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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 1I I iI lIt,tl 1 I I I I I t 4 IiIi I I i I jl_ I I."_-t-ff I -tT , I I I I I\+ II\t\ I I\tl I Ii t ---J* l I -l-+ I\t I I t I I\II I I\ I II 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 tl I iI liiLIil tl I jl1 I \ lri \\t+ I tl 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 e* il(3 N)(,C IJtilr II,-i -o 3soT' ==.o A) o.oao ,-4.:(f 6'f oa oLa :J 0)u *tr'* Js.f o- q) .Ua aoo!2o_Lqs o(o o :-O- r l\isi , ,\n r:,1:'.:" z> ,1 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: >O o