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Home My WebLink About38831_BALLARD, ROBERT_20040607❑CAMA / ❑ DREDGE & FILL GENERAL PERMIT Previous permit # ❑New ❑Modification ❑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 15A NCAC 1 I = , Rules attached. Applicant Name Project Location: County _ Address ' �,JStreet Address/ State Road/ Lot #(s) City_' State ZIP - Phone # ( ) ') Fax # ( ) Subdivision Authorized Agent 1.R, d /�V -af !!. City 41 sjja 1'`" l ` ZIP Affected ❑ CW C EW O'PTA ❑ ES ❑ PTS Phone # O River Basing "1e AEC(s): I OEA J HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body r. + (nat /man /unkn) ORW: yes / no PNA yes / no Crit. Hab. yes / no Closest Maj. Wtr. Body Type of Project/ Activity ,(Scale: Pier (dock) length ;+ Platform(s) X fb' Finger pier(s) -` Groin length number Bulkhead/ Riprap length avg distance offshore max distance offshore --I Basin, channel cubic yards Boat ramp Boathouse/ Boatlift Beach Bulldozing Other I I r _ - _ I I Ell 1 � � I• � j i 7- — — i I - - --- --- - „ et f I L— - - 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 I I o _ — - - See note on back regarding River Basin rules. A 4n/ Agent or Applicant Printed Name % Signature "Please read compliance statement on back of permit" it Y7�-, Permit Officer's Signature { , Issuing Date Expiration Date a: V Local Planning Jurisdiction Rover File Name Application Fee(s) Check # 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, certifythatthis project is consistent with the North Carolina Coastal Management Program. River Basin Rules Applicable To Your Project: ❑ Tar, -'Pamlico River Basin Buffer Rules ❑ Other: [C.,.r<euse 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 (252-946-648 l) 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 Mailing Address: 1638 Mail Service Center Raleigh, NC 27699-1638 Location: Parker -Lincoln Building 2728 Capital Blvd. Raleigh, NC 27604 919-733-2293 / 1-888-4RCOAST Fax:919-733-1495 Elizabeth City District 1367 U.S. 17 South Elizabeth City, NC 27909 252-264-3901 Fax:252-264-3723 (Serves: Camden, Chowan, Currituck, Dare, Gates, Pasquotank and Perquimans Counties) Morehead City District 151-B Hwy. 24 Hestron Plaza 11 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) www.nccoastaimanagement.net Revised 10/05/01 TES FP NOTE V/CE® 15 M 800 POST A-L MONEY ORDEA 11 SERIAL NUMBER 470 YEAR. MONTH. DAY POST OFFICE U S. DOLLARS AND CENTS 000 06727021 t7 L Api- AMOUNT L cE ril-M. X PAY TO -----FN-EGOTIABLE -ONLY.JgNTT�,j� H E U.S. AND POSSESSIONS SEE ADDRESS SEE REVEqSE WARNING FROM CLERKI NO USED FOR ADDRE If 4a;U 1:1.0-0,.0-0 0 8 0 0 2 1: . .. . ..... ..... .. 06 7 2 70 2 11. ?oil- 1�� - by 7=,. �s'� ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIER/,1tOORI:VGPIL[iN-GS/BOA: LIFTIBOATHOZ,SE) I hereby certify that I own property adjacent to �----�s (came of Property Owner) property located at (Lot, Block, Road, etc.) � 1 (Waterbody) ( own and/or Cou ty) He has described to nie, as shown below, the development he is proposin; 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 (i5') from my area of riparian access unless waived by me. I do not wish to waive the setback requirement. I do wish to %vaive that setback requirement. -----------------------------------------------------------------------------------------------------------------•-- DESCRIPTION A;ND/OR DRAWING OF PROPOSED DEVELOPAIENT. (To be filled in bY individual proposing development) v ti --------------------F-------------- ----------------------- ------------ --- - --------------------- Siona ure Print or Type Name Telef none Number Date- 06/02/2004 11:09 FAX 2106526618 HQ_AETC/DOZ Jun-024004 08:35 From-58ANOT 2522403243 T-374 P.002/002 F-421 ,ADJACENT RIPA IA'N PROPERT V ONV ER STATEMENT (FOR A PIE&I, 100RLY0 PIL.TNU,SIBOAT4 f FTIB OA THO U.5, I hereby certify that I own property adjzcent !a alz's (dame of Propel-ty Owner) property located at (Lot, dock, Road, tic.) on (Waterbody) ( nsvn and/or C ntyj He has described to me, as shown beia.s, the development he is proposing at that location, 1. and, I have no objections to his proposal, I understand that a pier/niooringpitin.2L'inoatli fi'bo;ithotise must be setback a minimum distance of fifteen feet (IS') from my area of ripariari access LM..less Waived by me. I do not wisli to «aivc the setback retlt:irenwnt I do v4sh to \Naive that setback mquirement. DESCRIPTION AN DIO]R D A (To be filled in bt' r,r L.................................................. "" Or PRQPOSED D>! VELOPAI£N'T; nprap ��lg d�►�eloprrte�,rj r ......... ----------------------- ------------ 4+1;k 0U(SLA-5 N Print or Type Name 210-4o-5- 227 Telephone Number Pate: . 02 O ` m