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Home My WebLink About87018A - Sullivana°ttoAar" N EICAMA ❑ DREDGE & FILL N9 87018 A B C D a� Previous permit I 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 ❑ Rules attached. ❑ General Permit Rules available at the following link: www.d .nc.gov/CAMArules Applicant Name t r'• I'±.. ; (� �t Address City W" ,, State '/ ZIP Phone # Ci6A @ , Email i t f Authorized Agent .)'i 'r r ):_ d'I ,A, IrI i s )t-- C'.1 , Project Location (County): C U ( it I i'��C: Street Address/State Road/Lot #(s) City .:i 1 Affected ❑ cW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body /k ! , (nat/man/unk) AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Mai. Wtr. Body CI yes/no - PNA: yes/no Type of Project/ Activity (Scale: i ,.lip) Access Length Pier (dock) length Fixed Platform(s) IINIIIESEE MINE, ■NMI ■■ M Finger pler(s) Total Platform area length/# Riprap length Avg distance offs here Max distance/ length Basin, channel Boathouse/ Boatlift�Cubic yards Beach Bulldozing MEN Other lil��■file■■■■Groin ►j�■H`� •rMBulkhead/ �. �■� � l�l�� l Komi No 011111 ■■■■A■ IN ■■ ■■ .��o . i 1 ■.;■ ..■�■■■ . ■■ ..�■�i ■ �� L�■l�HE Sam .■. SAV o - .no no ,.....Moratorium _.. ree Photos: r. �..� .. ._ C.� ..........■ .. ■■.■.....C.■ E 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 PROJECTAND REVIEWED COMPLIANCE STATEMENT. (Please Initial) Agent or Applicant PRINTED Name Permit Officer's PRINTED Name Signature **Please read compliance statement on back of permit** Signature Application Feels) Check ft/Money Order Issuing Date Expiration Date N.C. DIVISION OF COASTAL MANAGEMENT AGENT AUTHORIZATION FORM Dole Name of Property Owner �iApp! iiny for Permit: `� ---�II'I It . ._-�.(_.11lL--1--14LI...,�.lr �. Q.—��,1 ro-) Mailing Address: 3q 'I tut M� U �,, �,� �aydmat-kCusfal+-+ 1 certify that I have authorized (agent) ! 'stir u�.!+✓j j � .1-1, to ad on my behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to install or wnsfrvd (adivily) Nt 157 fill QY _, of (my Property located oq _ go k .{ f'1 }�(A Q.{}f li1 _) .270� This cenifiwllon Is valid thru (date) 31 IRD pro y Owner Signature Dah ck" Mk-PNIW.a P9p 9 91 9 f.AsM ,i, 27. R2! 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: W 11 1i I' 1 a t?J't'I d- PQki (, r J a a hl ✓ll /1 Address of Property: au (_fl&-hjca._ft. i4arb1rVjer—, /U/„�Z7gg1 Mailing Address of Owner: 31( I W'1 q Ts la nel b r Owner's email: 2Sl7,Ltv-tfd Ah i' r llr L A `Owners Phone#: T�`�� 4J y 367 Agent's Agent Phone#: 005 Z-o7Go!'3�0£'j Agent's Email: YYfn r /t /) Ji-fries V)K!5ULA t I dt°r s agaRiwmmmwmw ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION (Bottom portion to be completed by the Adjacent Property Ownerl 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. n you nave oofepuons to wnar is oemg proposes, you must notify the N.C. 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 onal 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 elan the appropriate blank below.) I DO wish to waive some/all of the 15' setback Signature or Adjacent Riparian Property Owner -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: L]� I- ARPO's a maf l :&60r, 4n V( lfn I I 1 l Date: Phone#: - 4 r f 2m — &5145 'waiver Is valid for up to one year from ARPO's Signature" Revised August 2022 11 941 N.C. DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM �IIFIED MAIL • RETURN R r^FIaT R nt iFgTFn or NAND D I��,, VERt (TOP portion to be completed by owner or their agent) Name of Property Owner —WA I)am u►�Id Pa, I'GtQ 5(t�l,'Vah Address of proporty: Msling Address of Owner: �I TWIt'] �slAitd CI FG Jt'i ]n � C I�Iy t�6 Owner's small: A-pn i er},►166wnees Phone#: JSH5—$N$ ^ y 367 Agent's Name: ITP 4 / aer- -, n Agent Phone#: RFp ,A4o a-3T-dA JA►t�InAe' 4Qrm" mlasj Agent's Email: rrfG Ott Pbankld a CtYJw ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION (Bottom cordon t®)tg completed by the Adjacent Property Owner 1 hereby certify that 1 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, 9 description or drawing wHh dimanal n must be 12MWed with this latter, I -DO NOT have objections to this proposal. I DO have objections to this proposal. a you have obJvcUone to what la behtg proposed, you must notlly the N. D/visfon o1 CAasPal Management (DCM) in writing within 10 days of receipt of this notice, Correspondence should he mated to 401 S. GdfAn St, Ste. 300, EUzabath City, NC, 27M, OCM representatives van also be Contacted st (252) 284-3901. No response is considered the same sa no objection if you Nava been rw~ by CortNed Mall, WAIVER SECTION (Choose onhr onel 1 understand that any proposed pier, dock, mooring pilings, boat ramp, breakwater, boathouse, 111. or groin must be set back a minimum distance of IT from my area of riparian access unless waived by me (this does npt apply tp bulkheads or rtorap revetmentSl (If you wish to waive the setback, you us4 the appropriate blank below.) /%/f 100 wish to waive some/all of the IT setback [ .0 -OR- �� _ __ SignatureofAdjac rrH Rfperfan PropertyOwner I DO NOT wish to waive the 16' setback requirement (initial the blank) Signature of Adjacent Riparian Property Owner: / TypedlPrinted name of ARPO: 1 '6c-. r I r L t l �� L We Mailing Address of ARPO: ff �(1e� S'a' i� / fir 1�i4 a zi ob ✓✓ �� CAuof, w�lctivdseVa¢Cc�nre�. coin ARPO's ema : ARPO's Phone#.- Ij'! i- .4G yy Date: _ / 0 �?� 0.2. 'waiver is valid for up to one year from ARPO's Signature* Revised August 2022 ■ Complete Items 1, 2, and 3, ■ Print name and address on the reverse "' your so that we can return the card to you. Y B. F6861ved I ■ Attach this card to the back of the mailplece, or on the front if space permits. _ 0V' {-i/ oracle Addressed ld: Ko IL<t�L7 (,�N, kt'-Ck y a i n�c;�l�trct �Gvt ltiay LJii�'h1Off1pLJ�f� II I��IIII IIII lillll IIII't�ll II IIIIIIIII IIII III 9590 9402 7882 2234 2222 06 7022 3330 0001 7645 4683 PS Forn 3811, July 2020 PSN 7530.02-000.3053 11 P Complete items 1, 2, and 3- ■ Print your name and address on the reverse so that we can return the card to you. ■ Attach this card to the back of the mailplece, or on the front if space permits. I. Article Addressed to: 3)D +C,a+f-\ l FOB Iho q a oa D. Is 0 Agan Date of De -1 m item 79 u Yes below: ❑ No 3. SeNICe Type ❑ Priority Mail expre ❑Adult algnatum ❑ Reg'stared Metre ❑ Adult Signewre ekl Reoted Delivery ❑o gsl MallR 0 Cednad Made (3Cartlfied Mad WMcl 9ed Calvary ❑ D try CM11m'. ❑ Collect on Delivery ❑ signature Conger n r4tKt w Dellvery Restricted Dellvery ReWicted Deliver 'sured Mall tsured Melt Reatdcted Delivery Don llo Return R, • �'�(,(/�i 2 Age X ❑ Adontre. B. R I:eejNa o�vG r�a0 D. Is delivery address different from Item 17 ❑ Yes It YES, enter delivery address below: ❑No 3. Sevice Type ❑ Pdorq Mall Eaptees® istered Mail- IIIIIIIII IIII IIIIII IIIlillll81111111111111111 RastricedDe very ❑ R,ealvWae ed MalResklc: O GerUfi;d M lb 9590 9402 7882 2234 2222 13 Delivery` ell wary ❑❑ CdiecctoMall o sslsSneNre Confirmalllon oon _ .. .. nr 190 un Delivery Restricted DdNM RasMcted Delivery 7022 3330 0001 7645 4690 Mail urea Restricted WIVW u sxacun vw vx - . sJN143A7lfIS ONb�'Nf SINNON'l'M � �oyu�fTM�LL 11dItl11J NIaON - .VNIIOJ aJNfdd11J - d�Ya(4 BJHrtl9 lRldW 0 � pC � � G C EuuamrFx - ®arxp rprE�n - as am ¢� �S IS �8 � 1 MUMSY YI3MVd A NYArMR I KVM' � as xry sEu F\6U d� KY VSV d j lE'B9CF 3 .IIALLL X 6 1—+NlH`llaNR.?.326EV +LE --li q 5 8 / a{ � �EL r; pit '� 3Q { A/vA 1 11 I� X }} !•' { { jLYLCF M .I I.CLLL S tll / UpI 3 / S p, z ER -kz 5 a i gill p g �� i 2� s�lfii �qg � Sq 3 �E�@a a uovow l'Da °� °.�� > fioil all .....,,,,G,s 2a^i s w r, ne�lfyap