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HomeMy WebLinkAboutBledsoe, Larry 76672Clo REDGE E FILL N9 76672ENERAL'peRnalr Previous permit # Date previous permit issued_ 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 'tO *aOa O UU,n .o.n* Proiect Location: Counry _ _ Street Address/ State Road/ Lot #(s) c zt? Phone # ( )E-Mail Authorized Agent ztP Affected AEC(s): Phone # ( )River Basin Adi. Wtr. Applicant Name _ - Address BCD (nat /man /unkn) Closest Mai. Wtr. Body ]cw LrOEA tr PWS: trEW ] HHF ,I PTA :l rH !ES L. T UBA ! PTS D TVA ORW: yes / no PNA yes / no >C (Scale:) IType of Project/ Activity, Pier (dock) length Fixed Platform(s) Floatina Platform(s) Finser pier(s) Groin lenSth number Bulkhead/ Riprap len8th i ayt distance offshore l max distance offshore : Boathousd Boatlift i ji + -!-- til:T--i--i i-+ -1 i. Beach Bulldozing Other I SAV: not sure Moratorium: nla yes yes yes tt : t-.- A buildin8 permit may be required by: ( Note Local Planning lurisdiction) Notes/ Special Conditions E See note on back regarding River Basin rules I -!L + +- H J--'lf+ -ft +l+rl_ltt_-l-!_r-L -t -+ t-+ l 4+LL ]-_]_-.{-'+r-r -f -l --lll -H+f- ..:Jft + lil lt I l1-+ I l j + +-f --- +--]-'+H -+-ill rll l l -+. +I rffi | I Pr tLl I +l l 48ent or Applicarr Printed Name Sqnature # Please read compliance statement on back ofpermit * Permit Olfi cer's Printed Name Signature Applicdion Fee(s)lssuing Date Expiration Date ElNew EModification EComplete Reissue lPartial Reissue State Subdivision 8arin, channel I cubic yards_ Boat r.mp _ Shoreline L.n8th ,' l 1t-l I :-.- I l +j- Check# Stetement 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 subiect the permittee to a fine or criminal or civil action; and may cause the permit to become nullandvoid. This permitmust be on the proiect site and accessible to the permit oflicer when the proiect is inspected forcompliance. The applicant certifies bysigningthis permitthat l) priorto undertaking any activities authorized by this permit, the applicant will confer with appropriate local authorities to confirm that this project 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 adjacent riparian landowner(s) . The State of North Carolina and the Division of Coasal Management, in issuing this permit under the best available information and belief, certify that this project is consistent with the North Carolina Coasal Management Program. River Basin RulesApplicable ToYour Proiect: Tar- Pamlico River Basin Buffer Rules Neuse RiverBasin Buffer Rules lf indicated on front of permit, your project 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 Office (252-946-6481) or the Wilmington RegionalOffice (910-796-7215) for more information on howto complywith these buffer rules. Division of Coastal Management Ofiices Morehead City Headquarters 400 Commerce Ave Morehead City, NC 28557 2s2-808-2808/ | -888-4RCOAST Fax:252-247-3330 (Sewes: Carteret, Craven, Onslow - Nonh of New River Inlet- and Pamlico Counties) Elizabeth City District 401 S. Griffin St. Ste. 300 Elizabeth City, NC 27909 252-264-3901 Fax:252-264-3723 (Serves: Camder, Chowan, Currituck, Dare, Gates, Pasquotank and Perquimans Coumies) E oth".' Washington District 943 Washington Square Mall WashinSton, NC 27889 252-946-6481 Fax:252-948-M78 (Serves: Beaufort, Bertie, Hertford, Hyde, Tyrrell and Washington Counties) Wilmington District 127 Cardinal Drive Ext. Wilmington, NC 28405-3845 910-796-7215 Fax: 9 l0-395-3964 (Serves: Brunswick, New Hanover, Onslow - South of New River lnlet- and Pender Counties) hft p://portal.ncdenr.org/web/cm/dcm-home Revised 706l I 7 R E E T RIP RI N L A{<Y \ (Namo o K9Ui e\6oE- f PropertY owner property located cger,Y. L! (Ad dress, LotaBlock, Ro H(^ ad, etc.)N.C. on tR(-T 5 !,..l+lta,?tn t (WaterbodY)(City/Town a ndror Co unty) The applicant has doscribed to me, as shown bel I have no objoction to this proposal' I have objections to this proposal' ow, the development proposed at the above loca DESCRIPTION ANO/OR onnwtNe oF PROPOSE D DEVELOPMENT (l ndlvldua I proPosing developmen'must ftll tn desirtPtion belottt or attach a site dtawlng) P at7 \\ fl\oieuEY J w a-'r"? I i,.'(t\ I \ \ t\,! 5 g LcY ""'i '( l! I und must me.( * w VER ECTI N I do wish to waive the 15' selback requirement' \ do not wish to waive the 15' setback requirement (Pro rty Owner lnformation)(Adj ent Prop SiCflature 7 L.glto e turprbfrtl erstand that a pier, dock, mooring pilings' boat ramp' te set oact a minimum distance of 15'from my area liVou *iif' to waive the setback, you must initlal the a breakwater, boathouse, lift, or groin of rioanan access unless waived by ppropriate blank below.) erty Owner lnformation) A A ,t{(R"{-Tee,.r.l^Print or TW 1b^DI xu ,bNamo Pdnt or TYPe Namo A\I 14^s s*aY c-e(-( Maifing Addre l+!-1,e(t ss .'{631tlc - Mailing Z7 Atr- crysraletZip q 11 -&j-\4 Telephon 5 er / email addrBss I Dote Nu Dqre' I hereby certify that I own property adjacent to ?.?-?'-i L\l- ,I 7 I omail sddtess ,'/. (drt1 'Valid for one calendar year a{1et signat ro" (Rovised Aug. 2014) l hereby certify that I own property adiacent to a- L +s.FY I RErrr Sr"oroe- (Name of ProPertY Owner property located at 9-t t i\osEttY Ure bt< Ku ' ?*r fur Sr,,.rqlt? (Address,Lot, Block, Road, etc.) HqB9ti . N.C.on in (Waterbody)(Clty/Town and/or County) The applicant has described to me, as shown below, the development proposed at the above I have no oblection to this proposal. I have objections to this proposal. s DESCRIPTI ON AND/OR DRAW]NG OF PROPOSED DEVELOPMENT (l ndividual proposing-develoqment must fi.ll-in deseription b elow or attach a site drawing). ? r?'?''1*tr ?I -t( (.rl nt('I'J;7^v WAIVER SECTION I understand that a pier, dock, mooring pilings, boat ramp, must be set back a minimum distance of 15'from my area breakwater, boathouse, lift, or groin of ripadan access unless waived by me. (lf you wish to waive the setback, you must initial the appropriate blank below.) I do wish to waive the "15' setback requirement. l *I do not wish to waive the 15' setback requirement.i Owner lnformation)(Adjacent Property Owner lnformation) ture L+.tv Y(errt B.")so e- Print or Type Name 7u t l\s'rPG-L cR6rk R). Pint ort74 Name rt ,'-t < u/a /Vtru, fto( Mailino Addnss H,ir e*; N'r 1.rr5 i .t Mailino Addresst/itbet t / Citv/Statelz.iD'qrq - ,{r{-}3{c-tw Teleohone Number 7ro gco ( / email addrcss 7t n7Telephone Number / email addressj-to-Lo Date 'Valid for one calendar year after signature' o** )/t/zo (Revised Aug. 2014) bcanP/ ' t4,' 't fl'{-r/",-- ?a"?.\(;> 1. 4o ,r? tG \{ ' I I) c) ., I .\, f€oef ^)j Ff J \n 1t 3 -\l \?, ---.-? \ rrr r wr{lYil.' F) o\hi ,! \) c ..{ 0,ae A 7rt v I I i I \ I I I Lrs\L 1 t \ \ \t I I I Il I t t i I t I i, I lI I I *-r' -- lPte"tv