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Home My WebLink About87001A - ScottoAC0A5" ❑CAMA ❑ DREDGE & FILL N9 87001 A B C D Aff GENERAL PERMIT Previous permit 3 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.deq.nc.gov/CAMArules Applicant Name _ Address City Phone # ( ) State ZIP Authorized Agent Project Location (County): Street Address/State Road/Lot #(s) City Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body (nat/man/unk) AEC(s): ❑ OEA ❑ IHA ❑ UW SPIMA ❑ PWS Closest Maj. Wtr. Body ORW: yes/no PNA: yes/no .. Type of Project/ Activity (Scale: ) Shoreline I meth Pier (dock) length Fixed Platform(s) —H ■��CIC� ��: CElm �■ : ..�®��::.SC::�C: .■ ..� ` ®::ii::: mom ■ mom amom ■■■■■■■a.. ■■® ■■�■■■■■■■■■■■■ B� Ions I pi . ■ 0� , a■■ a■■■■■■■■ �n ■■ ■■.ii■■■......... ® 0 ...■�■��.�■■...■■■■.�O ■■NNo MEN 0■�■niiiu�L�i■� ■�i� N■OEM ■■■■®■.®I��..■■..■■MEN ■■ME C■.■ ON ■■ ■■■ .■ .■ ■ .■. 1110 ■■■■®I A building permit/zoning permit maybe 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 readcompli3nce statement on back of permit" Signature (Please Initial) Application Feels) Check M/Money Order Issuing Date t' Expiration Date AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: l t Mailing Address: Phone Number: Email Address: I certify that I have authorized 103 - Z�Z-ra�lato to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: I b at my property located at Lot A� I `7 in V a !✓ County. I furthermore certify that 1 am authorized to grant, and do in fact grant permission to Division of Coastal Management staff, the Local Permit Officer and their agents to enter on the aforementioned lands in connection with evaluating information related to this permit application. Property OwDRA Information: v Signature , ( - �'E� Print or Type Name DW t l — 0-- Title 10 1 4 1 202!) Date This certification is valid through IC 1 41 1 2p2' A REC -NED BET 3120 DCM-EG N.C. DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIYER FORM RTiFtED Mlj ,. R&TVRN RFR�. ,EIP'T ft_F. ggE,�, r HANt? DLLIV}r_etl (Top portion to be completed by owner or their agernt) Name of P(vtrrr(ty rocs, of P101)eriy fileginct Address of Owner. A J C t_ agent Phone# Z J '_ `I) • `-K7 IC) agent`s Narce ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION �„ottynm oariio' ti ua cMtittietad try ttta AdIW4ar!i �rooattY Owneri 1 hortley cerhfy that I owrl property adjacent to the above rafereimt kxt prGVerty. Tile tndividuai apPiy+l+g for iras pormtt has desedbed to mo, as shown on the attented drawing, the development they are proposIN A c tgU/wi x +r h.4 TiTr+t�, isiSti.PKX?uI?jL0- 3112 lath• V 100 NO'f have obteettons to this proposal- __._...._M 100 have oia(ect+ons to this proposal. _..,_._..._.. _..__._.. u Rtuar rwury ure .........,.o.,... _ _. ff yotr have objections to what Is being ProPoss . lWanagament (DCM) to Writing wtttttn to days of rocelpr of ttris oottca, Corraapondanra should be n3aUod to 943 Washington Stittare VON, Washlrigtan, NC 27$ra9. DCAe rsprasentattves can also be csrnlactarl at (252) 946.6481, No response is considered the same as no oNectiorr it you have been norihtat by Car~ Ai WAIVER SECTION I mndarestar d that any W000aed tri+N, dock, moonnq pa rn7s. boat -amp, breakwater, boathouse, Nh. of groin must bij wt ba,_k it mirri num d*bInco of 13' tronu my area rat 'Oarfan 40M3 Welm wa4"iW3 by me ins does not apply to balkheeds or mi ra"tmentsj. {If you wish to waive gta se"O' You ( gmAw the apprapriaio hunk below DO wish to waive som(N'ali ry1 the i 3' setback Signature cY Adpacarrf Ripsr3en NroPartY owner •OR, I do not wish to waive the 16 setback requ,=r+rment pnival the blank) Signature of Adlaimm Riparian Property Owner TyPedlPrinted name of ARPO: Mailing Address of ARPO: ARPO'a email: AjjrC�:�.a 1. t+m ARPO'o Phone1 Date. �p o 'wawa! to valid for up to ane year from ARPO`s Signaturo` tRevised July 2021 IFlliED SM: R;-. i1Q KTAL SERV1�'ZE XU, DUMFR"'ES _ 1,9119 MAIN ST DUMFRIES, UN 22025-9998 8 10/10l2023 00)275-8777 11:33 pM Prcduct Otv Unit Price Price - - US Flag #10 Env 1 $0.85 i 3.65 First-class Mail@ 1. 3u.66 Letter, Stuart, FL, 34998 Weight: 0 lb 0.80 oz Estimated Delivery Date Sat 10/14%2023 Certified Mail® S4,5= Tracking N: 9589 07:W 5270 1304 402E 12 Return Receipt. Tracking N: 9990 9402. 8:0 3156 8542 tiff Affixed Postage 6,6 Aff xed Amount: $0.66 otal £>7.Sc Grand Total. ,asn Change �11.25 text your -:racking number to 28777 (2t1:Pc) to get the latest status. Standard Massage and Data rates may apply, You may a'so visit www.usps,com USPS Tracking or call 1-800-222 1811. Preview your Mail Trac'c your Packages Sign up for FREE @ hops::/infor,medde`ivery,usps,cora All sales final on s:amps and posta;)e. Refunds "or guaranteed services cr,i ,. Thank you for your pusiness. Tell us abou-: your experience, Go to: ht:PsWPOStalaxpe-ience.ccm/-?,�s or scan th s code with your mobile de ice, or call 1-800-410-7420, UFN: 512706--0013 Receipt H: 840-52200046-3-6960254-1 Clerk: 11 RECEIVED OCT 3 12023 DI. M-EC USPS.com® - USPS Tracking® Results https://tools. usps.com/go/TrackConfir[nAction_input?origTrackNu... USPS Tracking® Tracking Number: 9589071052701304402542 Copy Add to Informed Delivery (https://Informoddelivery.usps.com/) Latest Update FAQs > Remove X Your item was delivered to the front desk, reception area, or mail room at 10:11 am on October 13, 2023 in STUART, FL 34996. 'r fD Get More Out of USPS Tracking: a rs USPS Tracking Plus® Delivered Delivered, Front Desk/Reception/Mail Room STUART, FL 34996 October 13, 2023, 10:11 am Arrived at USPS Regional Destination Facility WEST PALM BEACH FL DISTRIBUTION CENTER October 12, 2023, 12:55 pm In Transit to Next Facility October 11, 2023 Arrived at USPS Regional Origin Facility MERRIFIELD VA DISTRIBUTION CENTER October 10, 2023, 7:05 pm USPS in possession of item DUMFRIES, VA 22026 October 10, 2023, 11:27 am 1 of 11/15/2023, 4:52 PM Durt, km i 1pi OwdooW $ 0 R*tUM f44VCWPI (0f4PQjr*N0) C4rood MWI AftlrWod DoINNY AdOft StgnWA90 Roqufmd 0 Adult Colature ndoldClod 0411VWY A IayI . too RECEIVED OCT 3 12023 DCM-EC 4ull fi!n Postmark Horo LEFTSide Dock 6'Wx 1201 (720sgft) Right Side 6ft x 50ft (300sgft) walkway Platform 16'W x 16'L(256sgft) Metal Roof Boat slip 2 Jetski Lifts * Pilings will be *Joist 4"x6"c * Girders 4" x 1 * Facer Boards w x a * All Bolts W Timber Bolts Stepdown 141 x 16' (224sgft) E RECEIVED )ee Scott ajestic Circle Hill, NC 27957 OCT 3 1 2023 DCM-EC USPS.com® - USPS Tracking® Results hutps://tools. usps. com/go/TrackConfirinAction?tRef=full page&tLc=... USPS Tracking® Tracking Number: 9589071052701282133254 Copy Add to Informed Delivery (https://informeddelivery.usps.com/) Latest Update FAQs > Remove X Your item was delivered to the front desk, reception area, or mail room at 6:42 pm on November 1, 2023 in DURHAM, NC 27701. T CD rD Get More Out of USPS Tracking: 6 USPS Tracking Plus® Delivered Delivered, Front Desk/Reception/Mail Room DURHAM, NC 27701 November 1, 2023, 6:42 pm • Out for Delivery DURHAM, NC 27701 November 1, 2023, 7:14 am • Arrived at Post Office DURHAM, NC 27703 November 1, 2023, 7:03 am • In Transit to Next Facility IOctober 31, 2023 • Departed Post Office WASHINGTON, NC 27889 October 30, 2023, 4:01 pm USPS in possession of item 1 of 11/15/2023, 4:55 PM E 0 q I E 0 i J J pqq Ul W < Z M