HomeMy WebLinkAbout78509A_Blystone, Sherman_20200224C�CAMA / FXDREDGE & FILL
GENERAL PERMIT
`New ❑Modification [-]Complete Reissue ❑Partial Reissue
N9 78509 ,A
Previous permit #
Date previous permit issued_
As authorized by the State of North Carolina, Department of Environmental Quality
00
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC H •''
IW Rules attached.
Applicant Name :51ne rMa," B!SA 0 �-N e Project Location: County CGM<ACN
Address -Jo 10,N w C04 V r I N C
City C MC P N State N C zip 2 4 9 Z I
Phone # (217) ???� cS —9 USE -Mail
Authorized Agent EarAin s J6cAKjer M ci r-I N
Affected ❑ CW 'ZEW r&PTA ;.ES XPTS
AEC(s): [IOEA ElHHF ❑ IH ElUBA ElN/A
❑ PWS:
ORW: yes / no, PNA yes / b
Street Address/ State Road/ Lot #(s)
I I I Nape N woad Q
Subdivision
B C D
City C11,4d e/v ZIP 219 2 1
Phone # ( ) River Basin PaSfuoiG'rq K
Adj. Wtr. Boda�/man /unkn)�-
Closest Maj. Wtr. Body Akbe rACAr 6 S<mr-3c .
Type of Project/ Activity
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MEMINSEMMEN
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MAREMOMESIM
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Agent or Applic Printed Name
x Pk;11: �kU r / r, 1�J7J/1
Signature ** Please read compliance statement on back of permit"
o) -1'k]L�
AP
plication Fee(s) Check #
&z�y I20,24 0�12q Z
Issuin Date 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 officer when 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
landowner(s) .
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certify that this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
Tar - Pamlico River Basin Buffer Rules
Neuse River Basin Buffer Rules
Other:
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 Washington District
400 Commerce Ave 943 Washington Square Mall
Morehead City, NC 28557 Washington, NC 27889
252-808-2808/ 1-888-4RCOAST 252-946-6481
Fax: 252-247-3330 Fax: 252-948-0478
(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)
(Serves: Beaufort, Berne, 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 FORM FOR PERMIT APPLICATIONS
Name of Property Owner Applying for Permit:
Mailing address:fl-
Telephone Number:
D' VV J.
I certify that I have authorized 9Ct (agent/contractor),
to act on my behalf, for the purpose of applying and obtaining all CAMA permits
This certification is valid through
(Property Owner Information)
Signature
S �1 P2 vy�
Print or Type Name
S
Title, co. owner or trustee for property
/� 2n? " -`1 -111 -
Date
Telephone Number
I Email Address
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERED
I hereby certify that I own property adjacent to 5 s � s
/n� (Nam( f Prime �ne 1
property located at I (� � 1f�1� � 0 OGY (oj•(, G
rr (Project Site: Address, Lot, Block, Road, etc.)
on �GL S i�/�L in
N.C.
(W t rbody) (City/Town and/or County)
Agent's Name #: Mailing Address:
Agent's phone #:
He/She has described to me as shown below the development he/she is proposing at that location,
and I have no objections to the proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing developmentmust fill in description below or attach a site drawing)
If you have objections to what is being proposed, you must notify the Division of Coastal Management
(DCM) in writing within 10 days of receipt of this notice. Correspondence should be mailed to 1367 US
17 South, Elizabeth City, NC, 27909. DCM representatives can also be contacted at (252) �64-3901. No
response is considered the same as no objection if you have been nQrgfied by Certified bail.
(Property Owner I formation)
5�
Signature
Print or Type Name
t k k "4JQ,-,.v-n ,7 9
D-Y-
Mailing Address
0, C
City/StatelZip
2�2--2,? 6- 17 2�
Telephone Number/Email Address
Date
'Valid for one calendar year after signature'
ace
rmation)
S151nature ` J
Z61cle4j K77
Print or Type Name e /�
Mailing Address
CitylStatelZfp
— 1J Inc ?��/Iei.11
Telephone Number/ Email Address
i. MR
I.
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERED
I hereby certify that I own property adjacent to s� �'-vw�� �J S" S s
(Name of Prop rty Owner)
property located at Z t ( �"`� �''` �Oc��Q
(Project Site
on ?Pi-S� .)-Q-r�, i n
(Wale) body)
Agent's Name #:
Agent's phone #:
Address, Lot, Block, Road, etc.)
C✓rn�-��. tJ .Q--,, . N.C.
(City/Town and/or County)
Mailing Address:
He/She has described to me as shown below the development he/she is proposing at that location
and I have no objections to the proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
If you have objections to what is being proposed, you must notify the Division of Coastal Management
(DCM) in writing within 10 days of receipt of this notice. Correspondence should be mailed to 1367 US
17 South, 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
(Property Owner Infor ation)
Signature
Print or Type Name
Mailing Address
&", 4-a-, (\ C-
City/StatelZip
252-2,�,�i7- �f-1Zs
Telephone Number/Email Address
.:)-Ity� c�
Date
*Valid for one calendar year after signature*
(Adjacent Property Owner Information)
Sig tore
Print or Type Name
/0F "K4✓eAlw000
Mailing Address
City/State2ip
Telephone Number / Email Address
/i1'/ /0"�
Date"
11:�.
February 20, 2020
Streets it Addresses
Streets Parcels
Main Roads 13
County Boundary
180
117 186
118
„� 192
1
114
196
104
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