HomeMy WebLinkAbout87003A - Beneck7.. `{5 P-tiv i F'Y ;J VR,�,.L/VG at r11116.E6 L
GENERAL PERMIT Previous permit
Date previous permit issued
New E]Modification 0Complete Reissue DPartial Reissue
As audtartzed by the State of North Carolina, Departrrxant of Environmental Ouzity and the 4 .costal Rtxnurccs Commission In an aw of emironmcnud coroetn pursuant to:
I SA NCAC `� ` I � Rules attached. Genera'. Pem e Riles available at the foliowaag link: st�+ry st ".Lg ggy�GhMFuules
Applicant Name-__.'�5Oi`.In, d,
Address 211A CarJSL �%NN1(- .
city_ j (ar-d S Rr—
Email
Authorized Agent
Project Location (County):_ —
St AddressiStare Road/Lat#(s)„ # .
sutidNW,ior, s
City �-ti"xi'- `r-t7(
Affected DCW 11Vm gm DES DM Ad. Wt:. Body__,f�runfunk
A€C.(s): DOEA DIVA DUW D5PIMA DPWS Cinsest hktj. Wa. Body /
ORW:. Yes/ PsNA: veSSwc)
rypeofProject/ Activ)ty c. �61X(eri a"'T' s<y%ite'..R1 4 nl,c} t». s_l 2-01Ki71
t4' xlt�' 10u et �t�vv m rrr m
(scale: N'T$
shoreline ienRth Ty` J�'�
Access Length "' ......
Pier (dolki Iength
ibred PfaUorm44s) _� A� ?x .. ...
Floating Platforms)
Finger plerisl
a
Total PlaNarm area �sQ� -�'}— T� '
Grain length/# b*c`1i^rtt,n'R S�
Bulkheadl Riprop iength
y —
Avg distance offshore
Max distance/?eng:h "
Bas:;n, charnel _...
Cubic yard; r..,, .:... ... .. :
Boat ramp ....,..;j
Boathouse/Boatlift
Beach 80dozfng
tither
$AV abservefi:
Moratorium: yes no
Site Photos: no
Riparian Waiver Attached: a no
A build leg fastmit/tuning Permit may be tequired by.
Permit Condiocins TARMWUN EUSFJBUFf€R icircle oft)
. .,,..�_...�,..._,�, See note on back regardire,, River Basin rules
T See additional notes/ccnditipns on back
I AM AWARE OF STATUTES,CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial)
,�t7ita IE�J �p i y/;e.
(Rent Or AP t PRINTED, blame
�� "Please ead c�mpkerc=_statement n back 4f mint"
Rix 11-51
application fee(s) Check p/Money Ordrr
Signature � --
tl/!�f 1 Z3 3/irq lZq
I ssuins Date Expiration Date
®CAMA ❑ DREDGE & FILL
GENERAL PERMIT
N New ❑ Modification ❑ Complete Reissue ❑ Partial Reissue
N° 87003 ib B C D
Previous permit
Date previous permit issued
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 rI H ` I Zal ❑ Rules attached. N General Permit Rules available at the following link: www.deq nc gov/CAMArules
Applicant Name---JOr`Y% S +Slcx
eel
Ueha Cy,
Authorized Agent
r
AddressaIi+g GMSS S4
7o1'(X
o�
PA.
Project Location (County); - %
''``�
City ge'-4arCI State
N.L
ZIP a1`�44�
1
Street Address/State #(s) o' 'it 2,
Phone # (2001) III- I W7
^Road/Lot
l Ss.( ?O IK2,01
Email
Subdivisionr$4Rot' br.
City ZIP a- ( G-J',
Affected ❑ CW MEW
® PTA
❑ ES ❑ PTs
Adi, Wtr. Body e t O nan/unk)
AEC(s): ❑ OEA ❑ IHA
❑ UW
❑ SPIMA ❑ PINS
/t
Closest Maj. Wtr. Body 41
6�' "s 1,2 S1d
ORW: yes/(E) PNA:
yes/0
Type of Project/ Activity
Z 4 r x I b'
0
4
Shoreline Length
Access Length "�
N
Pier (dock) length f es
Fixed Platforms) Ilnt '-A 111 �.
�Zi Y'x14,' �
Floating Platform(s)
Finger pier(s)
Total Platform area �q�f 5gi-�
Groin length/N
Bulkhead/ Riprap length -�
Avg distance offshore
Breakwater/Sill
Max distance/ length
Basin, channel
Cubic yards
Boat ramp
Boathouse/ Boatlift ^M
Beach Bulldozing
Other �kY
N
SAV observed: yes 0n If
Moratorium: ® yes no
Site Photos: (a no I
Riparian Waiver Attached: es no 1�,
A building permit/zoning permit may be required by: 1 (?hi9
Permit Conditions
I AM AWARE OF STATUTES. CRC
Agent or Applicant PRINTED Name Permit
reap lb -
(Scale: (\ITS
c4+ba,u,ar fe
❑ TAR/PAM/NELISE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
(Please Initial)
Signature *'Pleaseuad compliance statement on back of permit* -Signature v
i9,w .Q- 12511 ji//4/Z3 3//y/Zy
Application Feels) Check M/Money Order Issuing Date Expiration Date
❑CAMA ElDREDGE & FILL N9 87003 A B C D
GENERAL PERMIT Previous permit
3 Date previous permit issued
0 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: wwwdeq nc gov/CAMArules
Applicant Name
Address
City State ZIP
Phone#O �(it•i
Email
Authorized Agent
Project Location (County):
Street Address(Stete Road/Lot #(s)
Subdivision
City_
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTs Adj. Wtr. Body (nat/fnan/unk)
AEC(s): ❑ IDEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body
ORW: yes/no PNA: yes/do
Type of Project/ Activity
(Scale: )
Shoreline Length
Pier (dock) length
■
n■
■■■■■n■■■■■■■■IMIN
Fixed Platform(s)
■■■
1.�1■■■
■�
�■■■■
No
Finger pler(s)
ii
■ENE
®6■
■
No
MEN
'■C
ins
NO NO
III
ni
OEM
no
an
No
MIN■
■■■0
imom
Win
I
Emil
'EN
MEN
1111
min
nn®■■■
■
■■n■.■■nM0
nIN
I!■
■�■
m■■■■■■■n■
■■■■■
CubicyardsIN
ib...
l�
��0■11
�■�"ri�
Boat ramp
�1
■'"■
rTi�
�.
"'
Boathouse/ Boatlift
■
ni0
nii■■n■■n■■■
■
No
Bulldozing
ME
mom
nm.n�.�■
.n■■iBeach
®■®��
�AV observed:
yes no
■
■■■■n
■■in■■■■'�i■n■nuiiiiii
n/a
yes no
:MIN
:::::in•Moratorium:
::":::C
Cite Photos:
Yes no
Riparian Waiver Attached:
ves, no
A building permit/zoning permit may be required by: (� S 6, iv
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. (Please Initial)
Agent or Applicant PRINTED Name
Signature '-Please read compliance statement on back of permit• -
Permit Officer's PRINTED Name
Signature
Application Feels)
Check A/Money Order
Issuing Date
Expiration Date
N.C. DIVISION OF COASTAL MANAGEMENT RECEIVE®
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY OCT 3 0 2023
(Top portion to be completed by owner or their agent)
Name of Property Owner: Sb Nj A(N!) �G�tYGF1 1 8N�— ID��r�
Address of Property: Z41 62JZ"sy �pi�T t✓li if t�l�r 27q�
Mailing Address of Owner: 5I°SML
Owner'semail:5�64meck@4mni).cm Owner's Phone#: Z41'iI'Z-Ilb7
Agent's Name:
Agent's Email:
Agent Phone#:
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 forthis
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.) 17
I DO wish to waive some/all of the 15' setback
sm
I DO NOT wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property
Typed/Printed name of AR
Mailing Address of ARPO:
4Pi's Yi � ty&r t
ARP0's�email: C(0r�m�S rn u„sO-CclM ARPO's Phone#:
�-/
Date: A /�-3 *waiver is valid for up to one year from ARPO's Signature*
Revised August 2022
N.C. DIVISION OF COASTAL MANAGEMENT .ECOVED
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY OCT 3 0 293
(Top portion to be completed by owner or their agent)
Name of Property Owner: J m i AJP S;Re�y �EJfCI� ACM EC
Address of Property: Z19 of IT -RD. I 14fR-TFo20 Af Z7g44
Mailing Address of Owner: %5A M I -
Owner's email: Coat Owner's Phone#: 7-o7 - 7 / 1-- 71 �p 7
Agent's Name:
Agent's Email:
Agent
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 forthis
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.(;. uivrsion or t;oasrai
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 (Cho
I understand that any proposed pier, dock, mooring pilings,.
groin must be set back a minimum distance of 15' from my
appropriate blank below.)
I DO wish to waive some/all of the 15' setback
M
ramp, breakwater, boathouse, lift, or
of riparian access unless waived by me
ish to waive the setback, you must sign
I DO NOT wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian
Typed/Printed name of ARPO:
Mailing Address of ARPO:
Owner:
zlfyzj
ARPO's email: G ' ARPO's Phone#:� "� ►b` I Y�
��l aWY/\
Date: 3 *waiUver' is valid for up to one year from ARPO's Signature*
Revised August 2022
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