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Home My WebLink About30507_ROBERTS, ED_20011213� CAMA / ❑ DREDGE & FILL Y N® 3050 7 - C GENERAL PERMIT Previis Pemit # A ❑ New ❑Modification El Complete Reissue ❑Partial Reissue Date previous permit issued As authorized by the State of North Carolina, Department of Environment and Natural Resources and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC Rules attached. Applicant Name f , ( �t kf , i f Project Location: County (a' -j , , 1 Address City r " `l rot < < State f*'J! ZIP '?.SZ Z Phone # ("f?) 42'd - Fax # ( ) Authorized Agent C Fi1'f Affected ❑ CW � EW X-PTA CJ ES ❑ PTS AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A PWS: ❑ FC: ORW: yes /,, no, PNA De / no Crit. Hab. yes / no Street Address/ State Road/ Lot #(s) �?J PV5Tfjt%rj Subdivision City ZIP ,'(t 5 7 C) Phone # ( ) River Basin I,Wi41 CAI Adj. Wtr. Body , i i F t na /man /unkn) Closest Maj. Wtr. Body T�ccuf Sc t't-d Type of Project/ Activity i i; n ,it, I w (Scale: /,/< Pier (dock) length Platform(s) k Finger pier(s) Groin length number Bulkhead/ Riprap length avg distance offshore max distance offshore Basin, channel cubic yards Boat ramp Boathouse/ Boatlift Beach Bulldozing Other Shoreline Length / _ So SAM not sure yes (no - r ±iSandbags: not sure es � no I i Moratorium: n a yes no t Photos: yes no Waiver Attached: yes no I t A building permit may be required by: ❑ See note T on back regarding River Basin rules. Notes/ Special Conditions 4- nt"<t' "P) N4�Si 1 I.f Flf *uA � 7, 14,ke 1` A , v �, yo-�f 62) .4 4t," A; �+„:) � / 1 � � �rlt It J-i lac 1Jo yv�4. I jl Agent or Applicant Printed Name Signature Please read compliance statement on back of permit Application Fee(s) Check # ytr d Permit Officer's Signature Issuing Date / I Expiration Date 7 fill, Local Planning Jurisdiction 1 Rover File Name 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 1) 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, certify that this project is consistent with the North Carolina Coastal Management Program. River Basin Rules Applicable To Your Project: Tar- Pamlico River Basin Buffer Rules I Other: �I Neuse River Basin Buffer Rules 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 Quality. Contact the Division of Water Quality at the Washington Regional Office (252-946-6481) or the Wilmington Regional Office (910-395-3900) for more information on how to comply with thesebuffer rules. Division of Coastal Management Offices Central Office Elizabeth City District Mailing Address: 1367 U.S. 17 South 1638 Mail Service Center Elizabeth City, NC 27909 Raleigh, NC 27699-1638 252-264-3901 Location: Parker -Lincoln Building 2728 Capital Blvd. Raleigh, NC 27604 919-733-2293 / 1-888ARCOAST Fax: 919-733-1495 Fax: 252-264-3723 (Serves: Camden, Chowan, Currituck, Dare, Gates, Pasquotank and Perquimans Counties) Morehead City District 151-B Hwy. 24 Hestron Plaza Il Morehead City, NC 28557 202-808-2808 Fax: 252-247-3330 (Serves: Carteret, Craven, Onslow -above New River Inlet- and Pamlico Counties) Washington District 943 Washington Square Mall Washington, NC 27889 252-946-6481 Fax: 252-948-0478 (Serves: Beaufort, Bertie, Hertford, Hyde, Tyrrell and Washington Counties) Wilmington District 127 Cardinal Drive Ext. Wilmington, NC 28405-3845 910-395-3900 Fax: 910-350-2004 (Serves: Brunswick, New Hanover, Onslow -below New River Inlet- and Pender Counties) Revised 10/05/01 ERIC B. ELLIS NCDL 65047 2082 JASA M ELLIS PH(252)726-6775 205 NOTTINGHAM DR. 66-30/531 MOREHEAD CITY, NC 28557 Date ti �� j 133 Pay to the I / J� Order of- (2N Dollars FIRST CiTI7, nk T 173 � t o A n, �I Firsl zans Bank 8 T— Company jj'-u -1\ Atlantic 8aach, N.C. 28512 �. For�P4tJ0-56 7 1:0 5 3 L00 300i:00 L 3 L 7 4 48 78011' 0 2013 2 GUARDIAN® SAFETY BLUE ESBL ADJACENT RIPARIAN PROPERTY OWNER STAITAIENT (FOR A PIERIUNCOVERED BOAT LIFT) I hereby certify that I own property adjacent to, � /---,r 's (Name of Property Owner) property located at % a C S F// (Lot, Block, Road, etc.) on Sro,,061 �d �E� in r- (Waterbod) � , N.C. y (Town and/or County) He has described to me, as shown below, the development he is proposing at that location, and, I have no objections to his proposal. I understand that a pier/uncovered boat lift must be set back a minimum distance of fifteen feet (15') from my area of riparian access unless waived by me. I do not wish to waive the setback requirement. I do wish to waive that setback requirement. ------------------------------------------------------------------------------------------------------------------- DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: (To be filled in by individual proposing development) 16, Print or Type Name Telephone Number Date: v ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIER/UNCOVERED BOAT LIFT) I hereby certify 'that I own property adjacent to : z�1/5-F� 's (Name of Property Owner) property located at Russ e // C oV e P"o q (Lot, Block, Road, etc.) on Rro ctd C ►-e e K in _ /f/��.c�x,a r+ , N.C. (Waterbody) (Town and/or County) He has described to me, as shown below, the development he is proposing at that location, and, I have no objections to his proposal. I understand that a pier/uncovered boat lift must be set back a minimum distance of fifteen feet (15') from my area of riparian access unless waived by me. I do not wish to waive the setback requirement. I do wish to waive that setback requirement. --------------------------------------- DESCRIPTION AND/OR (To be filled in �� 1 ------------------------------------------------------------- F PROPOSED DEVELOPMENT: by individual roposing development) Signature •- Print or ame O Telephone Number Date: ----------- ------ 1