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Home My WebLink About51172_HERBST, WILLIAM_20080620❑ CAMA / ❑ DREDGE & FILL G.RENERAL PERMIT ❑New ❑Modification El Complete Reissue ❑Partial Reissue As authorized by the State of North Carolina, Department of Environment and Natural esources and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC - I- ,1"_ s ,Y Previous permit # Date previous permit issued Applicant Name Project Location: County Address # �1 ��t^�!� (` Street Address/ State Road/ Lot #(s) CityState ZIP Phone # ( ) j Fax # (_) Authorized Agent Affected ❑ CW ❑EW ❑ PTA ❑ ES ❑ PTS AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A ❑ PWS: ❑FC: ORW: yes / no PNA yes / no Crit.Hab. yes / no Subdivision ❑ Rules attached. City ZIP Phone # ( ) _ River Basin - i.. r Adj. Wtr. Body i (�!z.�lL'(� (natCmZAmkn) Closest Maj. Wtr. Body I � ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ .... - E:::■■::No MEMMEMEM:■■� 25 'HOM■� ■■■■■■■■■■■■■■■■■�■ir.■■■■■■■■■■■■■■■■■■ ::: -::11:=--"i A:::::::�::■::■■::::■E :. -�..�.�'+��: .. ■!L•J_.!J! Woo i111■■■■■■■■■■■■ n.■� ■■■c�■■�r.■►:►:►��■ ■ ■v®■■■■■■■■■■ so MEME OWN - , ■■■il■■■rG■■■OC■midi■'Gi►�■■►iiiiil■■■■■■■■■■■■■® ■■■■■■■■■■i■■■■■■■GiG�i�■■■■■v■■■ME WOMMMMOMMENEVE .�_•■.■..■■■..■.■.... :::■::::■■■:■■■�Zv ■■■■■■■■■■■■■ L ENEMEM :■: Agent or Applicant Printed Name % n Signature ** Please read compliance statement on back of permit ** risdiction Rover File Name Application Fee(s) Check # V 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, 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 (252-946-648 [)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. 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 UNITED STATJS., �Q • Sender: Please print your name, -address, and ZIP+4 in this box • �'/lam ��bsf= 410a e esl Ae cly'510 ■ Complete items 1, 2, and 3. Also complete item 4 if Restricted Delivery is desired. ■ Print your name and address on the reverse so that we can return the card to you. ■ Attach this card to the back of the mailpiece, or on the front if space permits. 1. Article Addressed to: Sose��l �- �csres C.iark� 2. A. ❑ Agent B. Receiv€d by (Printed Name) C. gate of eliver Co -G� D. Is delivery address different from item 17 ❑ Yes If YES, enter delivery address below: ❑ No 3. Service Type A3�bertified Mail ❑ Express Mail ❑ Registered ❑ Return Receipt for Merchandise ❑ Insured Mail ❑ C.O.D. .t Rncrririuii flcli�icni'7 XF t— Fcal ❑ Yes PE - - 102595-02-M-1540 ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIER/MOORING PILINGSBOATLIFTBOATHO USE) I hereby certify that I own property adjacent to a14A,1 " ✓ ° s property located at /PaLat-i.YDP,- (Lot, Block, Road, etc.) (Name of Property Owner) on G4 /J/+L in ;0/</, -5 4!!?f 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) Al 7 Zpe&ztl Mailing Address �nrr Jay Sr4aeeS, /ltd Z,TSl2 City/SiateiZip Zsz - 724 p 9s9Q Teleph(me jNumber Date 13 n �A e-eh 7 �CepM 1j4j<-geko OVTTi7 /tl t�O,4 3o<e�4eAb X jIs wlbf Owner Information) 14164 d Print or Type Name '?S-W - AAZ 4, - C. o i( Telepheme ,Vumber .�•ZG 160� Date Z - Pee-r jo Y` Kt VIRGINIA L. HERBST 1442 WILLIAM R. HERBST 147 Loblolly Dr. 66-21/530 Pine Knoll Shores, NC 28512 BRANCH 77614 PAY TO THE DATE r \V/ ORDER OF $ V ` WACHOvra achovia Bank, N.A. /7-2 � wachwda.com / FOR 1: S 3000 �19 i BO 2 ■ 10SS48 l� 1 42