HomeMy WebLinkAboutFairfield Harbour Property Owners Assn 77471C.,T
�l CAMA / ❑ DREDGE & FILL O
.� N . 77471 A B �� D
GENERAL PERMIT Previous permit# A
[YNew ❑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 I SA NCAC
.Rules attached.
Applicant Name , F-%- (/il „ %v /Qe,a 1) r� • A",
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Addressk2- Zee-c
City �/a <i� State A<� ZIP 7- 5 6a
c- c.. ice.•%,
Phone# 7ZZ)l�3 �Sa� E-MaillN/"oti'<-'
Authorized Agent
❑ CW
C EW [PePTA ❑ ES ❑ PTS
Affected
AEC(s):
OEA
❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
ORW:
yes .( no
PNA yes /` no ---
Project Location: County /
Street Address/ State Road/ Lot #(s) fr% 1• -
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city Nc4 f>C. ZIP 2_Sy >
Phone # (7 -2- 0 River Basin 2
Adj. Wtr. Body, / /f (nat 6ian unkn
Closest Maj. Wtr. Body 1
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Agent or Ap r'nt Printed Name f
�
Signature�'** Please read compliance statement on back of permit'*
/
Permit Officer's Printed Name
Signature
7� 1
Issuing Date Expiration Date
Application Fee(s) Check #
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 I) 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 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/ 1-888-4RCOAST
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
CAMA;/• ❑ DREDGE & FILL N° 77471 A B C ; D
GENERAL PERMIT Previous permit# ,1
n NeW : ❑Modification ❑Complete Reissue ❑Pa4ial Reissue Date previous permit issued jff�
As authorized by the State of North Carolina, Department of Environmental Quality
and the Coastal RasJurces Commission in an area of environmental concern pursuant to 15A NCAC `
Rules attached.
Applicant Name - Project Location: County
Address- - ° Street Address/ State Road/ Lot #(s) :' i
City State ZIP
Phone # O .. S bd...
Authorized Agent
Affected ❑ Cw
AEC(s): ❑OEA
❑ PWS:
ORW: yes / no
E-Mail u Ivlsion
City ZIP
❑EW IVPTA Li ES ❑PTS Phone# ( -)' "l O River Basin _
❑ HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body (nat /man-]unkn)
PNA yes / no Closest Maj. Wtr. Body - -
Type of Project/ Activity
Pier (dock) length _
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)—
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel _
cubic
Boat ramp
Boathouse/
Beach
Other
Shoreline Length
SAV: - not sure yes no -
Moratorium: n/a yes no "]
Photos: yes no -'! l
Waiver Attached: yes no i
A building permit may be required by:
( Note Local Planning Jurisdiction)
Notes/ Special Conditions
(Scale:
so
pgSee note on back regarding River Basin rules.
Agent or Applicant Printed Name ermitOffcer's Panted N.
Signature "* Please read compliance statement on backof permit«+ Signature
i
Application Feels) Check# Issuing 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 ❑ 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
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/1-888-4RCOAST
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 7106/17
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to F H " 110.4e { i 4 Ss a 's
(Name of Property Owner)
property located at 1 ° -PeI i c a. 2
(Address, Lot, Block, Road, etc.)
on ✓ Plixfl4e 1 ✓Nnm 14Ar2I6akrL , in FAtrePtet b N14000-f, NeuJ 73E2 .C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location/
I 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)
hn,ci'
//J/JC'e /-,4r9/1 /3 oc, rz
6d�W r[ai+7'��NC
WAIVER SECTION
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 yoy,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 Information)
Siggn�`ature
/"/Au2y IIN-csru/dSo�
/c02nt r Tgn. k ai?.«.�
AJtw �942s _ iU L .2 19G 0
(Adjacent Property wner Information)
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signature* I 5
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Pdnt or Type Name
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Mailing Address
.1fw 'RAea. NC 7-
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3301 FN rBA ®ftc99£NCC 1K,[4Al2f2- 7J-9sr.3 11t)
1ne Number/`email address Telephone Number ?email address
Date*
RF ,Elv.L 7 (Revised Aug. *Valid for one calendar year after signature'
NOV 0 6 2020
DCM-MHD CITY
t
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
hereby certify that I own property adjacent to rAmfle10 ntA26o-- P^t' Doerr AAsV&
(Name of Property Owner)
property located at
(t 00 e (,- c- 4.,
(Address, Lot, Block, Road, etc.)
onfAMCie(d 1„+ve, HAM16eh.- ,in PprrcF'tEeo N�n.b9u.-� /t/ew_gz,M.C.
(Waterbody) (CitylTown and/or County)
The applicant has described to me, as shown below, the development proposed at the above
locati
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)
WAIVER SECTION
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.
(Property Owner Information)
or
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(Adjacent roperty Ow err Information)
Signature* .
wtlornry Avda. r .
Print or Ty�ra Name
6 10 2' X-04 "6CA 0—
Mailing Address
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Date*
RECEIVED
*Valid for one calendar year aftel' ffluuire2OZO
(Revised Aug. 2014)
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