HomeMy WebLinkAboutCleveland, Don 77388Cc D
Authorized Agent
Affected
AEC(s):
-cw
OEA
PwSl
iEw
HHF IH
PNA
L ES rPTS
U8A N/A
Phone # ( )
Adi. Wtr.
Closest Maj, Wtr. Body
Basin
o
oRu/yes I uu -.-no
Type of Proiecg Actiyity
Pier (dock) lenSrh__
Fixed Platform(s) _
Floetint Pldform(s)
(Scale:)
FinSer
Groin lenSth
Bulkhead/ Rjprap lentth
ay8 distahce otrhore_
max distance ofrshore __
Basin, channel
Boat ramp - =--
Boathouse/ Eoatli{t
Eeach
Other
Shorcline LenSth
SAV: not iure yes no
Moratorium:
Photos:
yes no
A buildinS permit may be required by:
( Note Local Planning lurisdiction)
Note, Special Conditions
l see note on back reg-arding River Basin rules.
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Please statement on back of permit *Signature
lssuing
Agent
Fee(s)
(
Check#
/ .- DREDGE I FILL
EN IT
Modilication Reissue .lPanialReissue
As authorized by the Stale of North Department of Environmental Qualityand the Coastal Resources Commission in an area of environmental concern pursuant to l5A
N9 77388
Previous permit #
Date previous permit
Proiect Location: Counq/
Street Address/ State Road/ Lot #G)
B(
(/ /.
Applicant Name
/t JAddress
Ciry - State Ztp
Phone # ( ) E_Mait
.\
t. {-,.. -./ /)-
Subdivision
-l
i-T --r-ffiF
cubic rards I
-l
;I
llrrrtttt
l j1 r++
i,,,r'rr, llri r tttlllll
Permit Of{icer's Printed Nam6
I Expirltion Date
Statement of Compliance and Consistency
This permit is sublect to comPliance with this aPPlication, site drawing and attached general and specific conditions' Any
violation of these terms may subject the Permitee to a fine or criminal or civil action; and may cause the Permit to become
null and void.
This permit must be onthe proiectsite and accessibleto the permit officer when the prolect is inspected for compliance' The
applicant certifies by signing this permit that l) prior to undertaking any activities authorized by this Permit, the aPPlicant will
confer with appropriate local authorities to confirm that this prol-uct i' consist"nt with the local land use plan and all local
ordinances, and 2) a wri$en statement or certified mail return receipt has been obtained from the adiacent riparian
landowner(s) .
The State of Nonh carolina and the Division of coastal Management, in issuinS this P€rmit under the best available
information and belief, cenifythatthis Proiect is consistentwith the North carolinacoastal Management Program'
River Basin Rules Applicable To Your Proiect:
Tar - Pamlico River Basin Buffer Rules
Division of Coastal Management Ofiices
Morehead City Headquarterc
400 Commerce Ave
Morehead Clty, NC 28557
252-808-2808/ I -888-4RCOAST
Fax: 252-247 -3330
(Serves: Carteret, Craven, Onslow -
North of New River lnlet- and Pamlico
Counties)
Elizabeth Citv District
401 S- Grif{in St.
Ste.300
Elizabeth City, NC 27909
257-264.-3901
Fzx:252-264-3773
(Serves: Camden, Chowan, Cu.rituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Other:
i Neuse River Basin Buffer Rules
lf indicated on front of permit, your Proiect is subiect to the Environmental ManaSement commission's Buffer Rules for the
fuver Basin checked above due toits location within that River Basin These buffei rules are enforced by the NC Division of
water Resources. contact the Division of Water Resources at the washinSton Regional office (252-946-6491) or the
w#;;; c"gb".ion * 1l ro-7ie-n i5J for mo.e information on how to complvwith these buffer rules.
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-U8l
Fax:252-948-M78
(Serves: Beaufon, Benie, Hertford, Hyde,
Tyrrell and Warhington Counties)
Wilmington District
127 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.orglweb/cm/dcm-home
Revised 7/06/ I 7
]CAMA / DREDGE&FILL
GENER/AL PERMIT
nModification Q(ompleteReissue {JpanialReissue
As authorized by the State of Nonh Carolina, Department of Environmental eualityand the Coasal Resources Commission jn an area ofenvironmental concern p-ursuant to l5A NCAC
Applicant Name
ABCD
Previous permit #
D ate previous permit issued
ll Rules aBached
Address
City
Phone # ( )SubdiYisionE-l'4ail
Affected
AEC(s):
cw
OEA
PWS
:..1Ew
HHF
: PTA
IH
ES
UBA
PTS
N/A
ORrrV: yes / no PNA yes / no
City ztP
Adj. Wtr. Body _ _ ]La! /oall/qko)
)C
Type ol Proiecv Actiyity
Pier (dock) len$h
Fixed Platform(s)
(Scale:)
FloatinS Plarform(s)
Finter pier(s)
Groin len$h
Bulkhed/ tuprap lenSth
av8 distance offshore
max distance offshore
8asin, channel
ffir
Shoreline Leogdr
SAV: nol s
Moratorium:
Ptrotos:
yes
yes
yes
A buildinS permit may be required by:
( Note Local Planning Jurisdiction)
- See note on back regarding River Basin rules.
Notes/ Special Conditions
Agent or Applicant Printed Name
Signature q Please read compliance statement on backofpermit *
PermitOfiicer's Printed Name
Slgnature
Application Fee(s)Check#lssuinS Date Expiration Date
State ZIP
Authorized Agent
Project Location: County __
Street Address/ State Road/ Lot #(s)
phone # (_ )_'- - .- River Basin
Closest Maj. Wtr. Body
t-ffi
cubic Frds_ j :
s*"..p =-l '
goethol,sd Boddift_
B€ach BulldozinS
Other
_t_-__F_t_f-i_H{
f'l,.i | : i
t++ij+ru:ffi
Statement of ComPliance and Consistency
This permit is subiect to comPliance with this aPPlication, site d6win8 and attached general and specific conditions' Any
violation of these terms may subiect the permittee to a fine or criminal or civil actiofi and may cause the Perrnit to become
nullandvoid.
This permit must be on the Project site and accessible to the permit officer when the Proiect is insPected for compliance' The
applicant certifies by signingthis permit that l) Priorto undertaking any activities authorized by this permit' the apPlicantwill
confer with appropriate local authorities to ;firm that this proi-ect is consistent with the local land use plan and all local
ordinances, and 2) a written statement or certilied 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 ayailable
information and belief, certirythatthis Proiect is consistent with the North carolina Coastal ManaSement Program'
River Basin Rules APPlicable To Your Proiect:
11 Tar - PamlicoRiver Basin Buffer Rules | ' I Other:
I Neuse Rirer Basin Buffer Rules
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 buffei rules are enforced by the NC Division of
Water Resources. conract the Division of water Resources at the washinSton Regional oflice (252-946-6481) or the
ffi;t";;;R";;;"arornie tg ro_7ga-ii I 5; for more information on howto complywith these buffer rules.
Elizabeth City Dbtrict
401 S. Griffin St.
Ste. 300
Elizabeth city, Nc 27909
2s2-26r'.-3901
Fax:252-2&4-3723
(S€rves: Carnden, Chowan, Curituck,
Dare, Gates, Parquotank and Perquirnans
Counties)
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax:252-948-0478
(Serves: Beaufon, Bertie, Hertford, Hyde,
Tyrrell and Washin4on Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-796-7215
Fax: 910-395-3964
(Serv6: Brunswick, New Hanover,
Onslow - South of New River lnlet-
and Pender Counties)
Revised 7/06/17
Division of Coastal Management Ofiices
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ I -888-4RCOAST
Fax:252-247 -3330
(Serves: Caneret, Craven. Onslow -
Nonh of New River lnlet- and Pamlico
Counties)
http://poft al.ncdenr.or8/web/cm/dcm-home
Name of Property Owner Requesting Permit:U(a^d
Mailing Address:z l^,orcUood Dr
Enarlo\kle Nt z(5qq
Phone Number:4ti zll 51s(
Email Address:{)cleve @ trrfatobal. nc.l-
lcertify that I have authorized ob Dri hlz
ent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development (ebvild docx av
'Ll6 IY.5horcwood Dr
at my property located at
ln Oqrter(*Cou n ty
I 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.
Signature
Ou", Cle ue l"nd
Print or Type Name
Title
Date RECEIVED
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Property owner lnformation :
G * c{-*!^\
_p_,_1-<_, arlg
Nov 0 3 2020
DCM-MHD CITYThis certification is valid throush 9)-, =1--, Lru
Do r.-r C\ rvc-\'r.-r
I hereby certiry that I own property adiacent to T oo s
Ownor)2.\y N s \ o rl..,, oo -b v-t-property located at
(Address,Lot, Block, Road, etc')
o \.JC in F=,zvr N.Con(ClUITown endror CountY(Watarbody)
The applioant has described to me, as shown below, the development proposed at the abov€
I have no objection to this proposal.
I have obiections to this proposal.
DESCRIPTION AND'OR
(t ndMdual Ptoposlng davotopma'fi
DRAWNG OF PROPOSED OEVELOPTENT
must frtt ln do6,crtpiton b3,tow or at,,,ch a stte dnwlng)
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c---- - -
P
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WAIVER SECTION
I understand that a pier, dock, moorinETilingrs, boat ramp, br€akwatsr, boalhouse, lift, or groin
mr"i O" set back a minimum distance-oi 15;from my arsa of riparian acceas unless waived by
;;. if t* *iltto waive the setback, you mu3r tnittat the appropriate btank belou)
I do wish to waive the 15' setback requirement'
I do not wish to waive the '15' setback requinement'
))(Property ottner lnform.tlon
I
K'3"".r.-i ^- )/TC
,aq 2 ,nl
:.Ls )
f *'/'to
\
Print or TyN Name ) s.-D0
-5 5g
Telephone Number / email address
-1A ?,,;14;,LC lo6*l .
nJe- r
r
Telephona Number / email adelrcss
NoV 0 B 2g/ffevtsed Aw. 201a)
Date
rydid br one calefidar year alter s(,nature'
Dater
DCM-MHD CITY
(Neme of
localion. ./
t
f
---l-,t-'- -'-.-t --,-. l ,'. r
i
Ls
ADJACET{T RIPARIAiI PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to C\J ,t-
(Namo of ProPerty Ownor)
N €,V._-",,\r.
lll i S
property located at t?
(Address,Lot, Block, Ro.d, otc.)
6 in I:-Fi! te , N.Con(CityrToxrn lndror County)(Waterbody)
Theapplicanthasdoscribedtome,asshownbelow'thedevelopmentpropos€dattheabove
I havE no ohriection to this proposal.
I have objections to this ProPGal.
DESCRIPTION AND'OR DRAWNGOF Fioposeo DEvELoPirENr
(t ndivt dud ptoqoslng d€M(//oQrrre,|t mos;t f,tt ln decrlPlton batow or rt,,/ch a slte dnwlng)
I
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-t'lt:i
l
l.l
\r.l' WAIYEBSE9T9N
I understand that a pier, doct, moorinfrrfi--at ranrp' br€akwater' boathouse' lift' or groin
mu6t be set back a minimum bi"Gnce'oi lsifrom my area of riparian aoc€ss unles6 waived by
;;. ilil;;"h io waive tne seiuacr, vou must lnltlat the appropriate blank belo '')
)k.:I do wish to waiv€ the 15' setback requiremont
I do not wish to waive the 15' setback r€quirement
lnfomation)Owner lnfotmadon)(Proporty Ournol
t9,-N
Signalure
I tt r.))]r f\,-.,Pint ot NamePintor TyF Name
)rk t\)qh"
Mai,,ng Addrsss
r_
Ctty/State/ZiP,5
')-c- J*Y
t-v I , p'<r Llw
Telephone.j ,^, .
Number / email address d'-frtcEMED
rn,,!#a0d4l$
a);I
Date
{alid br one cabttdar year afte{ signEture'
Date*
-7.o?-4
/ amail
DCM-MHD CITY
location.
n
(
Dr.
)RW PNA yes
Type of Proiecv Activitl
Pier (dock) lsiSth
Fixed Pladorm(s)
Floarint Platform(s)
Fin8er pier(s)
Groln lengrh
Bulkhe.d/ Rlpr.P l"n$h
avt dbtanc! orrtho.€---
mo( dlstancs offthorc- - ---
Bajn, ch.nftal -
cubic fe.ds
Boar ramp
Eoathous€/ Eoallift
Be:ch Bulldozht
Oth€r
L ,A f.fu))-
1A
1,lvrr)^/.
kf bc:n*/-.//^*
(Scale )
\o ri:#s
6[
/v'
of,
./C
^,,1J,
)-i^./
"9(t,'ic.,
€2qf.at1,',,n
Shor€llne LonSth
SAV: not sune
Moratorium: ry'a
Photos:
ye!
y63
Qtp.:n, G *L( trle "4
€rA building Permk maY be reqtired bY:
( Note Local PlannlnS Jurisdictlon)
Notes/ SPoclal Conditlong
cf.
Appll.etion Fer(t)
read comPliance sEtement on
#lssu rn8
C.U t1
M -MHD cl
ep ew .t a., )
PermitOm<er'sNam€
Signature +r Please-2-t_t
RECEIVED' , Sce nots on back r68.rding Rivar Basin rules'
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