HomeMy WebLinkAboutGodard, Eric 77392CtrGAMA/trDREDGE&FILL
G N ER/AL PERMIT
EModification ECompleteReissue EPartialReissue
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 l5A NCAC
Date previous permit issued
Project Location: County
Street Address/ State Road/ Lot #(t)_
Subdivision
c zlP
Phone # ( )- River Basin
Adi. Wtr. Body (nat /man /unkn)
Closest Mai. Wtr. Body
N9 77392
Previous permit
ABCD
#
Applicant Name-
Add
State zlP
Phone # (_)
Authorized Agent
E-Mail
Affected
AEC(s):
trcw
N OEA
tr PWS:
tr Elv
tr HHF
tr PTA
trrH
trES
tr UBA
tr PTS
trN/A
ORW: yes / no PNA yes / no
)C
Type of ProjecU Activity
(Scale:)
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)_
Groin lengh
nurnber
Bulkhead/ Riprap length_
avg distance offshore _
max distance offshore_
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
Shoreline Length
SAV:not sure yes no
Moratorium:
Photos:
Waiver Attached
nla yes no
yes no
: yes no
A building permit may be required bY:
( Note Local Planning Jurisdiction)
E S"" note on back regarding River Basin rules.
Notes/ Special Conditions
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Agent or Applicant Printed Name
Signature x* Please read comPliance statement on back of permit **
Permit Officer's Printed Name
Signature
Application Fee(s)Check #lssuing Date Expiration Date
ENew
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Statement of Compliance and Consistency
This permit is subiect 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 officerwhen the proiect is inspected forcompliance. The
applicant certifies by signing this permit that l) prior to undertaking any activities authorized by this prmit, the applicant will
confer with appropriate local authorities to conlirm that this proiect 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 ad,acent riparian
landowner(s) .
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best availabb
information and beliel certirythatrhis proiect is consistent with the North CarolinaCoastal Management Program.
River Basin RulesApplicable To Your Proiect:
Tar- PamlicoRiver Basin Bufler Rules
Neuse River Basin Buffer Rules
l l other:
lf indicated on front of permit, your proiect is subiect 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 OIfice (252-946-6481) or the
Wilmin6on RegionalOffice (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/ | -888-4RCOAST
Fax: 252-247 -3330
(Serves: Carteret, Craven, Onslow -
North of New River lnlet- and Pamlico
Counties)
Elizabeth Citv District
401 S. Griflin St.
Ste. 300
Elizabeth City, NC 27909
252-264-3901
Fax:252-264-3723
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquoank and Perquimans
Counties)
Washington District
943 Washin6on Square Mall
Washingon, NC 27889
2s2-946-6481
Fax:252-948-M78
(Serves: Beaufon, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
I 27 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-796-72t5
Fax: 9 l0-395-3964
(Serves: Brunswick, New Hanover,
Onslow - South of New River lnlet-
and Pender Counties)
http://portal.ncdenr.org/web/cm/dcm-home
Revised 7/06/ I 7
AGENT AUTITORTZATTON FOR CAUA PERMTT APPLICATION
Name of Property owner Requesting Permit n,ever r..l arvl e r i c g nclard
Mailing Address:
Phone Number;
Emall Address;
t certifu that I have authorized
J1e -Aqe -o *b{,
to act on my behall for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed developrnent:
at my properff located at r tJ t"l cti or _;j r i V e. ,,,*,
in on.St oyrl ,.,-Coung.
t fufthermore certity that I am
Divisian of
on f/re
permit application.
Property Ormer lnformation:
Signafure
orType Name
n€-l.
Title
)Q-J-Lfr-JJ-oza-
Date
l14 l-tri )* hr
.cuzEn.<borr N( e(.<Ktf
- )a-.qadarJa) rr ',<trr ir es,(o
r, rlr\ q...L+r n-{r
This certiflcatlon ls vallcl through
I hereby certifu that I ornrn property adiacent to
property located at
of Froperty
{Address, Lof,Blcck Road,
,s
on in N.C(!ftfaterhodyl {Cttyflown Sountyl
The applicant has described to me, as shown below, the developrnent proposed at the abovelooation.
i :- I have no objecfion tu this praposat.
I have objections to this proposal.
iSo' ia3ng Vin*1 *qlt
ta \-tdrca l{2 t-{dior
me.
that a pier, doc*,
to waive
I do wleh to waive the 15f setback rcquirernent.
I do not wish to waive &re 15 s$ack requirenrent.
lifr, or groin
unles$ ltftaived by
lnfomration)
----------7--X
iProp€rty
Telaphone
*
Date
Valid for one calendaryear afier eigna&re'{Rew'sed Aug. 2014)
drawing)
ADJACENT RTPAR|AN PRSIPERW OWNER STATEMENT
I hereby ceilifu that I own property adjacent to
property located at
of Propefi
Lot 8lock, Road, etc.
t^
D
)on tn N.C.(Waterbody){City/Town County)
has described to me, as shovvn below, the development proposed at the above
I have no objection to this proposal.
I have objections to this proposal"
DEVELOPMEI|TT
a sife drawing)
l5o'tong vinll watl
N&d"*-,do wish to waive the 1Sl setbaclclwuirement.
I do notwish to waive the 15' setback requirement,
(Property
City/StateEip
The applicant,trM
1u lldiA tl2 \14iQ
Date
Valid ior one calendar year after signature*
(Revisad Aug. 2014)
DESCRIPTION AN D/OR DRAYUING OF PROPOSED
( I ndfu i d aal proposiing d ev 6Io p m ent m ust f I t I
I a pier, dock,
must be set a
me.
Signature
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NC Division of Coastal Management
Cashier,s Official Receipt 13942 A BOD
/,*-,oQ2Date:
Received From:
$D
Permit No.:v 3 a(
Applicant's Name:o)(Check No.:/ost5
County:nsld
Project Address:D-.
please retain receipt for your records as proof of paymsnt for permit issued.
Signature of Agent o. Opr,,""n,, .-
/
Signature of Field Representative:
Date;
Date:
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