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Home My WebLink About47082_OVERBY, R.T._20061206*�A/ ❑ DREDGE & FILL GENERAL PERMIT Previous rmit# New []Modification ❑Complete Reissue ❑Partial Reissue Date pre ous 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 15A NCAC Applicant Name Project Location: County Address Street Address/ State Road/ Lot #(s) City State ZIP f ❑ Rules attached. Phone # (_) Fax # () Subdivision_ Authorized Agent City ZIP Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Phone # O River Basin AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body (nat /man /unkn) ❑ PWS: ❑FC: CH b / Closest Maj. Wtr. Body ORW: yes / no PNA yes / no rit. a . yes no Type of Project/ Activity (Scale: ) --- -, .,----- --- ----- J I J i Pier (dock) length Platform(s) - Finger piers) Groin length number Bulkhead/ Ripraplength avg distance offshore max distance offshore Basin, channel I__ cubic yards Boat ramp Boathouse/ Boatlift Beach Bulldozing - Other Shoreline Length SAM not sure yes no Sandbags: not sure yes no Moratorium: n/a yes no Photos: yes no Waiver Attached: yes no----- A building permit may be required by: Notes/ Special Conditions + � — i j — ----- — ❑ See note on back regarding River Basin rules. Gr DEC Q S 2006 Agent or Applicant Printed Name Permit Officer's Signature Anrinhpwi Signature "Please read compliance statement nSacTof p rmlt'`— —'t� i ih ate Expiration Date Application Fee(s) Check # Local PlanningJurisdiction 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 [1 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 (910-796-7215) for more information on how to comply with these buffer 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: Fax: 252-264-3723 Parker -Lincoln Building 2728 Capital Blvd. Raleigh, NC 27604 919-733-2293 Fax: 919-733-1495 (Serves: Camden, Chowan, Currituck, Dare, Gates, Pasquotank and Perquimans Counties) Morehead City District 400 Commerce Ave Morehead City, NC 28557 202-808-2808/ 1-888ARCOAST 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 910-796-7215 Fax: 910-395-3964 (Serves: Brunswick, New Hanover, Orslow -below New River Inlet- and Pender Counties) Revised 06/29/05 ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIER/MOORING PILINGS/BOATLIFT/BOATHOUSE) I hereby certify that I own property adjacent to / , ��_ 's (Narne of Property Owner or Applicant) Mailing address if different from location address 11341 CCU Y��` �71 1-2 C/� /94 , (town, state and zip) �14 -c A 1 72�? v 0 �� "� L. -% phone numbers you can be reached at f ��3 4��a Sl ULU12006 property located at ,,?1 9 (Lot, Block, Road, etc.) Morehead City DCM on (Waterbody) N.0 own and/or County) He has described to me, as shown below, the development he is proposing at that location, and, Ihave no objections to his proposal. I understand that a pier/mooring pilings/boatlift[boathouse 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. initials I do wish to waive that setback requirement. initials ------------------------------------------------------------------------------------------------------------------- DES'CRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: (To befilled in by individual proposing development) 70 I� ---------------------------------------------------------------------------- -------------- ------------------- �1 Signa e Print or Type Name `� / �Q Z 3 (/7)1 Telephone Number Date: www nccnastalmanaaement net/Permits/AT)TA(FNTR TPA PTA NPP0PFRTY0WNFP.4TATFM-PNT ,if N . % Ai if r' ADJACENT RIPARIAN PROPERTY OWNER STATEMENT • (FOR A PIER/MOORING PILINGS/BOATLIFT/BOATHOUSE) I hereby certify that I own property adjacent to ' . 7- C) Y� 's (Name of Property Owner or Applicant) ..,,,�"�� Mailing address if different from location address 4341 CCo- �"fij- / y (town, state and zip) -2? k u 3 6'A0 J t' '� SEC � phone numbers you can be reached at -2. -2 � ,? ? o S 1 �006 property located at '?) CiU8 ?'U-n; f)l (Lot, Block, Road, etc.) on ,in CH/� C/�1-e:e� y C/�a c:t�— ,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/mooring pilings/boatlift/boathouse 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. initials &�Zz) I do wish to waive that setback requirement. initials ------------------------------------------------------------------------------------------------------------------- DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: (To be filled in by individual proposing development) p 7v �7 --------------------------------------------------------------------------------- - - - - - - - - - - - - ------- Signature Print or Type Name Telephone Number Date: 0 Z www ncmastaimansa(-.menr n&/PermicdA T) TA ('FNTR TPA RTA NPRnPFR'T'YnWNFR 4TATFMFNT nrif R T OVERBY NCDL 358302 4341 CORDIALITY CHURCH RD PH 252-443-4205 ROCKY MOUNT, NC 27803 1126 W258/531 /p/ V DATE DOLLARS PRIME CHECKING FOR/ /„'tr v✓ f° `' J� / a l:053102586i: 6275225532++ 01126