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Home My WebLink About50758_BOYCE, RONALD_20080425❑ CAMA / [:]DREDGE & FILL GENERAL PERMIT ❑New r❑Modification ❑Complete Reissue []Partial Reissue 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_ �l !" Previous permit # Date previous permit issued Applicant Name , ) t _. t Project Location: County Address ! r I ( ( Street Address/ State Road/ Lot #(s) ❑ Rules attached. City State ZIP Phone # () Fax # (;) Subdivision Authorized Agent t ) City ZIP -.r 5W " !80 Affected Cw D Ew p PTA ❑ ES ❑ PTS Phone # ( ) River Basin AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body t / an /unkn) ❑ PwS: ❑ FC: ORW: yes / no PNA yes / no Crit.Hab. yes / no Closest Maj. Wtr. Body Type of Project/ Activity Pier (dock) lenj ■■■■■■■■■■■■■■�■■■■■I�■■■■■■/■/�■■■■■■� V■■ ■■■■■I■■®■■■■ilk■■■■■■■■M■■ ■o ■■■■■■■■■■■ •. ■..I.■■■...■■■......1..■....f...■.....�.■. M. M. ......■......■......■.....�.........■�... ME ®::: ■■■■■■ 1■:■■ �®■■■■■1WEENEWENIMMEMEM_ MEN ON 0 ��e:L'91■■■N■1�■■ .... = -■�►�I�L:�iiiir:::.iilliii:::::1. ►�:�i� :i■■"�1�.■I■■�1■■ ■■\ II■■■■■■MENEEN Agent or Applicant Printed Name Signature Please read compliance statement on back of permit Application Fee(s) Check # Permit Officer's Signature Issuing Date Expiration Date w 1 � Local Planning Jurisdiction Rover Fire KM4 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: ❑ 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 Raleigh Office Morehead City Headquarters Mailing Address: 400 Commerce Ave 1638 Mail Service Center Morehead City, NC 28557 Raleigh, NC 27699-1638 252-808-2808/ 1-888-4RCOAST Location: Fax: 252-247-3330 2728 Capital Blvd. (Serves: Carteret, Craven, Onslow -above Raleigh, NC 27604 New River Inlet- and Pamlico Counties) 919-733-2293 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) 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, Onslow -below New River Inlet- and Pender Counties) Revised 08/09/06 ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIER/MOORING PILINGSBOATLIFT/BOATHOUSE) e lgo e- e. I hereby certify that I own property adjacent to 0 LI/ L-p 's (Name of Property Owner) property located at j A -7 29 I FF— ('j O Dp -4 , (Lot, Block, Road, etc.) on ��!'� Soc/�°Q> ,in o.� 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 must be set back a minimum distance of fifteen feet (15') from my area s l�k"s waived by me. ' . I do not wish to waive the setback requirement. APR 1 8 ?008 I do wish to waive that setback requirement. Moreheau (.. itv DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: (To be filled in by individual proposing development) (Applicant Information) Mailing Address City/State/Zip Telephone Number Date (Riparian Print or Type Name Telephone Numbb Jos) Date MONEYGRAM PAYMENT SYSTEMS, INC. DRAWER P.O. BOX 9476 MINNEAPOLIS, MN 55480 N PLEASE READ REVERSE SIDE www.moneygram.com DATE/ .1.01.370R8277 101 il N 954964000690006 R1013708827' v VDETACH HERE r O F Ox 04/ 28/`08 „�a_rc ooa �'°� V OO �c 9 200. 00 arcW� i EMPLOYEE W 715 (1/07) 700/14000 M 91881-0 f ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIER/MOORING PILINGSIBOATLIFT/BOATHOUSE) I hereby certify that I own property adjacent to 9'L4d A�alAcu h4iiV's (Name of Property Owner) property located at (Lot, Block, Road, etc.) /� on ,in 6" (e f I �U�j& j /V�JC ,N.C. QOVaterbody) (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. V I do wish to waive that setback requirement. APR 1 ?008, ---------------------------------------------------------------------------------------------------------- DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOP chead C:itV Ali( (To be filled in by individual proposing development) (Applicant Information) MailingAddress City/State/Zip Telephone Number Date Y4 ------------------------------------------------------ (Riparian Property Owner Information) Signature �v Print or TvDe Name _ /Z-V-Jill 4— Telephone Number Date NCDENR North Carolina Department of Environment and Natural Resources Division of Coastal Management Michael F. Easley, Governor James H. Gregson, Director William G. Ross Jr., Secretary Date,,tiG Applicant.Name fe Mailing Address y Y �r. 8 2008. Morehew cit. I CM I certify that I have authorized (agent) n�,) /�,/i. cuf to act on my behalf, for the purpose of applying for and obtaining all CAVIA Permits necessary to install or construct (activity) at (location) 7 This certification is valid thru (date) I.LN/ � e) Signature 22-1c.ltIf 400 Commerce Avenue, Morehead City, North Carolina 28557 Phone: 252-808-2808 \ FAX: 252-247-3330 \ Internet: www.nccoastalmanagement.net An Equal Opportunity \ Affirmative Action Employer - 50% Recycled \ 10% Post Consumer Paper c THF. FRONT OF THE DOCUMENT HAS A MICROPRINTAMOUNT BOX AND THERMOCHROMIC. ABSENCE OF THESE FEATURES WILL INDICATE A COPY. Lt TS-t6t8 MoneYG 'am, INTERNATIONAL MONEY ORDER 919 Money Orders _ 4 ; iI + 7. j •{ i •• _ —� J. J. —r F _ .. _ i ti i• I'1 i�- I Ii T.1 � N M Q LL. PAY TO THE PAY ONLY THIS AMOUNT V ORDER OF:ORDEN PAGAR A L �t\ME { DE: O BA K BEFORE CASHING t' ►,////�//jam-� I- i 'a ' A I '_ . T - PURC ARERHBYS GN/NG YOU ACRSIGNER E[ TORHW fRVIf COMGRANDO OTHFR T FIRMADEL ON THB RADORSfOf ADDRESS:/ DIRECCION: Ste/ able i' E j I! i 3 �I _, ' I_f i i ?- — `r ,- Citizens State Bank ISSUER/DRAWER: of Clara City MONEYGRAM PAYMENT SYSTEMS, INC. 0 7 {� �• � '^' ! r-' 'j' = �• �• �� ? ! 1 .[. - Clara City, MN TO AUTHENTICATE RUB CIRCLE PARA AUTENTICAR RESTREGAR EL CIRCULO 7088 2 7 78111 90 -