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Home My WebLink About51210_HEATH, WILLIAM_20080807a;rE� DGE & FILL 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 I SA NCAC ❑ Rules attached. Applicant Name Project Location: County Address r} Street Address/ State Road/ Lot #(s) } •� a ... City _ . State Phone # ( ) Fax # () Subdivision Authorized Agent City ZIP ❑ Cw ❑ EW ❑ PTA Affected ❑ OEA ❑ HHF ❑ IH AEC(s): ❑ PWS: ❑FC: ORW: yes / no PNA yes / no ❑ Es ❑ PTS Phone # ( ) River Basin lC t- ❑ UBA ❑ N/A r ,`` Adj. Wtr. Body �.: 1 Li. (l_ (nat.in Junkn) Crit.Hab. yes / no Closest Maj. Wtr. Body .-F. ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ M. ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■E■■■NE■E■■■■■■E ■ENE■ ■O■■■■■EE■E■E MMUMMEMEM No 0 MEMME rO1 ■■■■■■■■■■I■E�l�l■■■■■■■■■■■■■■■■■■■■■■NONE ■■ ■■■ �:i�l■■■■■■■EN■■O■® ■ENE■■■■N■ ■■ ME No EMO ■EEO■■��■■■a::■■■�■l�■E■EE■■E■■ENENEE■E .. - • EEl�►>�1��L�J■■f��E■/i11�!E�iE �E■■NEE■ENEE■E 1�11�i1t lfrri%�I�i��■�ics��l�■■�■■NNE■■■■■N fL'JN■NON■■■■■NNN■NNNN■NIiE� ■ENE■■■ ■■E■■■■■■NEE■■■E■■■■E■■■■■■E■■E■■EEE ■■■■■■■■:■■■■■No■■MEMMIN ■■■■■■■■� 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 50� 7 L Local Planning jurisdiction Rover File Name r 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 Raleigh Office Mailing Address: 1638 Mail Service Center Raleigh, NC 27699-1638 Location: 2728 Capital Blvd. Raleigh, NC 27604 919-733-2293 Fax:919-733-1495 Morehead City Headquarters 400 Commerce Ave Morehead City, NC 28557 252-808-2808/ 1-8884RCOAST Fax: 252-247-3330 (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 If Zd Z z 7 19910 17 TOU AUG 4 2008 Morehead City DCM 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_°°� Name of Property Owner Applying for Permit: TLcdu 'd g e'r\k--la Mailing Address: l o r►1'� k� st(y-k A),0, � I certify that I have authorized (agent)—gDCke-r 0-OrfxC21C to act on my behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to install or construct (activity) �LCI at (my property located at) ,prc.nfr kAITI J This certification is valid thru (date) M Property O'wner Signature Date 400 Commerce Avenue, Morehead City, North Carolina 28557 Phone: 252-808-28081 FAX: 252-247-33301 Internet: www.nccoastalmanagement.net An Equal Opportunity 1 Affirmative Action Employer — 50% Recycled 110% Post Consumer Paper I. S r e 6 nc k HENRY HEATH FARM ACCOUNT e f HENRY HEATH DL 1976383 PH. 252-523-6296 1580 MIKE STOCKS RD HOOKERTON, NC 28538 PAY �q DATE TO THE ORDER �f First Citizens Bank Qfst fiirstcitizens.com FOR --1150 "0 l 3u' ':❑ 5 3 L00 3001:00 3 t, 9 7 3 70 28 2►i' 11013 66-30/531 ! / ✓ 349 $2 v0- DOLLARS 8 '°-