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HomeMy WebLinkAboutCannon, Kelli 76625C�, 'MA /-116REDGE & FILL N9 76625 A B D #cl NERAL PERMIT Previous permit# flew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued As authorized by the State of North Carolina, Department of Environmental Quality and the Coastal Reso r es Tmissiorn' anarea of environmental concern pursuant to 15A NCAC�n❑Rule attached. me Applicant Na(r ' f ( o i 1 J Project Location: County C' "7/Y� S c , -�)-7, r 1el' �h Street Address/ State Ro?d/�oj #I{s) State .AX zip l � / )) ( t/ C . J r Phone # Authorized Agent Affected El CW '2EW $kPTA • LIES' ❑ PTS AEC(s): ❑ OEA -E1 HHF ❑ IH ❑ UBA ❑ WA ❑ PWS: ORW: yes / noJPNA�es /. no/. no Subdivision City >' �/I /r zip O Phone # O ver Basin r Adj. Wtr. Body ? `' " r�✓t /man /unkn) Closest Maj. Wtr. Body Type of Project/ Activity �■■■■■■■■■■■■■■��Jlu IT ai■■■■■■■■■���,�� f[ NC...a.... ■■■■l■m■■■M"'a M ►.� M NEE NEI Iwo M:::NEE .....■ m■ MEMO■■�■■■■ ■■■■■ NN_ ME NEE �■ ■■■■■■■�■ 1■■It■NEE N►►M`�! ■■■■■■■■H■■■■■■■■■ti■!■■If I11A■rA■NEE ■■ w4LNE■ ■■■■■■e1�I�/■11 ■■■■■■■■■■■■■■■riB■■■■■■■MEN IEEE■■■ ■■■�■■■■■■■�■■■■■■■b �1l ■I��H■■■■■■■ ■■N\■■■■■■■■■■■■u■■■■ :.. RE ■■\■� ■■� ■■■ 1■■ ■■■■■ ■■ ■ Mff MIN 1111110 OEM no No ME •.H■■■■.■■..■■■�■■■....■�.■■..■.■■■ ..■■NEE .■■■�■■■■■.■■■■■■.MEN ■...■■■ .�■■...MEN ..■OEM ■�...■■■.. .... ..■■■■ ■■ ■■.■■. ■■■■...■■■ ■■.■n■■■i■■■■■■■n■■.....■ ■a■■■■■■■■■ ■■.■■■...■ ■w.■■. .......■�.Gtiln�Pi Illl�il---= ■• �..r�■7■ . ,ONME ®■�CA 0....��..■■�1��:,■■■a■■ .�...� ■�rv.., Agent or Applicant Printed Name sl Please read compliance statement on back of permit" t _placation 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 nul I 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, certifythatthis project is consistentwith 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 CERTIFIED MAIL • RETURN RECEIPT REQUE§TED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONfWAIVER FORM Name of Property Owner: Address of Property: 1 i 1 VJU l I V t'RI ILA I (Lot or Street #, street or Road, City Agent's Name #: 13000 bywy-5 Mailing Address: Vt- Agent'sphone#: (2hZ)2-+—g4O5 HAyZKM/, 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 drawin the development they are proposing. Es t tori'o''�xd0a'7i t` i1 OE if�n7gffi` rntFs'�tab�Jt5�iWuffiMtta`4Fv�`s<`CeTgr',. /dam- (1 Wirt I have no objections to this proposal, 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. Correspondence should be mailed to 400 Commerce Ave., Morehead City, NC,28557. DCM representatives can also becontacted at(252)808- 2808. No response is considered the same as no oblection if you have been notified by Certified Mail. WAIVER SECTION I understand that a pier, dock, mooring pilings, 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.) do wish to waive the 15' setback requirement. �/ i do not wish to waive the 15' setback requirement. (Property Owner Information) (Adjacent Property OwnerInformation) Signature Signature f Vlw¢� i'y57"i V l,t CAVW01V Print or Type Narhe t✓n `ktnnt-lQw p�f tNl�sl��a G4{ Pao Mailing Address' 6(Mtt\ tJ(, 2-'l 1y3 City/State2ip 10 - 131-"113 Telephone Number 11 >tit" 11010 Date �l��,n /r�✓X �'r/xn. � i�"t'Y11 r'i t��l. ���Yav��2l Print or Type Name 2917 4-xi�o-J /� r Mailing Address /11� �C ly,/VC .2g�f7 City/State2ip ),�.) - ) y7-X ) Telephone Number 5-3o_ao Date Revised 6/18/2012 v M W A-; Ji %,Z;Ai jIj T4 I 'WOOL JUMPING RUN CREEK � m --------� o HIGH WATER APPROXIMATE LOCATION OF NEW FIBERGLASS SEA WALL REMOVE EXI WOOD DOCK EXISTING WOOD TO REMAIN REMOVE EXISTING BUILDING NEW CONCRETE HOG SLAT 75' DECO SETBACK ' EXISTING CONCRETE BOAT -------------____ ' RAMP TO REMAIN EXISTING CONCRE SLAB TO REMAIN TING HOUSE REMAIN 20' MBL ----- ------------------------------ - GRAVEL OF TO REMAIN 151 WHITEHURST ROAD SMYRNA NC 28579 LINE 40 0 20 40 80 -1 N i AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: ;\' 16NA-20 keb r`'r (0�10 /l f- N D`�' Mailing Address: Phone Number: Email Address: I certify that I have authorized 25�5 s�7t\�Hr1�w )31 1+LFI�kt�n 0-A �1 6 1-7 Li� 9 I %- 73 / -113e-) Agent/ to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: k wA-ti at my property located at [S ( LA N T h H 0 k S r 0-VV0 in Ml r-Yt E'T County. l 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: Signa e 1 / N" Iteo a4L Print or Type Name O wv�4:Y� Title z-Y I Zu Date This certification is valid through &� /mil 2� � t ..' ally'9si :?G4flj!gt.tiiJij ra?1:�i1-.' V1�3LiYi`� i!1 !:••'3fTzl ''arkk"i1JY �y'}'�11 1' s1Ui1 >�? /•1ivS:^.; Ilk ;:c YliCikJO 4fkc't1 �I,xy$•,I+t -ej q k)gi'.1q:emffl v)l !!6fiE:,'.��' In.,1WIvIsa9h 3;yiur)gtna prii"Aroboi €sA; kg (?I 'l.}1?.'ri15F13 � §l :ol\ *. isi fl'lsl� !^.(41 .kclf3?`"/, 'J1 t)- }!yCsk'F'. k4i tiff.? i 1'$�:1 `d31Yi9:' •a%(dCi''�.R1si1't, 1. t 201. 1;,1 `S�i1 Ni.1 (1 A""rmCA6t17:'1T'1ivv1,-Amw 14C6'f`)e'i, 1-x) lit '1';SVS•i�. bF:i.'V,�ljd5 `'S'a w`1i f;� vv'i f7,, • .I't3k}Elki'.�T'.fi �9fmv W 4,x, MEBANE 100 VILLAGE DR MEBANE, NC 27302-9760 364960-0302 (800)275-8777 05/12/2020 09:44 AM t Oty Unit Pri( Price Class Mail® 1 $0.55 $0,1 omest1c) tMOREHEAD CITY, NC 28557) =,ight:0 Lb 0.90 Oz) >timated Delivery Date) •iday 05/15/2020) ad $3. ;PS Certified Mail #> 1192970000126640723) Receipt $2. PS Return Receipt #) 90940257750003626696) Postage ($D.' 'fixed Amount:$0.55) — — ------------------ $6 ... ------------- ;ard Remitd 'd Name:VISA) :punt #:XXXXXXXXXXXX1102) Iroval #:012566) Insaction 4:428) :A0000000031010 Chip) ., ,o 7 iTr iG �i Tracking or call, 1-800-222-1811. review your ftj rack your Packag ign up for FREE informeddeliverv.com es final on stamps and post e. Is for guaranteed Services on y. ank you for your business. HELP US SERVE 1'OU BETTER TELL US ABOUT YOUR RECENT POSTAL EXPERIENCE Go to: https://postalexperience. or scan this code i4ith Your mobile dev ce: or call 1-800-410-7420. YOUR OPINION COUNTS =ipt #: 840-52700614-2-5087282-2 Clerk: 06 F Postal CERTIFIED o RECEIPT m ttl Domestic -�• 110 11 11, B Certified Mail Fee _ $r„,r`r - 1i�112 FU $ o� Extra ervlcoo Fees (clreckbox, edd/ee e ❑Retem rf 0 RsW,t(M1eAwpy) $ ❑q m Raxkt(elomalc) $ 4;G rill Postmark Q ❑Cenmetl Mflll geaNcted Delivery Here O �Adutt $Ignalure Required $ -. T [)MYM1 $IpneAxe Restricted OelNery $ C3 M1 Postage W.55 Q' i15/12/2020 Total Postage and Fees ru s $69E p Sent To � L:E 4 a f ■ Complete items; '1,'2, and 3. ■ Print your nanle' and address on the reverse so that we can r&Lfferthe card to you. • orlach on their � + i to the back of the mailplece IIIIIIIII IIII IIIIIIII I IIIIIIII I IIII III IIIII III 9590 9409 R77r nnno __ 7019 2970 11001 2664 Form``38� 1� July 2015 PSN 7530-02-000,9053 DOMesttc Return Recelpt ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (I -OR A PIER/t1100RING PILINGSIBOIITLIL 7%It 0A7'FIOUSE) I hereby certify that I own properly adjacent to i't,:ULk GA_,aN0r1 d WGIjMtb R��jasjs (Name of Properly Owner) property located at _ �5 �W NtTtiHU,(LsT "A-b (Street Address, Lot, Block, Road, etc.) Oil 4VMV'uJ(A VWI�J Mr1-e r----, in- SvHyr la; 6AYL L"Zr 7__ COO PT)6 N.C. (Waterbody) (Town and/or County) He/she has described to me, as -shown below, the development he/she is proposing at that location and 'I have no of jections to this proposal. _ I understand that a pier/mooring pilings/boatlift/boathouse must be set back a minimum distance of fifteen feet (15') from my area of riparian access unless waived by roe. I have indicated my intentions by initialing below: .I do not'agree to waive the 15' setback requirement. (initials) -JA-3 I do agree to waive the 15' setback requirement. (initials) ----------------------------- DESCRIPTION AND/OR DRAWING OT PROPOSED DEVELOPMENT: ` (To be filled in by individual proposing development) St.nature Print or Type Name Telephone Number Date: