body (nat/man/unk) AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Mal. Wtr. Body ORW: yes/rid; PNA: yes/no Type of Project/ Activity (Scale: Access Length Pier (dock) length Fixed Plattorm(s) Floating Platform(s) Finger pier(s) �I r ~- -i;r o �t s '1 Total Platform area i �_ _ _ Groin length/p _ _ �— `�'� —1,— _ — Bulkhead/Riprap length r — —� --�-- Avg distance offshore—{— -- --- - -}' —�i'- �- - Breakwater/Sill - - --� \ I `- - — Max distance/length - Basin, channel`- Cubic yards Boat ram P Boathouse/Boatlih I Beach Bulldozing Other t_ -: .__.t ilk— F_ ` SAV observed: _ yes no— .r r ; - Moratorium: 'n/a yes no Site Photos: yes no -I — T Riparian Waiver Attached: yes no A building permit/zoning permit may be required by: Permit Conditions ❑ 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. Agent or Applicant PRINTED Name Permit Officer's PRINTED Name Signature "Please read compliances[ tement on back of permit" Signature Application Feels) Check q/Money Order Issuing Date (Please Initial) Expiration Date N.C. DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM SEP 1 4 2023 CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY (Top portion to be completed by owner or their agent) DCM-EC R Name of Property Owner: VZ:P^bA 14o^s u1 ► *n1yas441 /� ` r,L b Address of Property: 3 V� S/r^LL �: U/ Lr� 1i2 . O" Mailing Address of Owner: stleYI g. Owner's email: //�% Owner's Phone#: r7 57 t — `i-t ' 3a ilk Agent's Name: )GeTJAMId nB �a , /Agent Phone#: Si "3tS j- �3r3 Agent's Email n�'✓lL �fAjd A(- C HOj/Yt.4: ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION (Bottom portion to be completed by the Adiacent Property Owner) I hereby certify that I own property adjacentto 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 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 grain 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 Signature Adjacent Riparian Prop- y caner -OR- I do not wish to waive the 15' setback requirement (initial the blank) Signature of Adjacent Riparian Property Owner: Typed/Printed name of ARPO: 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 EEC E I V E D ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM t y p023 CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY SEP (Top portion to be completed by owner or their agent) �^�.�nn C Name of Property Owner: Address of Property: 3UU S/tnQlt A� C--/Iz . c: ✓t c 1 �`2a4 Mailing Address of Owner: S r�Y4�ti IJ Owner's email: /�-7V Owner's Phone#: L Sri % 1-t "3.;I&c)- Agent's Name:1GNd1n j' I-lAf rX4L nn AgenttPhone#:aSa 331"%3(3 Agent's Email: Iu �Gia+l % L ^� L gv✓ A,94r 1 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 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. It 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 X i -OR- 1_� I do not wish to waive the 15' setback requirement (initial the blank) Signature of Adjacent Riparian Property Owner: Typed/Printed name of ARPO: Mailing Address of ARPO: ARPO's email: Date: ARPO's Phone#: 'waiver is valid for up to one year from ARPO's Signature* Revised July 2021 w fA) 46/ O• c,, 4- i- � � " a .k�td �:f i ' ✓ � 'a r: �. � � �� _ � :� _9 �,� _, i 03 r, �� t i i � �� 4 i-�� i3 � �� ,� , �r� .r ,�'� y '� �� Rf tiT`,`�� r��I Y+H� � � rV��S i��' �� i F, IR � � � a: ��' � , f t #�d < (1 '' 1 v t ■i�' � R'�j�:> , y d11 t14 � ,y. Y � 1; .1 ,�, �,+ r1y �IW 11"!i � i^c r. '1 C � �' 4 _ .— t� i`��1 � _ T � `,I t _ _ � .. r__ p� NO&I S �/ � a ad It-� 11 ,,.. •� �t�L'�kj'4At -: �� e* _ �, '.� .. �. ,. ` M1 ,--.., a .. 1 � _ i ..:.a.: �tR �.., 1 ,i" — ;; t1J PAi s f +4 r� CD 0