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Home My WebLink About50669_DORSEY, RONALD_20080331❑CAMA / ❑ DREDGE & FILL G E N E RAL r PERMIT Previous permit # ' ❑New ❑Modification ❑Complete Reissue El Partial Reissue tiji 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 ❑ Rules attached. Applicant Name i ; Project Location: County Address i J Street Address/ State Road/ Lot #(s) City State 'ZIP Phone # O Fax # O Subdivision Authorized Agent City ZIP Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Phone # ( ) River Basin AEC(s): ElOEA ElHHF ElIH ❑ UBA El N/A Adj. Wtr. Body ' i t r1 nat man unkn ❑ PWS: ❑FC: Closest Maj. Wtr. Body ORW: yes / no PNA yes / no Crit.Hab. yes / no ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■I SEMEN ■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■ . . ■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■f■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■ ■f■■■■ ■ONE ■■9F.I■■■■■■■■■■■�■■■■■i■■■■■■■■■■■■■ ■■■■■��f#iumo■■■■■■■■■ ■■■ ■:■ ■■tn■■■■■■■■■�■■■■■■■■■■■■■■■■■■®■■■ ■■ ■■�■■■■E: = :■OMEN ■■■■■ ■■■■ ■■■■ ....■i■■■■■■■■■■■■■■.■■■■■■■■■■■■■■■■ ■■■■■■��■w■■■■■�■■■■■■■■■■■■■■■■■■■f■■■■ ■■■ mill ■■■■■■■■■■■ ■■■■■H■iSiAl+��■��,■■�■■■■■■■■■■■■■■■■■■■■■ C..••••._•o�•••�•••i■■■.ommo■■■■■■■■■■■■■■ ■■■ immmfill■■■rlli=■■■■■■■■■■■■ ■■■ffi■■■ ON ■■■■■■■f■■■■■■■■■■■■■■■■■■■■■■■■■■ ■.■..■...■..f■...■■.■■■■■■■■■■■■■■f■■■■ Agent or Applicant Printed Name Signature Please read compliance statement on back of permit Application Fee(s) Check # Permit Officer's Signature /1Y Issuing Date - Expiration Date` Local Planning Jurisdiction Rover File Name Is 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 ❑ 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 Raleijzh Office Morehead City Headquarters Mailing Address: 400 Commerce Ave 1638 Mail Service Center Morehead City, NC 28557 Raleigh, NC 27699-1638 252-808-2808/ I-888-4RCOAST Location: Fax: 252-247-3330 2728 Capital Blvd. Raleigh, NC 27604 919-733-2293 Fax:919-733-1495 (Serves: Carteret, Craven, Onslow -above New River Inlet- and Pamlico Counties) 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 s ®Tt�l f Saa MA I' � More'e""j CitY pC North Caroiif.12 Department of Environment and Natural Resources Divil!�ion ojl' Coastal Managsment Michael F Easley: Governor Charles S. ,tones, Director William G. Ross Jr., Secret iry Date) Applicant Naaaae I✓ �/t%��C% V 0 �.. Mailing Address /U C `�- �-7 53 I certify that i have authorized (agent) abh/t' ( Ieo kb to act on ml- behalf, for the purpose oa applying for and obtaining all CANLk PerT nits necessary to install or construct (activity) �� `"I at (location) PC & 1" q c;F. �C C "r,)L _—.. This cer afi Signature Valid thrau ate) !;d 208 T (FOR A FiEp G, M F PUED EO'Y- LIFT) djactn- co (I--OL, Black-, Road —,etc —) on (T'V ate r bo d Y) N. C. Clown andlor�County) He has desc-- be-J to m,,=, IS shoWn below Lht devCloprpenc he. is proposing at thac location, and, r hav�-1-10 objections to his proc�o--'-Il. I understand must be Sett back a minimum d' d . ghat a P'er/uncoven�l boat LE7. waived by me. Iswc-t Offs- (.IL5') -tam my of riparian access unless 1 do not wish to waive the Set ack re uirement. I do -,Fish 10 Waive that setback 'Le-GuilrCment. DESj-;F-=iDjN - -D/OR (To be filled in ------- ----------------- qU �FR0POSED; DEVEL0P-NM,f-T- V fadiv&U-CZ proposing d E4 ------------------ — ------------- c' Signature Priric or Type Telephone NumcFr MAR 2 5 2008 -• _ V ..> ., 3 -_ _ i-3_t :.�,1 i g . ' 4 r 1i ��,�'. f_y r - y ._ .1 w' /� J �f. \ f (T l ( -rip A FI.E-,V V(--0Y PF� �Ci'n1 %T f$�t rt/ DCpvl 0,' ! uroii ct to _ aQla_ _t__ proper^Y fccated at (L�t, Bl1a R-, Road, etc.) on r r atei body; C. (Tow-n ZIld/ori CoUIIC y) He has desc_-ibri to me as shorn below the deve!or7.penc he is proposing at tat location, and, I have no objecdons to his proposal. I understand Ghat a pieriunc:overed boat lir mus[ sit back a minimum distant✓ or riiue-n - tit (,5') Tom my acta or riparian access unless waived d by me. ' 1 I do riot wish to waive the setback re•;uirement. I do wish to waive that setback recuzreme '1C. J� D O i �-D/OR DR,� w : "U OF PROPOSED; DEYEZOP?Y�,�,?: (To be d ' ' ' i1l�ua1 proposing develpmerzs) ------------------ ----- -------------------- ----- - ------------------ - -------------- Si�natu e Print or Type i iame Teierhone i�iumbc�r J WESTERN( UNION (MONEY ORDER INTEGRATED PAYMENT SYSTEMS, INC,.ISSUER Greenwood Village, Colorado --�- - ---�-�--- 0 8 - 87 3 83 3 318 82.40/1021 PAY EXACTLY PAY TO THE / t PAYMENT FORIACC:T• 4 ORDER OF G - ��// R Western Un— Money HASEH, SIGNER FOR DR VURCNASER By SIGNI YOU AGREE TO THE TE ON THE REVERSE al - Junction - Downtown. N A , Grand Junction. Colorado Order and Design is a Sen,lte mark of Weslem Union Holdings, Inc /Payable at Wells Farqo Bank Grand . I rl t ..■ I: LO 2 L004UUI; 4uubb r �n "us"