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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. I - --l L -l ] __l i l l !!!_t II l-- L_:- ) I (. I 11 t/l I L I t It/ A a IlL)l/)I ) I r t-/ 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) l'' l .i" c---- - - P \i 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 I I|.,- ; 1 -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' ,w o !oo; 0) o -cA^-c>Yo !co-aCroq)o N ou) o) -3 e.t t c!(! E lo c 'ri .E o 0)! o q) 'tr = CL G =E'(, Etr3