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HomeMy WebLinkAboutMatthews, Gregg 77136CXCAMA i omwn & rILL "GENERAL PERMIT B wif DI 'Ji'A 11 A 0 k,v pN A 06wit Mai Wt, Body Type of Project' Activit) rase nx j Mr, ........... . "I 3, ", :.. o/ T"A 111X ti CAMA / ❑ DREDGE & FILL �R N9 77136 A B (D D "GENERAL PERMIT Previous permit# ew [-]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 0714.1100 ec ules attached. Applicant Naarm9�en�cQ �` Q(Q�/ S Project Location: County—�to�io �r/z7oc c> _ l )r t �i a Street Address/ State Road/ Lot #(s)'�- Address Po. _ ( � ZI P9S5-7- 0 Phone # Authorized Agent YCP_C, 9 I Affected El CW Ll EW ❑ PTA ,�*S ❑ PTS AEC(s): OEA ❑ HHF ❑ IH ❑ USA ❑ N/A ❑ PWS: n ORW: yes ,jpd' PNA yes Type of Project/ Activity Pier (dock)length i Fixed Platform(s) Floating Platform(s) Finger pier($) Groin length — avg distance i max distance Basin, channel Boat ramp Boathouse/ Boadift Subdivision �1A City ZIP Phone # (_) /n�R_iiver Basin AINA Adj. Wtr. Body � A /' '(.t (�m1t^an%/unkn r) i—.-.t Mai wf. Rn.ly /Vp� SNi V / 'C/s ME - .�ffny� n�■N■N■■N�H/iiC::■NII 1 in���®v�AVY�y�fti SAV: notsure yes no Moratorium: n/a yes no Photos: yes no Waiver Attached: yes no/ A building permit may be required by: ( Note Local Planning jurisdiction) Notes/ Special Conditions S �Ign ure ** Please read compliance statement on back of permit** pq OD, 30 1/0 Application Fee(s) Check # If Y (Scale: I D4See note on back regarding River Basin rules. qIPermit Of icer's Printed Name tIE` ssuing Date pira on Dat 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 comply with these buffer rules. Division of Coastal Management Offices Morehead City Headquarters 400 Commerce Ave Morehead City, NC 28557 252-808-2808/ 1-888ARCOAST 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 FORM FOR PERMIT APPLICATIONS Name of Property Owner Applying for Permit: Ge cc-6 t`l0Ztr—U S Mailing address: 1Vl ��cs 0 G. Telephone Number: I certify that I have authorized (agent/contractor), to act on my behalf, for the purpose of applying and obtaining all CAMA permits necessary for the proposed development of � pi u at my property located at M '3`l ,� ��C>�uZi ) , F This certification is valid through (Property Owner Information) 2 - - -- --/1 --11 , Signature Print or Type Name (Rik-' c L�Z Title, co. owner or trustee for property 9 y — �)-0 Date Telephone Number Email Address (date). RECEIVED AUG 10 2020 DCM-MHD CITY ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent tor-RCC-G CO 1I OLW N4eaN1 "-w S 's (Name of Property Owner) property located at -Zy2�-J' L (Address, Lot, Block, Road, etc.) on r �1 } in (�i C-U3 7uI1. , N.C. (Waterbody) (City/Town and/or County) The applicant has described to me, as shown below, the development proposed at the above I o tign. aslk 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) i'5rs i�N4- +✓M L WAIVER SECTION I understand that a pier, dock, mooring pilings, breakwater, boathouse, back a minimum distance of 15' from my area of riparian access unles wish to waive the setback, you must initial the appropriate blank below. I do wish to waive the 15' setback requirement. 1 do not wish to waive the 15' setback requirement. (Property Owner Informatio ) Signa(}ure p �(� + CltitekCS l 1A.'J�rC1 Print or Type Name �Jz7 �ri,kr'i� (1� Mailing Address J�,l�„dzll /JG City/S��e2ip,/� Telephone Number lift, or groin must be seIRECEIVED s waived by me. (If you > AUG 10 2020 DCM4HD CIT (Adja , n Property Owner Information) Signal i e �n Print or Type Name 112 SCLA -ill rr. -2C1Zy `C Mailing Address W (-4J ? U'Z bk City/State/Zip Telephone Number ADJACENT RIPARIAN PROPERTY OWNER STATEMENT hereby certify that I own property adjacent to lam--0-C-G-L +-CQ -)t *f+J MAIIr+Eta S 's (Name of Property Owner) property located at (Address, Lot, Block, Road, etc.) on CLJ in (Waterbody) (City/Town and/or County) N.C. The applicant has described to me, as shown below, the development proposed at the above I ca io . 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) t WAIVER SECTION understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin back a minimum distance of 15' from my area of riparian access unless waived by wish to waive the setback, you must initial the appropriate blank below.) I do wish to waive the 15' setback requirement. V�A I do not wish to waive the 15' setback requirement. (Property Owner Information) z� Signature 1-411M KuWeG�t Print or Type Name /2Y0 .S rcfi %iA Mailing Address N(,>k) 6) v 7- City/state/Zip N'G Z,'rS 7V Telephone Number z5 v-fS3s'b1/37 Date g -1 ] 2 0 Print or Type Name Mailing Address 0 G"% Pow i 9 f City/statelzip `,? ;3Sn -0 Telephone Number Cam 2c,55`b Date must be set me.p EGEIVED AUG 10 2020 DCM-MHD CITY Information) (Revised 611812012) CAUA la