HomeMy WebLinkAbout46709_SAUNDERS, RICK_20061006,_d7R�..�-�`4ii'wt•I`:. ,... .��S N,. .. E't F�ii'�'i�_�y1�i_, ,�..?T-`"
❑CAMA / ❑ DREDGE & FILL
GENERAL PERMIT
❑New ❑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 15A NCAC
Applicant Name
City State ZIP
Phone # ( ) Fax # ( )
Authorized Agent
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS
AEC(s): ❑ OEA ❑ HHF ElIH ElUBA ElN/A
❑ PWS: ❑FC:
ORW: yes / no PNA yes / no Crit. Hab. yes / no
Previous permit #
Date previous permit issu d
❑ Rules attached.
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision
City ZIP
Phone # ( ) River Basin
Adj. Wtr. Body - (nat /man /unkn)
Closest Maj. Wtr. Body
Type of Project/ Activity
(Scale: N
Pier (dock) length
Platform(s)
Boat
Othe
Shor
SAV:
Sand
Phot
Waiver Attached. yes no
A building permit may be required by: El See note on back regarding River Basin rules.
Notes/ Special Conditions
Groin
Bulk
Basin
Boat
ft
Beac
Mo
Finger
r pier(s)
n len h
number
head/ IZprap length
avg distance offshore
max distance offshore
- � —, --- — --
channel
cubic yards
ramp
_���-- i - —•— i { — - — I { { I {
house/ Boatli
__ �
h Bulldozing - - -
I� I.
i
eline Length
not sure yes no
bags: not sure es no
Y
I
I � {
ratorium: n/a yes no
os: yes no
Agent or Applicant Printed Name
Signature "Please read compliance statement on back of permit"
Permit Officer's Signature
-r
Issuing Date Expiration Date
Local Planning Jurisdiction Rover File Name
Application Fee(s) Check #
Agent or Applicant Printed Name
Signature "Please read compliance statement on back of permit"
Permit Officer's Signature
-r
Issuing Date Expiration Date
Local Planning Jurisdiction Rover File Name
Application Fee(s) Check #
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
Iandowner(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 I) or the Wilmington
Regional Office (910-796-7215) for more information on how to comply with these buffer rules.
Division of Coastal Management Offices
Central Office
Mailing Address:
1638 Mail Service Center
Raleigh, NC 27699-1638
Location:
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
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)
Morehead City District
400 Commerce Ave
Morehead City, NC 28557
202-808-2808/ 1-888ARCOAST
Fax: 252-247-3330
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico 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 06/29/05
t,•� T w';iy
DJAC.ENJ' Ri-� Ai Air ' FY (y r, y t �'OR .9 P.T, '.R/UIYG"Ca ��^�j 'n �j 7I'''rT�.,r. S .fit`::'7
I .0 [!_.,� D d7 O11 L � j
�fs:'f I hereby certify that I owrr property adjacent to
. - S
(iti:iirr.re or Property OU vneri—
property located at BUG----�/
(Lot, BlacZYV—load
onLn
/
(T07rr aztdlnrl County)
He ha-s desc,
`ibed to me, as shown below, the devP!
location, and, I have no objections to his prot3osaI. Z under orient he 1 p.zopositr�
at i.hat
must be set<Oac!c a minimum distance of rr�n fit i ",
st< nd r;hat a p4duncovercd boat; .lift
waived by rne. { {�) from my area a[ i ipanan acc-gss unl -Ss
I do not wish to waives seliback requirement,
i
I I do wish to waive that setback requirement.
;•---------ESC'R-iPTIc�I`;-------------------------------------------
D-----I----__-----
A'+Z3/OR DRAWING OF PROPOSED T�E4��.
(To be fv[ed in by 1�zdiYLd111;[yr%posin des•d1rn
�,�,enr)
t
CA Nam-
Morehead city DcM
P
d
PL 6 o-------------------------- -- --- -----
Signature I-
f
Tnfnir or Typ., Pv.7;rne
Telephone Nurrib,�r -
Date:
I
p F 1, y ER I ATEMEN.
0 wNk . ss�p
.(FOR A PIERIUNC O BRED Bo/tI,111M
I hereby ct!rffy that I own properry adjacent to
S
(N.-Ilme Of Property 0sruer)
property located at
(Lot, Block, Road, JC-)
on � z:,z "(f-
(Waterbody)
in
(ToTv-n and; arlCount')
�;. C.
He has desc,-ibed to me,
as shown below, the dev--Iopr�ient he, is PrQP0-Sih.'!j7 At .hat
location, and, I have no objections to his proposal. I undersand Uiat a pi c�rlunc,
must besetback a Minimum distanc:� of�ft - i pier/uncovered boat'� ft
r! fe—At CILY) fror-,, rn area of riparian ac&g ass
5
ss utU
waived by me.
I —donot wish to waive .the se back requirement.
I do wish to waive that setback requirement.
---------------------------------- -----------------------------------
--------------------------- ------
DESCRIM(DN
AND/OR DRAWING OF PROPOSED: D-8VELOP-IYLE:,4T: -- --
(To be.IV-od in by ihdiY&uz-j r-,posing det-C-111,pMent)
SS I? JUL
.0
reheacl C
- ----------------------------------------- ------------ 7f.
LQ
16+\ST) t4 (0
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Print or Typ,t�4'.Vlie
-Z-A—
Ttflephone Numb,1'r
Date: 1t Cr I T
I M AMT,� Q.�A*
? KS , � C-
09 I �.
-74,'�A
NCDENR
North Carolina Department of Environment and Natural
Division of Coastal Management
Michael F. Easley, Governor Charles S. Jones, Director
Date / - _ C)-?
Applicant Name j S�-6 I'� D
Mailing Address O) o t—A�) 65
Resources
William G. Ross Jr., Secretary
I certify that I have authorized (agent)to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity)u C-1�
at (location) ` �� �110 L6Cq C`D V ?—I
This certification is
r
Signature
(date) B-Ifjj��7
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: 252-808-28081 FAX: 252-247-33301 Intemet: www.nccoastaimanagement.net
An Equal Opportunity 1 Affirmative Action Employer — 50% Recycled 110% Post Consumer Paper
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DATE JANUAR`r . 042007,93-541/920
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DATE •JAt'aIJW)R%` 04, o 2r'I; •7 93-541/920
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' O BOX 9476, MINNEAPOLIS, MN 55480
�EE: FIRST INTERSTATE BANK, HELENA, MT
DOLLARS BY SIGNING YOU AGREE TO THE SERVICE CHARGE
AND OTHER TERMS REVERSE SIDE.
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