HomeMy WebLinkAbout87080A - Flach, Paul and Michelle:° °"'N❑CAMA El DREDGE & FILL S 8%��� (Ai B C D
3 GENERAL PERMIT Previous 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: v .deo.nc.gov/CAMAruW
Applicant Name Authorized Agent
Address Project Location (County):
City State ZIP Street Address/State Road/Lot #(s)
Phone#O '
Email Subdivision
City r' ZIP
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/no PNA: yes/no
Type of Project/ Activity - r
(Scale:)
No
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A building permit/zoning permit may be required by: - ' E( �' �'-' �� ('' i"
❑ TAR/PAM/NEUSE/BUFFER (circle one)
Permit Conditions
❑ 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) t s,11 C
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name
Signature **Please read compliance statement on back of permit' *
Application Feels)
Signature„
Order Issuing Date
Expiration Date
JAI dcomr'r ❑CAMA ❑ DREDGE & FILL N? 87080 A B C D
I GENERAL PERMIT Previous 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.dea nc.gov/CAMArules
Applicant Name
City
Phone # ( )
Email
_.. _.
Authorized Agent
Project Location (County):
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 Maj. Wtr. Body
ORW: yes/no PNA: yes/no
Type of Project/ Activity
(Scale:, )
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Total Platform area
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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/canditions on back
I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THATAPPLY TO THIS PROJECT AND 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
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner, Paul Flach
Address of Property: 108 Miller Lane, Elizabeth City, NC 27909
Mailing Address of Owner 108 Miller Lane, Elizabeth City, NC 27909
Owner's email: tony.flach@gmail.com
Agent's Name
Agent's Email:
ECEIVED
FEB 1 t 2024
Owner's Phone#: 757 617-2486 DCM Vn_EC
Agent Phone#:
ADJACENT RIPARIAN PROPERTY 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 noury me rv.c. urwsron or �oasra+
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 riprao 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:
TypediPrinted name of ARPO; OVA" f t
Mailing Address ofARF v1C ./���V
ARPO's email: Tv tM [ Oo AN P
Date;
"waiver is valid for up to one year from ARPO's Signature'
Revised August 2022
N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION(WAIVER FORM
CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner: Paul Flach
Address of Property: 108 Miller Lane, Elizabeth City, NC 27909 -RECEIVED
Mailing Address of Owner: 108 Miller Lane, Elizabeth City, NC 27909
Owner's email. tony.flach@gmail.com Owner's Phone#: 757 617-2486
Agent's Name:
Agent's Email:
FED 1 12024
Agent Phone#: mC A_EC
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
description or drawing, with dimensions, must be, rovided_with this letter
_X— 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 Mait.
WAIVER SECTION (Choose only onel
I understand that any proposed pier, dock, mooring pilings. boat ramp, breakwater, boathouse, lift, or
groin must be set back a minimum distance of 15from my area of riparian access unless waived by me
(this does not apply to bulkheads or riprao revetments). (If you wish to waive the setback, you must sign
the appropriate blank below )
I DO wish to waive somelall of the 15' setback
Signature of Adjacent Riparian Property Owner
-OR- y�
I DO NOT wish to waive the 15' setback requirement (initial the blank) �!c
Signature of Adjacent Riparian Property Owner: / w-- 'ram C
Typed/Printed name of ARPO: AA<k- �) M )A LL.
Mailing Address of ARPO: 2Z J )Q 4Y1-I `U 6 E
ARPO's email: J ) "15 !? n°ARPO's Phone#:
Date: 1 2� ZUZ _'waiver is valid for up to one year from ARPO's Signature'
Revised August 2022
RECEIVED
FEB 1 ' 2024
DCM-EC
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