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Home My WebLink About89103A - Baker, LisaciCOMT"1&F-,v1'CAMA ❑ DREDGE & FILL GENERAL PERMIT NO 89103 Previous permit Date previous permit issued (AjB C D Hevv ❑ 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 t'-1 {, }, '% '' (; ❑ Rules attached. General Permit Rules available at the following link: www.deq.nc goy/CAMArules Applicant Name L I •--.., 1„,_ �� Authorized Agent Address Project Location (County): -D., W City '. State - ZIP -7 9 4 < Street Address/State Road/Lot #(s) I t • .• .- ��' r A Phone # ( ) Email -; I', : i 2 Subdivision city t,,� l.l,_,.i`• ZIP Affected ❑ CW❑'EW ❑ PTA ES PTSAdI• Wtr. Body -- Jan/unk) AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body _ (" r r r ORW: yes(i%) PNA�-yes/no Type of Project/ Activity (Scale:)"- 3gI) Access Length - r i r Pier (dock) length Fixed Platforms) Floating Platforms) ; Finger pler(s) -- j---L,1_ Y i r Total Platform area — - r r Groin length/# Bulkhead/RiPra length P Br i Avg distance offshore — --- ---)-- - Breakwater/Sill r Max distance/ length Basin, channelCubic yards I_ Boat ramp - • 1 Boathouse Ifoatli r o �� I f c f I _ e r Beach Bull d_'zin o Other SAV observed: yes no,I K a 1- -i �� "- 'Z Moratorium: .ri/a yes no )�[z Site Photos: i yes no r - -{ { --- - --� -�- } •-- L- - RiparianWaiverAttached: -yes no _ a A building permit/zoning permit may be required t�},I -T ❑ 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) Agent or Applicant PRINTED Name Permit O{ tr-"" PRINTED Name Signature *'Please read compliance statemem on back of permit" Signature Application Feels) Check ff/Money Order Issuing Date Expiration Date AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit. L-2> ki'IXL L Mailing Address: fi +� i�C� K L rT 1-14 u-°%G 2 74 L/9 Phone Number: I- -Ln(!Z - 22'Ic3 Email Address: 5a61)kc2-51atC x,�-co I certify that I have authorized la"') b-CTT Agent / Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: � U c i-' p 7- at my property located at 10 L 2> fl irt-.T -rr (k"' t2 in R County. l furthermore certify that i 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 Infortnation: 2 a1oc Signature Print or Type Name Title / 7 Date This certification is valid through III boat ramp, breakwater, boathouse, lift, or my area of riparian access unless waived by me ,(If you wish to waive the setback, you must sign the blank) N.G. DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION IVAIVER FORM CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERY (Top portion to be completed by owner or their agent) Name of Property Owner: Address of Property: 11�_?z t a.0 �r� �zrt4 iaP slc N� 21�tuR r r/ Mailing Address of Owner: - Owners email: - S I�l Q 0�c%'1-1� Owners Phone#:R 2` 2'zy O (�ItS p4:-�G_Gea s� Agent's Name: tL "S" ifJlrTT Agent Phone#: rJ$Cit- 1' ' Agent's Email: -- ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION (ootipm..portion to be completed by the Adjacent PronertV 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. h you have objections to what is Patna prupvsm+, Yvu ^.....r •••- .-._.--------- - Management (DCM) In writing within 10 days of receipt of this notice. Correspondence should be marled to 401 S. Griffin St., Ste. 300, Elizabeth City, NC, 27909. DCM representatries can also be contacted at II 264-3901. No respell" is considered the same as no objection if you have been noted by Cartified Mail. WAIVER SECTION I understand that any proposed pier, dock,/n0 groin must be set back a minimum dista of the appropriate blank below-) 100 wish to waive someta the -OR- 1 DO NOT wish to waive the i 5' 4 Signature of Adjacent Riparian Property Owner: ARPO'se III: Ilr'�[1/(t'JGuak� ARPO's Phone#: 75� "X7� �� Date: ��'walver is valid for up to one year from ARPO's Signature` Revised August 2022 V N.C. DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERY (Top portion to be completed by owner or their agent) Name of Property Owner: LI-4 A A KedZ- _ Address of Property: '(` a 22 CiRGV-L- Ry V,T-TTY }aP,Jt( N,v 2-19v9 Mailing Address of Owner, _ fr i Owner's email: �o,MAIC.OwneesPhone#; '757-CoR't.. ' 1-z.9D Agent's Name: 'Po eri:f N1lartc T? Agent Phone#: 2`S 2. Agent's Email: :Rl d rQ ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION (Bottom portion to be completed by the Adjacent Property Owner) 1 hereby certify that t 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. p description opAmwing, with dimensions must be provided with this lette. 1 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 Cify, NC, 27909. DCM representatives can also be contacted at (252) 2"3901. No response Is considered the same as no objection if you have been notified by Certified Mail. 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 diss(taance of 1 om my area of riparian access unless waived by me (this does not apply to bulkheads or ri&ap rev ltm (if you wish to waive the setback, you must sign I DO wish to waive somelatl of Signature K412a I DO NOT wish to waive the 15' setback requirement (initial the blank) Signature of Adjacent Riparian Property Owner: TypediPrinted name of ARPO: V DSti' .S / IJ DC6, Mailing Address of ARPO: ARPO's email: ` ARPO's Phone#: IJ` /�_ t 3ei�i Date; � } � `waiver is valid for up to one year from ARPO's Signature' Revised August 2022 . "T i e r PAW