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HomeMy WebLinkAboutMacDonald, MaryECAMA / ❑ DREDGE & FILL No. 76317 A B ;' C D GENERAL PERMIT Previous permit# []New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued 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. Applicant Name , Project Location: County Address r i ,• - �. City -State,, ZIP �E Phone # ( ) ` �/ ° i ; ( E-Mail t Authorized Agent Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS AEC(s): ElOEA ElHHF ❑ IH ❑ UBA ElN/A ❑ PWS: ORW: yes / no PNA yes [!no i Street Address/ State Road/ Lot #(s) Subdivision City�ZIP . Phone # O River Basin ✓' gf Adj. Wtr. Body I "1 " t^• �...` ((nat /man /unkn) Closest Maj. Wtr. Body Type of Project/ Activity �~ 162 o ` (Scale: dE Pier (dock) length I I Fixed Platform(s) Floating Platform(s) 1 Finger pier(s) I � i 1 Groin length number Bulkhead/ Riprap length MI. avg distance offshore i max distance offshore -� Basin, channel I rj cubic yards j 1 � I Boat ramp Boathouse/ Boatlift Beach Bulldozing t , Other ! i FF I Shoreline Length I ' SAV: not sure yes noLif Moratorium: n/a yes no Photos: yes no4E ! Waiver Attached: yes no I A building permit may be required by: ❑ See note on back regarding River Basin rules. ( Note Local Planning jurisdiction) r � 1 Notes/ Special Conditions i (� ' �- Y VIll Agent or Applicant Printed Name Signature ** Please read compliance statement on back of permit Application Fee(s) Check # Permit Officer' Printed Name_,.. Signature' �3 Issuing Date piratio 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 ❑ 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 howto complywith 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/ 1-888ARCOAST 252-946-6481 Fax: 252-247-3330 Fax: 252-948-0478 (Serves: Carteret, Craven, Onslow - (Serves: Beaufort, Bertie, Hertford, Hyde, North of New River Inlet- and Pamlico Tyrrell and Washington Counties) 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) 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 CERTIFIED MAIL • RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIIFIICATIONIWAIVER FORM Name of Property Owner: Address of Property: (Lot or Street #, Street or Road, City & County) Agent's Name#: borb F PAC-bo to,II Mailing Address: A A04-"o—'r- 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 have no objections to this proposal. I have objections to this proposal. If you have objections to what is being proposed, you must notify the Division of Coastal Management (DCM) in writing within 90 days of receipt of this notice. Contact information for DCM offices is available at httgJ/www.nccoastaimanaaement.netlweb/cmistaff-listinct or by calling 1-888-4RCOAST. No response is considered the same as no objection if you have been noted by Certillied Mail. WAIVER SECTION I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift 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. b G Mailing Address h City/State 11io Telephone Number/Email Address Date (Riparian Property Owner Information) Signature Print or Type Name D'� V0 5 `l3 Mailing Address fL t.l.Ti 61n N b 2"7( D� City/state- p 4IJ--71o� sb�� Telephone Number/Email Address 21 )b 1 u-ub Dal (Revised Aug. 2014) Im 'AA Al� it, lit �o ju q 1:1 f) z ric rill vv ,7,i j- Z` ry nj M Ar CERTIFIED MAIL • RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM Name of Property Owner: Address of Property: (Lot or Street #, Street or Road, City & County) Agent's Name #: 1. AV I U r M4(—b0n(d1 Mailing Address: Agent's phone #: As Aaove Amme4ona14629e,gt a(t,�07 O2/<o/'Lou 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 have no objections to this proposal. I have objections to this proposal. 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. Contact information for DCM offices is available at http:l/www.nccoastalmanactement.net/web/cmistaff-listing orby calling 1-888-4RCOAST. No response is considered the same as no objection if you have been notified by Certilled Mail. WAIVER SECTION I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift 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. (Property Owner Inform tion)�1�� � SIg at Print or Type Name Mailing Address l ti CitylStatelZip Telephone Number/Email Address Dare (Riparian Property Owner Information) 'Signature Print o-rl ype Name -ram �q Meiling Address CitylStatelZip (611,11) CC%1 Telephone Numberl Email Address Dale (Revised Aug. 2014) lV'k MIA AJ md-, nueo-wo.. Pf, ..I:! oar; W imA"Ol A Aw.'"I " j:�� typo sam %-ws lb, 60 cat lemw IN A AGENT AUTHORIZATION FOR LAMA PERMIT. APPLICATION Name of Property Owner Requesting Permit: X- LZ a_ezl_� J.L1J Mailing Address: r�,l e' l5 e,, Phone Number: Email Address: �a -ya_ e1__� I certify that I have authorized 9�®u�f�✓' �°1a�oe��®,�s7; Agent / Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: Rejo6at-@ CxSAgr /04mX44�tZ at my property located at%� in 64erl=�e2fX,. County. 1 furthermore certify that .l 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: Print or Type Name Title Date This certification is valid through 4 / jd /"—' jo i�_ -i` .� � 1t 2� .t � .. t� .. "3 t j\�'f ,:, I..._. �� �t,]�i.�. } r. I. l ; �.�L � If. F! �• �.1� 9f F�. ..�.. 3. AS TV, .. -- ;r eft .• , �. t.i: 1:-1' .� �. .[ jV f.• ." t