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Home My WebLink About87172A - Ward, William and Karen❑DREDGE & FILL N9 87172 A B C D GENERAL PERMIT Previous permit s 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 +i Authorized Agent Address Project Location (County): City State ZIP Street Address/State Road/Lot#(s) Phone # (_) - Email Subdivision City I ZIP Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body (ndt/man/unk) AEC(s): ❑ OEA ❑ IRA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body ORW: yes/fio% PNA: yes/bd Type of Project/ Activity (Scaler' " 1 Shoreline Len h Access Length Pier (dock) length Fixed Platform(s) — Floating Platform(s) IMMEMEM Finger pler(s) Total Platform area ■....NOON �.■■■�:�:®:::' Groin length/# Riprap length Avg distance offshor Other Photos:Bulkhead/ SAV observed: yes no Moratorium: n/a Site Riparian Waiver Attached: yes no MEMOMEM son . ■ .■� ■ E .■■ NONE ■MEN .■.■ M 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. (Please Initial) Agent or Applicant PRINTED Name Permit Officer's PRINTED Name Signature "`Please read compliance statement on back of permit* Application Feels) Cher Signature p/Money Order Issuing Date Expiration Date AGENT AUTHORLZADON FORM FOR P RMIT APP ICATI nc Name of Property Owner Applying for Permit: tAti 11 rW r r P.WjJA- Mailing address. ( U I fa -As ill cre QA Telephone Number 157,65D, 447,1 7,y I certify that I have authorized?6,4yS 1 O Y.l DeW boi nticontractor), to act on my behalf, for the purpose of applying and obtaining all LAMA permits necessary for the proposed development of BWy- h 9d- RECEIVED FEB 2 1 W DCM-EC at my property located at 14 T of n't7 Rd L�Le nur , V C This certification is valid through (Property Owner Information) Signature Print or Type Name Title, co. owner or trustee for property 01 - 3 1- 2024 _ Date ,15-1 rb5o , 4"#-2-1 Telephone Number wavd•k4-n I v ejg , , Garr, Email Address (date). RECEIVED N.C. DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORMFEB 2 1 2024 CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERY (Top portion to be completed by owner or their agent) DCM—EC Name of Property Owner: NI'/li'A-eA Pj&U,'6% JOAnn &, p 1�R-4 J k)k,y0 Address of Property: 1 10 fyta2ni ij/ay �� /�a )Fb, N-h,✓ We- 2 F-7a 2., Mailing Address of Owner: /0 Owner's email: 4,4R#;N(. wW ) yg-j ;r eloa4o ' N - Agent's Name: RAO"i/J5 4wo Ii�Je/vf1,w MA V,t- Z33ZZ ; Phone#: %S7- (a,-D - Agent Phone* 2^5Z--1/2-b - 3Lg, Agent's Email: L/J A/C 7�'IV(f ®u! %rsm� Cpstt ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION (Bottom portion to be completed by the Adjacent 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 description or drawin with dimensions must be rovided with this letter. SqE P4;f 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 C at Management (DCM) in writing within 10 days of receipt of this notice. Correspondence uld be mailed to 401 S. Griffin St., Ste. 300, Elizabeth City, NC, 27909. DCM represented can also be contacted at (252) 264.3901. No response is considered the same as no objec ' if you have been notified by Certified Mail. WAIVER SECT�boamp, I understand that any proposed pier, dock, mooring pilingseakwater, boathouse, lift, or groin must be set back a minimum distance of 15' from n access unless waived by me (this does not apply to bulkheads or riprap re(if you wish to waive the setback, you must sign vetm the appropriate blank below.) t Uc 1 DO wish to waive some/all of th setback Signature of Adjacent Riparian Property Owner .OR- n Ish to waive the 15' setback requirement (initial the blank) Signature of Adjacent Riparian Property Owner: Typed/Printed name of ARPO: 5 &1-40 F(o 11 i-ag jf7rsr�✓ lY �7a%'/� Mailing Address of ARPO: 1? 2- 1,1o"j'81,9w ®%, ,Qp 19,0 „0 Ate- 27f?2- ARPO's email: 6077%1'r^2a 2.L01 )4621 e00 Afih RPO's Phone#: 7D3 ^ 3 b Z ^ o 0,0 Date: 20, 2024 *waiver is valid for up to one year from ARPO's Signature* Revised July 2021 N.C. DIVISION OF COASTAL MANAGEMENT RECEIVE ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY FEB 2 1 2024 (Top portion to be completed by owner or their agent) �, %I&i'h i Kt2df�Q v► V�tXj t i:ACM-EC Name of Property Owner: Address of Property: _ 136 ►Tv' ri4610W PuJil' Mailing Address of Owner: !� f 0 1ft .yy�py� Owner's email: W O-*Ts7tCyrt 1p! l' l Owner's Phone#: 7- &5V - 4411 Agent's Name: Agent Phone#: Agent's Email: 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,- rawing with dimensions must be provided 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 (DCAI) 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, yQu must sigin the appropriate blank below.) r I DO wish to waive some/all of the 15' setback- / /-? ! 1/ -OR- oiynalure orHuiacenr nrpanan Property I do not wish to waive the 15' setback requirement (initial the blank) Signature of Adjacent Riparian Property Owner: Typed/Printed name of ARPO: f n 11111 5 , 4 Mailing Address of ARPO: //////''_ ARPO's email: ARPO's Phone#: Zo �` �r f q o l�_b Date: / _ `" 7 4 "waiver is valid for up to one year from ARPO— s Signature* Revised July 2021 RECEIVED FEB 2 1 2024 DCM-EC /3G ,yl�,rn/vw Pf 4, 1g44&0 We- — SEA•wMa \ �. .. . q ,gayh /./ \ y <z i