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Home My WebLink About87196A - Woodard, WilliamSF-1 ❑CAMA [IDREDGE & FILL Nv 87196 A B C D GENERAL PERMIT Previous permit11, 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.deo.nc.gov/CAMArules Applicant Name 1 AJ i i ', , ,, ,I J It Address i I I i 1 It r 1, c i-I City �'J State )J C_ ZIP Phone # ( ) Email Authorized Agent c) v's (((-CC U. Project Location (County): i .LJY' P l'Fy Gt-c-- StreetAddress/State Road/Lot #(s) I (( "ct.i NA '".y.`i Subdivision City �'�. zip ❑ ❑� ❑ ❑ ❑ Adj. Wtr. Body �.. hS lA) G.� 4 t) �.z I" (nat`m"anh4ink) Affected cW EW PTA ES PTS AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wt, Body ORW: yes/,-,o i PNA: yes/no Type of Project/ Activity Jr (Scale:1 4Gr ) Shoreline Leneth I <�)=.> Access Length Pier (dock) length Fixed Platform(s) I — — ❑ ( i_ i j Floating Platform(s) Finger pier(s) Total Platform area Groin length/# Bulkhea{l/Riprap length Avg distance offshore Breakwater/Sill Max distance/-1e15gth r'i r Basin, channel Cubic yards Boa[ ramp Boathouse/ Boatlift Beach Bulldozing Other- __r ,__ _ d.Aw _ T _.e.r..� ..... r •_ - ._ - —rpi---- — —)--' -- - I 7 i • `+ - _ _ -. - T� __ 1 - SAV observed: yes no Moratorium:; n/a yes no Site Photos: Yes Riparian Waiver Attached: . yes., no . A building permit/zoning permit may be required - j —. — - Permit U TAR/PAM/NEUSE/BUFFER(circle one) ❑ See note on back regarding River Basin rules ❑ See additional notes/conditions on back it 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** Signature Application Feels) Check#/Money Order Issuing Date Expiration DIVISION OF COASTAL MANAGEMENT AGENCY FORM FOR PERMIT APPLICATIONS owner of the property Ylocated at: (propem owner CIL do hereby authorize acting as agent) to act as my agent for the purpose of ob Area Management Act and/or � � � n�:� �,c�,� - Dredge and Fill Act permits, that may be nr =c- r posed development at the above - indicated property, which entails: {describe proposed developmenr ror wh.'ch permits are being sought) T-nis agency authorization is limited to the specific activities described above, and will expire on: on which agency authorization expires) (date) N'�cJ ! i _ name of owner) (title, if officer of core. owner or trustee for property) 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:.7 VII i11 r\ M tt 1i-Q%0 SIC U ✓ I . Address of Property: � 1 11 M A-r L r ti 5'r. rn OU O d< QC a] � S Mailing Address of Owner: 1\ Arwe AS A bey E� Owner's email:AJJA2 MCCoMA'tI++ Owner's Phone#:;, 2 2 / o03 Agent's Name: it rk t I I. x� l L4 Agent Phone#: Agent's Email: 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 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. F I DO NOT have objections to this proposal. I DO have objections to this proposal. If you have objections to wnat is being proposea, you must nary the rv.L,. uiwswn Or wesial 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 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.) I DO wish to waive some/all of the 15' setback Signature of Adjacent Riparian Property Owner -O R- 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: ./ Itl) Ubt\KM Sf FEf WdaX fit. V NSA ARPO's email: S�(lfiAiO�GN6L,��r ARPO's Phone#:-�aS9'CgA Oo�i Date: 'r ` 'waiver is valid for up to one year from ARPO's Signature` Revised July 2021 4sY- 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) t � j`t� Name of Property Owner: y J j I% rYM A t V 3O& M^ I Address of Property: l / ` A-1—' I !L 5 (• / ' r wc L N L c 9S ,t o Mailing Address of Owner: (��5� A!r`2 AS U (v Owner's email: `� tVR��yU+��r iM� GfiO ner's Phone#: ,i Agent's Name: ✓ " ur Agent Phone#: ? Agent's Email: 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 /V/✓I DO NO ave 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 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.) 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: Typed/Printed name of ARPO: ,f f lun/C� �G/ Mailing Address of ARPO: ARPO's email: '' /I/,, 1= LJD a l& it 41ARPO's Phone#: Date: '11Z *waiver is valid for up to one year from ARPO's Signature* Revised July 2021 ! , CD cs L.L. ° \ � k § Q z § \ � / u )& }§ }j ) ] (� \ %f/ \) \ \ \) ƒ \ \ \ }\