HomeMy WebLinkAboutSmith, Alton 75969CN T
Reissue
bt th. Stac! of Nordr C.rolim. Dcpanmim of
and th€ Co.stel CommBsion in an area of
Appl
Add
Phone Mail
Authorized Agent
Date permit issued
puBuant to l5A NCAC
Proiect Lo€ation: County
Address/ State
City ztP
Phone #
Adi. Wtr.
Closest Mai. Wtr.
No. 75969 A
Prwiors permh #B
XPanial Reissu€
E wilgr*i6l Quality
Street
Affected
AEC(s):
-i cw
- OCA
trEW
C HHF
] PTA
_tH
fqst use
o
D
D
ORW: yes /PNA yes I
Mi cky Penny
AFnt or Agplkant Prirrted
^f{ncah+#- f r-7
Signaru
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ft.r (dock) ldrSth
(Scale:)
Fe.d PUorrn(.) _ffi-+
FlodrE Pl.rfom(r) _+-++
F'nt€r plc(s)
G.dn bngth
]+
+
avg dlsBnce ofihore
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mu dbtanca ofrshorc r
B6in. chanml tt #--+
cubk F.ds J-rt---+--{---]--.t---J-
Bet ..mp __
Eo.thou$i Bodift
B€ach BulldoznS
OdEr
Shorclin. LsrSth It
SAV: not trri!
rlor&riun: rve
Ptrdoa:y€5
A blildint p€mit may be by:on back River B&rin
( Note Local Phnniqg.lurisdktion)
Note,
\
Applkatlon F.!(s)
compllance stat€ment on back '/1
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Che& #
I FILL
Lot #G) ._.....'.-.---
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Type of Proiecv ActMty
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DGE E FILL
New Modification Complete Reissue panial Reissue
by the Srate of Nonh Carolina, Department of EnvironmentJl Quality
and the Coastal Reso Commission in an area ofenviron
No. 75969 A
Previous permit #
Date p reYious permit issued
B
Appl icant
pursuant to l5A NCAC
Adi. Wtr. B
Closest Maj. Wtr. B
Project Location: Counot C 0
Add
City State
Phone #-Mail
cw
- OEA
EW
HHF
)qst uaa
Street Add ress/ State@
Subd
City
Phone # (
ztP
ver Basi
!qk!)
)<)
Type of ProiecV Activity
Pier (dock) length
Fixed Platform(s)
Floatint Platform(s)
(Scale:)
Fin&r pie(s)
Groin lentth
praP
aW distence ofrshore
max distance ofrshore \-/,--a
rcqcubic Frds Vfi J-/-Boat ramp
Boathousey' Boatlift
n
Beach Bulldozint
Other ---sl
Shore line Length
xMoratoriurn: nla y6
Photos: yes
WaiverAttached: yes
&
A buildinS permit may be by'on back in8 River Basin les.
( Note Local PlanninS Jurisdiction)
Notes/Con
Agent or Applicant Printed Name P€rmitOfllcer's P
Signatu
tut()
P
Application Fee(s)
compliance statement on back of o€rmit #
I7o;
Check#
11
ls*i(g Ex
E PERMIT
Lot #(s)
Authorized Agent _I
Affected
AEC(s):
PTA
IH
tr
tr
ORW: yes /PNA yes I
I
I
t-]
LIBasin, ahannel _ r-t
I
M
Statement of Compliance and Consistency
This permit is subiect to compliance with this application, site drawing and attached general and specific conditions' Any
violaiion of these ierms may subiect 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 proiect site and accessible to the permit officer when the Proiect is inspected for compliance The
applicant cenifies by signing this permit that I ) prior to undertaking any activities authorized by this Permit, the aPPlicant will
confer with appropri; l;l authorities to .onfir- that this proiect is consistent with the local land use plan and all local
ordinances, "na
z) " written statement or certified mail return receipt has been obtained from the adiacent 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 Proiect is consistentwith the North CarolinaCoastal Management Program'
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 loiation within that River Basin. These buffer rules are enforced by the NC Division of
Water Resources. Contact the Division of Water Resources at the WashinSton Regional Office (252-946-6481) or the
wil;i";;; R"gi.naloffice (910-796-7215) for more information on how to comPlywith these buffer rules'
River Basin RulesApplicable To Your Proiect:
Tar - Pamlico River Basin Buffer Rules
Neuse River Basin Buffer Rules
Division of Coastal Management Offices
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ I -888-4RCOAST
Fax 752-247-3330
(Serves: Carteret. Craven. Onslow _
North of New River lnlet- and Pamlico
Counties)
Elizabeth District
401 S. Griflin St.
Ste.300
Elizabeth City, NC 27909
257-2U-3901
Fax:252-264-3723
(Serves: Camden, Chowan, Curritr.tck,
Dare, Gates. Pasquotank and Perquimans
ColJnties)
=1 Other:
washington District
943 Washin4on Square Mall
Washington, NC 27889
252-946-6481
Fax:252-948-0478
(Serves: Beaufon. Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-796-72t5
Fax: 9l 0-395-3964
(Serves: Brunswick, New Hanover.
Onslow - South of New River lnlet-
and Pender Counties)
http://poral.ncdenr.org/web/cm/dcm-home
Revised7l l17
GE E T c N
Name of Property Owner Requesting permit:\k 3 S,*:.IL \r
Mailing Address:q\o Lz.e
ftt o- {*C Be.aL. cvL zrStL
Phone Number:g rq-tr\tr-5.tt3
Email Address:
I certify that I have authorized
N
ent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:{.,-.dcl \ UelJ
a
at my property located at (+\^-$c Be..L\O Le€
tn /Coun ty.t-
I furthermore ceftifu that t am a.utho-rized to grant, and do in fact grant permission toDiision of coastar'Manaoement staff, tne toiat iiiit officer and their agents to enteron the aforementioned tinds in connectii- iii "iiirting information retated to thispemit application.
Property Owner lnformation :
Jr-
\,4-S^\ 5r
Print or Type Name
Title
tL o\
Date
This certification is valid lhrough \L t O\ t ZO
RECEIVED
0EC 0 I rri19
DCM.MHD CITY
I hereby certify that I own property adjacent to ft\V-.S".,V sr S
property localed at 4to Lec Sa
on \]d ot Bloc
fv{\c^(* L{, N,C.
(Address, L K,R )
IN \a
(Waterbody)(City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location. -.p \ (, I have no objection to this proposat.
I have objeclio-nsJoJhis_pr,oposal_
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(lndividual proposing development must fill in description below or atlach a site drawing)
I {+\iJ
^Yrtv V t-r/
\ 1/)'<' t
l<'iq
r.gz4 ae?'
".ra.tt S
'-----=>
te"lart
q ce(4 ^.\*- R.-.-\e\"$+,\
lunderstand that a pier, dock, mooring pilings, breakwater, boathouse, lifRg6p
back a minimum distance of 15' from my area of riparian access unless waivib
wish to waive the setback, you must initial the appropriate blank below.)
I-fX 6 ldo wish to waive the 15'setback requirement Dci,r_rrrHD c,ry
I do not wish to waive the 15' setback requirement
in must be set
by me. (lf you
OEc 0y
(Property Owner lnformation)Adjacent Prope rty Owner lnformation)
s,e trt\iotF
Print or me
eU^\S*\tl,.. 5r
Pint or TWeL1\P Lt Name(*\o(<+.fr+wi NL Z-QS:L
Mailina Address*{tl*i R"."l^ \-[ z(ErZc{fftY{K- Ltt3 "'Yl4'Ytfi-t"oos
Te Telephone Numberq2- Dt -t1
Number
7 -''t1
Date
(Revised 6/1gny 2)
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
?2at tan.l,
walvER sEqTlou
Date
I hereby certify that I own property adjacent to (|\ t^ S,*'r\. \ -
(Name of Property Owner)
prop"-'tv locdted at 0 L"4*.'
on t\l*,x-z . (Address. Lot BlockA-4 in tl+lc-, N.C,(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
locati
I have no objection io this proposal
-.---....-,,.._- I havLobjeclio-ns-toJhis-proposal--,- --
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(lndividual proposing development muslfill in description below or attach a site drawing)
,t\os6\- t ''l REccl
V ry
soBn$'{lc\- - lt -+-.r:G-?-4cr{\r L -.{--\l'_-.<v
se-\44
?,o( <trrA
lo4' eep
q gN,\'Qr*"2o'l
Wtt gl \[, "$r
WAIYEBSEgTSN ?'d
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. (lf you
wish to waive the setback, you must initial the appropriate blank below )
I do not wish to waive the 15' setback requirement
(Property Owner lnformation)
s,'t"^T5 5-,1,. \r
Print or TvDe Name\l-D'Lcz gt
(Adjacent Property Owner lnformation)
s,e
Print or ype ame
l:a s na
e
fi4{31(€*g"". t tv' z ss t z *"Hffilf+,.
Bnon
W4^Wr-ut t3 "'5Wpa'rqL2
Teleohone Numbertz tl 11
Tel;frone Number
{rlc 4* tz--
Date Date
-0
fReyised 6/11nU 2)
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
D[i 1,u ]
DCM-Ivlh- _,, ,
"r1
s&I do wish to waive the 15' setback requirement.
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