HomeMy WebLinkAbout50619_HARGETT, ANNETTE_20080317❑ CAMA / ❑DREDGE &FILL �VI� I � ' J 50 ro 19
GENERAL PERMIT Previous permit #
❑New ❑Modification El Complete Reissue El 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
❑ Rules attached.
Applicant Name Project Location: County
Address
City -
Phone # () _
Authorized Agent _
Affected ❑ CW
AEC(s): ❑ OEA
❑ PWS:_
ORW: yes / no
State 2IP
Fax # ( )
❑ EW ❑ PTA ❑ ES ❑ PTS
❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ FC:
PNA yes / no Crit.Hab. yes / no
Street Address/ State Road/ Lot #(s)
Subdivision
City ZIP
Phone # () River Basin
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Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit"
Application Fee(s) Check #
Permit Officer's Signature
Issuing Date
Local Planning Jurisdiction
Expiration Date
Rover File Name
t
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
landowners).
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certifythat 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
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/ 1-888ARCOAST
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
I
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to
(Name of Property Owner)
property located at //Z/ ZE511E OR
(Lot, Block, Road, etc.)
on L C �-JL-c J , in 1 /u�RT 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.
I do wish to waive that setback requirement.
-------------------------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
(Applicant Information)
Mailing Address
City/State/Zip
gipz
Tel p oh ne Number
J-6-o �/
Date
(Riparian Property Owner Information)
dA�"_ � -
Signature t
MOFF
Print or Type Name
qm
Telephone Number
m Ae, 4:
Date
R
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to 's
(Name of Property Owner)
property located at
, 11 (Lot, Block, Road, etc.)
on �W C 0 , in , 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.
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
(Applicant Information)
Mailing Address
�'r'- gR 9
City/State/Zip
Telephone Number
-?- 47 -D
Date
(Riparian Property Owner Information) D
Signature
Print or Type Name
Q I D g4'%- yvL� cr
Telephone Number
Date
J_R
ANNETTE GRAY HARGETT 3132
NCDL 2094363
TH 910 326 3627 ss-ao ssl
Date sos
.M LESUE DR. 1�Q
HUBERT, NC 2
Pay to they � e� $ .2, 6e: -f-6
Order of.
FIRST CITIZENS
FiratCiwRlw..574t'N.B. 28d Trust Comparry
www.flrstcitiz_ens.com
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GUARDIANOSAFETY BLUE WBL
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MONITORING & COMPLETION REPORT
[CAMA Major Development & State Dredge & Fill Permktsj
�H11
PERMITTEE'SNAME: �r�(�r� �, II_ PERMIT# 5I 260 CC
LOCATION: �� �, n T�
FIELD REP. Q
MONITORED BY
PHONE: DATE REPORTEDLY COMPLETE:
DATE OF INSPECTION $ rZ 0 %
1) Do thpa�ure
d dimensions of the development differ from those indicated in the permit and workplat?
YES/ircle one].
1
COMMENT: N
2) SEDIMENTATION &,440SION CONTROL: Has Permittee seeded, grassed, or otherwise stabilized all
disturbed areas? YE N [circle one]
COMMENT:
3) FUTURE MONJORING & ENFORCEMENT ACTION: Is further investigation or enforcement action
needed? YES circle one].
COMMENT: