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HomeMy WebLinkAboutMcElvey, Jason 77017C Statement of Compliance and Consistency This permit is subject 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 officer when the project is inspected for compliance. The applicant certifies by signing this permit that [)prior to 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 Coastal Management, in issuing this permit under the best available information and belief, certifythatthis project is consistent with the North Carolina Coastal Management Program. River Basin Rules Applicable To Your Project: ❑ Tar- Pamlico River Basin Buffer Rules ❑ Neuse River Basin Buffer Rules ❑ Other: If indicated on front of permit, your project is subject 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 Regional Office (910-796-7215) for more information on how to comply with these buffer rules. Division of Coastal Management Offices Morehead City Headquarters Washington District 400 Commerce Ave 943 Washington'Square Mall Morehead City, NC 28557 Washington, NO27889 252-808-2808/1-888-4RCOAST 252-946-64$1 Fax: 252-247-3330 Fax: 252-948-0478 (Serves: Carteret, Craven, Onslow - North 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: Camden, Chowan, Currituck, Dare, Gates, Pasquotank and Perquimans Counties) (Serves: Beaufort, Bertie, Hertford, Hyde, Tyrrell and Washington Counties) Wilmington District 127 Cardinal Drive Ext. Wilmington, NC 28405-3845 910-796-7215 Fax:910-395-3964 (Serves: Brunswick, New Hanover, Onslow - South of New River Inlet - and Ponder Counties) http://portal.ncdenr.orgtweb/cm/dcm-home Revised 7/06/17 CERTIFIED MAIL • RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM Name of Property Owner: Address of Property: I )__ /d �� 0 o / (Lot or Street #, Street or Road, Cit & County) Agent's Name #: Mailing Address: -j�D 9 7 (�owmrMJ Q2vPGt �2 Agent's phone #: I hereby certify that I own property adjacent to the above referenced property. The individual applying for this permit has described to me as shown on the attached drawing the development they a%proposing. A description or drawing,with dimensions must be provided with this letter. _1(V� I have no objections to this proposal. _-_ I have objections to this proposal. If you have objections to what is being proposed, you must notify the Division of Coastal Management (DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is avellable at http:/fww v.nccoastaimanagement netlweb/cm/staff-listing or by calling 1-888-4RCOAST. No response is considered the same as no objection if you have been notified by Certified Mail. WAIVER SECTION I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or li be set back a minimum distance of 15' from my area of riparian access unless waived I you wish ow, idle the setback, you must initial the appropriate blank below.) I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Property Owner Information) 5302 �D imi+tj Mailing Address �Q Lttti Nc- J�a�3 City/Slate2ip 5�{0 0�10 - 6 91/1 Telephone Number/Email Address r !I«te (Riper' Prop y Owner Information) Signature 4 Pnnt or Type Name ° 44,tkc Mailing Address 2 e4 -76 City/State/Zlp Z S?� 1 co 3- S704 l� Ell ' � cc. Telephone Number/Email Address �O �/�� Date __ _— kil - cod (Revised Aug. 2014) CERTIFIED MAIL - RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM Name of Property Owner: 1ScrJ c u P Address of Property: (Lot or Street #, Street Agent's Name #: Agent's phone #: f Road, City ti County) nn Mailing Address- S30 7 %jam mrw Q?odd /J/t Mailing NG d7%293 I hereby certify that I own property adjacent to the above referenced property. The individual applying for this permit has described to me as shown on the attached drawing the development they are proposing. A description or drawing with dimensions must be provided with this letter. V k7- I have no objections to this proposal. I have objections to this proposal. If you have objections to what is being proposed, you must notify the Division of Coastal Management (DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is available at http://www.nccoastalmanagement.net/web/cm/staff-listing or by calling 1-888-4RCOAST. No response is considered the some as no objection if you have been notified by Certified Mail. WAIVER SECTION I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift must be set back a minimum distance of 15' from my area of riparian access unless waived by me. (If you wish to waive the setback, you must initial the appropriate blank below.) I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. Property Owner Information) .5'rK urut�• Print or Type Name 53v7 &tpfne iaR�o�C lQX �M fling Address „ IAA C 83 City/state/Zip �Fo -R(O o 12 1 A < ti 7Fi?c�?aA�ba �T Telephone Number / Email Address Date (Riparian Property Owner Information) Sigm�a„„tulte {{�� �g1" I��lll'�11i.,.. Print or Type Name iVSIsitids QM Mailing Address Gty/SI' ta0p Telephone Number/Email Address Onre (Revised Aug. 2014) 1 . J JI� 1 7 LAB ,Olr 3 �' 13p� L Lz C)c i. nl' �Zrlo,V .� i , �a i�Pck . i� l ZLo YJ r - !dt �r �Vn1PlN`� RJn� l�P 94"1 W RY &4-S GreV L-1v