HomeMy WebLinkAboutBeasley, Jaredt7 CAMA / ❑DREDGE & FILL N° 78982 A B c D
ENERAL PERMIT Previous permit#
New'' ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
C'
OAsaorized by the State oT North Carolina, Department of Environmental Quality
and the Coastal Resources Commission in a rea of environmental concern pursuant to I SA NCAC f
// ,DR les attached.
f
Applicant Name Jcr� ��� *' Project Location: County ( /�o (-s
Address pp' } 7 �/ti '• lj r ` _ Street Addrf ss/ State Road�jLot #(s)
City C� Stag(' ZIP �� �4, f •J I f}} ��'
Phone # Yj) t E-Mail Subdivision
Authorized Agent_
r
Affected 0,9w
AEC(s): 1-1OEA
❑ PWS:
KO Q71'rA� ❑ ES ❑ PTs
❑HHF ❑IH ❑UBA ❑N/A
ORW: es no PNA yes /ono
Type of Project/ Activity
er
Fixed Platform(s)
)
Fixed PlaHorm(s)
Floating Platform(s)
Finger piers)
Groin length `
number
Bulkhead/ Riprap length
avg distance offshc
max distance offsh
Basin, channel
cubic yards f
Boat ramp
Boathous Boatlif
Beach Bulldozing
Other
Shoreline Length Of
SAY: not sure yes
Moratorium: n/a yes
Photos: yes
Waiver Attached: yes
A building permit may be required by:
( Note Local Planning Jurisdiction)
Notes/ Special Conditions
or Applicant Printed Name
6 f/LGJ Aur
,
f k-1
Cityi ZIP f
Phone # ( ) ver Basin%
Adj. Wtr. Body U t, 6 1 nat man inkn
Closest Maj. Wtr. Body ° ✓Y
Permit
/' d j /-/ (Scale: A%-Tl )
❑ See note on back regarding River Basin rules.
1
aiu leaze read compliance statementon backofpermit** Signatur -'
"
elation Feels) Check# lssuinADao Expiration Date
Statement of Compliance and Consistency
This permit is subject to compliance with this application, site drawing and attached general and specific conditions. Any
violation of these terms may subject the permittee to a fine or criminal or civil action; and may cause the permit to become
null and void.
This permit must be on the project site and accessible to the permit officerwhen the project is inspected for compliance. The
applicant certifies by signing this permit that 1) prior to undertaking any activities authorized by this permit, the applicant will
confer with appropriate local authorities to confirm that this project is consistent with the local land use plan and all local
ordinances, and 2) a written statement or certified mail return receipt has been obtained from the adjacent riparian
Iandowner(s) .
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certifythatthis project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
Tar -Pamlico River Basin Buffer Rules ❑ Other:
❑ Neuse River Basin Buffer Rules
If indicated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules for the
River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the NC Division of
Water Resources. Contact the Division of Water Resources at the Washington Regional Office (252-946-6481) or the
Wilmington Regional Office (910-796-7215) for more information on how to comply with these buffer rules.
Division of Coastal Management Offices
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ 1-888-411COAST
Fax: 252-247-3330
(Serves: Carteret, Craven, Onslow -
North of New River Inlet- and Pamlico
Counties)
Elizabeth City District
401 S. Griffin St.
Ste. 300
Elizabeth City, NC 27909
252-264-3901
Fax:252-264-3723
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax: 252-948-0478
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-796-7215
Fax:910-395-3964
(Serves: Brunswick, New Hanover,
Onslow - South of New River Inlet -
and Pender Counties)
http://portal.ncdenr.org/web/cm/dcm-home
Revised 7/06/17
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: ,iax-ed t Ajll I7P ,• �Kf[�
Mailing Address: ( Z05?
&�jcA /.i G z� Sci 0
Phone Number: Z,5Z- 107Z- 511 10!�
Email Address: (X kea-,1!W ()-,) e 5m% 1 • cave)
I certify that I have authorized jUS'LA eve- / f � %r_ r e 6, 0 ,
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: Re-4 rci Doc-\,.-- D7 ,e,
at m/y� property` located at ( (),n6c
in t ar County.
/ 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 Information:
Signature
. jk2 &�Iszf f
Print or Type Nampl
OZN�r�r/
Title
2oz��
Date
This certification is valid through / /
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to 1 xa Ai Arr�('�, 's
II (Name of Property Ownef)
property located at ZFI g 1 v �bc! I r ,
(Address, Lot Block, Road, etc.)
on I ur ��,. �i I , in Isle N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
locatio .
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
RcP Dcc�'- IRly
Sur^c �icu%ru.�.
WAIVER SECTION r
I understand that a 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. (If you wish to waive the setback, you must initial the appropriate blank below.)
�— I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
Owner Information) (Adjacent Property Owner Information)
City/State/Zip � -
Z2- 9//0 9
Telephon7 Nu ber/email address
Date
'Valid for one calendar year after signature*
Ate.-Pv)P&a 2�
Signalu e*
i2 si=�
Print or Type Name
t Z to i trna=' I pL
Mailing Address
F/n�Llrts I5r c- 1JL_ Z�IH!
Ci Btate/Zip
IC/-i�/5^ ZG3�/ W L i 3GY �EG .P- 02 e,,M
Telephone Number/email address
)Co ) 7i0 oO
Date*
(Revised Aug. 2014)
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to hc-ej '7� ��,� s
(Name of Property Owner)
property located at Z0)S T 1
p (Address, Lot, Block, Road, gtc.)
on r, e .xP/I , in E'U Islam , N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must rill in description below or attach a site drawing)
d 0
o � _
� rl
WAIVER SECTION
1 understand that a 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. (If you wish to waive the setback, you must initial the appropriate blank below.)
Y— I do wish to waive the 15' setback requirement.
Date
I do not wish to waive the 15' setback requirement.
(Adjacent ProQ" Own Information)
'Valid for one calendar year after signature" (Revised Aug. 2014)