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Home My WebLink About87298A - Broome, Joshua and O'Canes, Kristel#PINew ❑CAMA ❑ DREDGE & FILL N9 87298 A B C D Preous GENERAL PERMIT Dtepreioslpermitissued [-]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: wwwdeo nc gov/CAMArulec. Applicant Name K ( , 00 k E J ; ,_ Authorized Agent Address , < < f' <J Project Location (County): I<. City State I-)f: ZIP Street Address/State Road/Lot#(s) a604 1<•y, Phone # (+<�_) Email Affected ❑CW ❑EW AEC(s): ❑ OEA ❑ IHA Subdivision City 0 .1 ./ ZIP PTA F.,ES PTS Adj. Wtr. Body f'oIS:.v-•/ ;(nat(mWunk) Z ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body Ic ORW: yes/no PNA: yes/po Type of Project/ Activity x, c > 1 k , I L 1", J ' 1? F:r. Ie (Scale:Urt S. j !3 . ■■■■■■■■�1■■■■■. ■�. .C■■■■ SOMEONE■i .■�.M�.C® ■ Finger pler(s) i� ■ T—ota] Platform —arm Bulkhead/ Riprap length Avg distance offiibore Max distance/ length — 0 No OEM MEN NEEN �l .. ■�■ ■■■■■■H■ ■■ . ■N MEN ■■■■■■�■■ IN Basin, channel Cubic yards a�.. IBM ■■■ i■■.�..e�i. ■ �■� .■■■■ ■� �p a MEN Boat ramp.. B ■■o■■■■ ® ■■E■■■ ■■■■■ ■I/■Beach NJ 0 M Bulldozing er® ■ ■�.■i iir�■I■■■■■■■■ SAV observed: yes�e■ii�� , n/a yes no Photos: yes no IFIEN i �1Moratorium: ��Site U11 Nil" SKU En A building permit/zoning permit may be required by: !1 , i .� . rl. !'- I • ?. c. j,.< _I 1- i� ,S' 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" Permit Officer's PRINTED Name Signature Issuing Date Expiration Date Application Feels) Check #/Money Order 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: J08Hut4 )312(7044& Address of Property: 10(2)1 /aZSr -,1�eLS �0ti Mailing Address of Owner: J 9m s4M'- n Owner'semail: A3A—oh 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 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. 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 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 ri rap revetments). (If you wish tow ve the setback, you must sign the appropriate blank below.)/j o ix/teG+w I DO wish to waive some4of the 15' setback S/gnatu of Adjacent Riparian Property Owner -0 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: U�CX�"/ L Mailing Address of ARPO: ARPO's email: r �r�^0 ((� 7 ARPO's Phone#: Date: 2a 1 *waiver is valid for up to one year from ARPO's Signature* Revised May 2021 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 PropertyOWner,70SOLAA BKoamc 4 KR/sTEL brCAti4S Address of Property: ZOO(# Rivie9smol r IRtb. el- IZABI:Tlr 01Tyy NC-- 479c? Mailing Address of Owner: 2004 RNEe SNaPE RbELr 2 d6rW C r 7-),', NC• Z 7 9OS BQOtlME,' f:gSTj'oNN4r@tS'MM/L•CAH BRooMF - 757-2S4f-(el7G Owner's email:Woc*NAs �R"�rrtRrr • cam Owner's Phone#:0 cAAm r - 3& f -648 -OS7It Agent's Name: Agent's Email: Agent 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. 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 notrry the N.C;. uiwsion or c;oastar 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 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 M I DO NOT wish to waive the 15' setback requirement (initial the blank) Signature of Adjacent Riparian Property Owner: (hr� -Af4 Vl � 1 Type dlPrinted name of ARPO: • 0 eC� P `k V. 1 IL�Q K rk? /'/ Mailing Address ofARPO: �� )�I VS)tny'��d �ly obe/"G'I C-ifi '17`0V ARPO's email: n ) W,,,.cc.+1(\RPO's Phone#: Ga52,2 1 U J. 5- Date: - *waiver is valid for up to one year from ARPO's Signature* Revised August 2022 4 N•5} �00 Q.A.(L 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: S05Nla.-A 3RoOMI- 'I O'CAN4S Address of Property: 2oo& RtvamsHorQE Ab ELtZAgETN CrTY NC- 279o9 Mailing Address ofOwner:Z000 Rt✓Ai2SA6Rg4 Rb E"ZABETH Ctry ^/G 279a �iQOWpE-%ATrSONM 9/�GHp[4•Coh $QODMf `• 7C7-ZS4 -4w i76 Owners email:koCA ur3 V mA t4. Com Owner's Phone#: o tAAL4 s - 84r -54-? - 0 V 7 y7 Agent's Name: Agent's Email: Agent 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. -_.d— I DO NOT have objections to this proposal. I DO have objections to this proposal. /t you nave 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 (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 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 -OR- Signature of Adjacent Riparian Property Owner I DO NOT wish to waive the 15' setback requirement (initial the blank) Signature of Adjacent Riparian Property Owner: Typed/Printed name of ARPO: Phone#: dM-339-'2/Q 3 for up to one year from ARPO's Signature* a?�� Revised August 2022 I Gr401 ,ry1,�a.fi s _ tlS YiUN S i A A` M f I I L T•ifi:(t': -yam . "'rid fRl a . kJJ�k�9 1 J t '}4 � ni1 J F t t { ' d