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Home My WebLink About87203A - Richard B Clark II, Trust�o1AUDW', MaQCAMA ❑ DREDGE & FILL No 87203 n; s C D Previous permit 61 IT GENERAL PERMIT Date preiospermitissued W 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 t ' ❑ Rules attached. 12 General Permit Rules available at the following link: wwvvdeo.nc.gov/CAMArules Applicant Name Address City State ZIP Phone # O 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/(io , PNA: yes/no Type of Project/ Activity A (Scale:rj?.' , j sYc Access Length Pier (dock) length Lt4 HtA Fixed Platform(s)�� _ - f j . .-. _ LL.-- _._ i. i_ _.__fir i W Floating Platform(s) Finger pier(s) 1 __ 'F __ --I T - _ ,._.__ __ i..-i- -- - _. T _ - Total Platform arear1 :a L # Groin length/ft w - Bulkhead/ Maw length Avg distance offshore Breakwater/Sill Max distance/ length ` N- Basin, channel Cubic yards_/ Boat ramp Boathouse/Boatlift Beach Bulldozing �-- - - --- - -- --- _ - j- - __ t i .�. - Other i SAV observed: yes Moratorium: n/a yes no Site Photos: yes no Riparian Waiver Attached:, 'ves no, T i ` • >�k i ,_ A building permit/zoning permit may be required by: Ir�t+,i•.�,o-, O•o.•r'`( t. 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" Application Feels) Check ft/Money Order Permit Officer's PRINTED Name Signature 3/S �aoay q tv(t- y a.d�4 �t��''":� Sl I Issuing DateI �1 ;))" Expiration Date AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: RIct+ADS Ci + Rk II � %RU.S Mailing Address: T & &Y T 333 Phone Number: !% sr) 0 - 7 Email Address: R•COPk(7 CLOAK & V(0.Cdn," I certify that I have authorized W 14 11`r 5 W l i`t.i C'> , Agent I Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: at my property located at N1o0N1-1(-I4 DQ, 1107 �oat) Q C, in 19 R!� u) ry1 h-&S County. 1 furthermore certify that 1 am authorized to grant, and do in fact grant permission to Division of Coastal Management staff, the Local Permit Officer and their agents to enter on the aforementioned lands in connection with evaluating information related to this permit application. Property Owner Information: //�, Signature i�tC-ttA" (2U Print or Type Name Title � , as , aaa Date This certification is valid through / a IA3 I l 26d 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: q �,11/426 a Q-Ch k I�� /12U 5 7- Address of Property: G-T ARC j4&PT-(�i-✓J Ak, Mailing Address of Owner: P6. AOx J-11yod 7c)/U U A. -23 L 6 Owner's email: RCCAOlr Co)RkCyEKce' co,-, Owner's Phone#: 7f % 90 6 7 Y a 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 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. xI 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 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.) k I DO wish to waive some/all of the 15'setback��Signature of Akaacnt/R'icparia�nJPrroperty 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 ofARPO: 3PC 7T MC661A�l Mailing Address ofARPO:Jg3V /'I-e-)&IQA 140L' . A10A��k (J. �3573 ARPO's email: %�i iaaG^_� f_u ARPO's Phone#: Date: *waiver is valid for up to one year from ARPO's Signature* Revised July 2021 / �,� moo/v l-1? k •) bpl /iC to T b79 �0 te'r FAZ f fo`3� S Lt P r1' �b iui� I,gjLI< 14 6A b .� SIN" b �s �poQ fo .13 \Ikl k kd' 1\0 (3J S� AQ �,�w 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: 'S i C04,&o 8 C'i44p-x a. 7X L)s r Address of Property: 1a�2 t'Y)OONt, 4 k iDp 1�F2 jl u,gl3 A%C Mailing Address of Owner: TO, AOA7333, IJAMp%e;xJ LIA a3(�c CO,N Owner's email: P Cl APy- � C(f)Q) � 6WC&ner's Phone#: '7.S % :S N0 Agent's Name:02lo14AA0 C OL4 Mt} C /� Agent Phone#: �� 7 `-S 1O 6 Agent's Email: �Q CuWK 6 0-MAIL,Cr�✓l� 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 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.G. 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 Adja nt 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 ofARPO: 21CfiAA4) 8IVCLAAK Mailing Address of ARPO1?,0. Aox 7'4q . ) 61't'\D7aN Ufi 93 L"9 ARPO's email: kQI;Ak-nCrM6I1•C0--D ARPO's Phone#: '�59670 G' 9y 0 Date: 9 a a ' ifi Z `f *waiver is valid for up to one year from ARPO's Signature* Revised July 2021 / a I MOON �-1 I" ) AR, f )epT.-VCR4 IJ c 46T b;g 4c, % 8'-z 97 •�o Alatk 06A d y( N',& V' 6 x) 123 k KV, 1\0 n i �Y(o Or