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Home My WebLink About89306A - Pollack, Jeff,t` r"N❑CAMA ElDREDGE & FILL N9 89306 a; B C D Previous permit 3 :GENERAL PERMIT 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 Pernik Rules available at the following link: www.deq.nc.gov/CAMArules Applicant Name ` n Authorized Agent .I " Address Project Location (County): City State ZIP - % Street Address/State Road/Lot #(s) Phone # ( ) Email i. I Subdivision City - Affected ❑ CW 2 EW ❑PTA ❑ ES ❑v' PTS Adj. Wtr. Body (nat/man/unk) AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body ORW: yes/no' PNA: yes/rio' Type of Project/ Activity (Scale: n/T5 ) C6n.nlinn lnn,»F � 1C�:■ •::.. ..■ ■� Ma ■■■ NONE M ■:ma: =a :■■:■:■:■� ■ 5MME�:: M.M.:::a:: :1 :..a:.■■:■: ■ ■■: ■u::■■■ ■■■■■■ am:■■.p:■■■■■■■■.■.J■■■■■.: Bulkhead/ Riprap length Avgdlstanceoffs ore- .��■ ■ 11 ■1 �■■a■■■:■■ 1111010 :::■N ■ao■■ ■■■■■■■ ■■�� ■■■■ �RAM■■■■■■■■■ ■■■® : ■ ■"■.■■■■■ ■■ a:i�■ ■ ■ I ■■■■�a.aaa::aaa : ::.■ ® WA■■�■.■.... .■a'aa■MN■■■■NMM■■■■ ' ■■■■■.....■1001, aiuEL300■p■■ ■� ®■■■■■■■..: NONE ■■■■■■■■■N■■:■MEN ■ ..■. ■■■ ■■■ __■■■■i■.■■■■■ 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. Agent or Applicant PRINTED Name Permit Officer's PRINTED Name Signature **Please read compliance statement on back of permit** Signature Application Feels) Check p/Money Order Issuing Date (Please Initial) `/ / Expiration Date AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: c Mailing Address: on R >' rr r I Phone Number:L— Email Address: nr W N d T Ash Mg, /, Cep I certify that I have authorized Robert Midgett Agent t C7*actor to act on my behar, for the purpose of applying for and obtaining ail CAMA permits necessary for the following proposed development, /vJ fit.., Gl it If. A F'>` at my Property located at Jt ( t [�eT UAL, -t,,,� C l�ti in �> QCounty I furthermore certify that I am authorized to grant. and do in fact grant paimission to Division of Coastal Management staff, the :.ocat Permit Officer and their agents to Prier on the aforementioned lairds in connection with evaluating 'information related to this permit application. Property O er Info ation: SignMare /y Print �o}(Type Name Title 6 l� 22)Z Date This certification is val.d through !!, t_ L N.C. DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM y..RTIFIED MAIL � RETURN IRN RECEIPT R'rQ IFcrcn 21 HAND DELIVERY (Top portion too.ry b-e� completed by owner or their agent) Name of Property Owr.er: C' f r L (-O C �Z- xt Address of Property. 0 h /'ta r LI, c f Cr').1.+'t c e'i� ry Mailing Address of Owner. S An Owner's email: a �n,tn, cIOS 3 Lt2� 0'u"+ +'� Owners .'Lf Phorsit. Agent's Name: Robert Midgett Agent Phonelf 252-202-7033 Agent's Email: ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION (bottom portion to be completed by the Adiscent Property Owner) I hereby certify that I own Property adjacent to the above referenced properly. The individual applying for this Permit has described to me, as shown on the attached drawing, the development they are proposing. A descrimion or dpiwinc. w h d'anensions� must be provided with this let'er. !` DO NOT have objections !o this propi al. _ 100 bare objections to this proposal. . Management (DCM) in writing within 10 dayt ile N.C. Division of l s of receipt of this notice, Correspondetia shouldbe MR/led to 401 S. Griffin St., She. 300, Elizabeth City, NC, 27909. 0CM representatives can also be contacted at (2S2) 264.3901. No response is considered the same as no objection if you have been notified by Certified Mail. WAIVER SECTION (Choose only onel l understand that any proposed pier, dock. mooring piar:gs, boa{ ramp. breakwater, bualhouse, lift, or groin must be set back a minimum distance of 17 from my area of dPadan access unless waived by me (this does not apply to bulkheads o rerap revetments). (I` you wish to waive the setback, you must sign the appropriate blank below.) / I DO wish to waive some/all of the 1 b' setback •OR- Sgnatum Of AdfacenrRiparian Property Owner I DO NOT wish to waive the 15' setback requirement (initial the blank) j( Signature of Adjacent Riparian Property Owner; ( Typed/Printed name of ARPO: Mailing Address of ARPO: ARPO's omalk Date: ARPO's Phone: 'waiver is valid for up to one year tram ARPO's Signature* Revised August 2022 104 Miller Lane,Elizabeth City N.C. Remove 125 ft of existing Rip Rap from west side of property To east side of property. Build new 125 Bulkhead in its place 4 N.C. DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM CERTIFIED MAI' RETURN RECEIPT REQUESTED.REQUESTED.or HAND DELIVERY (Top portion to be completed by owner or their agent) Name of Property Owner. _ -%t � � 11 '� " `� t `- b Address of Property: ! [%�� ! i-' r �GL-- AI. .- v L 3. Z . t.r�'� I'll � a Mailing Address of Owner: Owner's email: v'"3 r%r fcj-e i+51/[u'� Owner's Phonelt Agents Name: Robert Mldgett Agent Phone#: 252-202-7033 Agent's Email ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION (Bottom Portion to be completed by the Adjacent Property Ownsrl I hereby certify that I own property adjacent to the above referenced property. The individual applying for this permit Aa5 described to me, as shown on the attached drawing, the development they are proposing, A nasr 1=Or Mmwnn wan wi...---:--- .. i 00 NOT have objections to this propos3L IWI DO have objections to this proposal. Ir you have objections to whirl being propose , you must nobly the N.G. Division of Coastal Management (DOM) in Wilding within f0 days of receipt of this notice, Correspondence should be mailed to 401 S. Griffin St., Ste. 300, Elizabeth City, NC, 27909. OCM representatives can also be contacted at (252) 294-3901. No response is considered the same as no objection !f you have been notified by Certified Mail, WAIVER SECTION (Choose only one) I understand that any Proposed Pler, duck, mooring p irgs, boat ramp. Brea%v ate:, boathouse, lift, or gran mast be set back a minimum distance of 15' fror•, my area of riparian access unless waived by me (this does not apply to bulkheads or rip ao a tme ts). i';l you wish to waive the setback, you must sign the appropriate blank below.) 4j� �A 100 wran to waive somelail of the 15 setbacYt/` -OR- ! f - Signature olAnj»CeN Ripariac Prnperty Owner I DO NOT wish to waive the 15' setback requirement Natal the biankl Ignature of Adjacent Riparian Property Owner: 7 p k,ch TypedlPdnted name of ARPO: Mailing Address of ARPO's email: Date: ARPO's Phone#: 'waiver Is valid for t:p to One year from ARPO's Signature - Revised August 2022 104 Miller Lane,Elizabeth City N.C. Remove 125 ft of existing Rip Rap from west side of property To east side of property. Build new 125 Bulkhead in its place