HomeMy WebLinkAbout46781_SHALLER, ANN_20061018F!]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 NO
Previous permit #
Date previous pe
Applicant Name r '` Project Location: County
Add % ,. 1 Street Address/ State Road/ Lot #(s)
ress
City
State ZIP
Phone # ()
Fax # ( )
Authorized Agent
❑ CW
❑ EW ❑ PTA ❑ ES ❑ PTS
Affected
ElOEA
❑ HHF ElIH ElUBA ElN/A
AEC(s):
❑ PWS:
❑ FC:
ORW: yes / no
PNA yes / no Crit. Hab. yes / no
Subdivision
City ZIP
Phone # ( ) River Basin
Adj. Wtr. Body ((at /man /unkn)
Closest Maj. Wtr. Body
Type of Project/ Activity
(Scale: r� )
Pier (dock) length
Platform(s)
Finger pier(s)
Groin length
number Ed
Bulkhead/'Riprap length
avg distance offshore
max distance offshore
❑ I I
Basin, channel
I
cubic yards -_❑�—
Boat ramp—{—
Boathouse/ Boatlift
1
Beach Bulldozing
Other
Shoreline Length
SAM not sure yes no
Sandbags: not sure yes no
Moratorium: n/a yes no
Photos: yes no
Waiver Attached: yes no. - - -
A building permit may be required by:
Notes/ Special Conditions
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on back regarding River Basin rules.
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❑ See note
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Agent or Applicant Printed Name Perm it Officer's Signature
Signature "Please read compliance statement `y V Date Expiration Date
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Application Fee(s) Check # Local Planningf urisdiction Rover File Name
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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, certifythatthis 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
Central Office Elizabeth City District
Mailing Address: 1367 U.S. 17 South
1638 Mail Service Center Elizabeth City, NC 27909
Raleigh, NC 27699-1638 252-264-3901
Location: Fax: 252-264-3723
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
Fax:919-733-1495
(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,
Orslow -below New River Inlet- and
Pender Counties)
Revised 06/29/05
OCT-10-2006 TUE 10:35 AM h!C DIV OF COASTAL MGMNT FAX NO. 4
EWR
O C T 1 2 2006
N'Ofth C"Irai na Dop—irtrnent of Environment, end N rp�LdD jty DCM
I'AV1,81011 Of Uastal Management
Ci i if los ` . Jones, Director William G. Ross Jr., Sccretary
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(14s7'1)05'0 ot! .applyiiq, for;tnd obtairaiug all CANXA Pernaits mcce,ssary to
d'11�1!',�7tUS6 VAW ilit-is (et,:tk')
400 C:ci-fti"tvne Annue, M01.0h?ad City, North Carolina 28557
1 FAX: 252-2,17-33301 Internet; �vww.nrcocstalmanac0ement.n�t
�, 6q,. it Opj on:nity 1 Affirmative Adon Emidoyor - 50% ReeychA 10% Post consumer Paper
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ADJACENT RIPARIAN PROPERTY OWNER STAT
(FOR A PIERIMOORING PILINGSBOATLIFTBOATHO
I hereby certify that I own property adjacent to
property located at
(Name of Property Owner)�1�`
t�-- 14-o? "
(Street Address, Lot, Block, Road, etc.)
on ��I�LT� �d1C� in !!-2l.lbt�l.�jVap , N.C.
(Waterbody) (Town and/or County)
He/she has described to me, as shown below, the development he/she is proposing at that
location and I have no objections to this 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 have indicated my intentions by initialing below:
I do not agree to waive the 15' setback requirement.
(initials)
X, e J. C I do agree to waive the 15' setback requirement.
(initials)
---------------------------------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
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Telephone Number
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT., i
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hereby
(Name of Property Owner)
property located at 11) 95 F JZe�,tX
(Street Address, Lot, Block, Road, etc.)
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on \�f b11 d2W... 12AV sTL, , in G\ ,�W K— ;_G#�lGl t-1��•/ , N. C.
(Waterbody) (Town and/or County)
He/she has described to me, as shown below, the development he/she is proposing at that
location and I have no objections to this 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 have indicated my intentions by initialing below:
I do not agree to waive the 15' setback requirement.
(initials
I do agree to waive the 15' setback requirement. - 49A*Z&LA, otJ Ly
(initials)
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
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Signature
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Telephone Number
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LEGEND:
EIP ... Exisitng Iron Pipe
EIS ... Existing Iron Stake
EPK ... Existing PK Nail
CP ... Computed Point
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DB. 363, Pg. 313
DB. 847, Pg. 439
MB. 031, Pg. 065
0nslow County Registry
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66-112/531
ROBERT N SHULLER BRANCH 13111
ANNE C SHULLER
2"5 WESTDALE DR !
FAYETTEVILLE, NC 29303
910-484-5929
L8 70 29 391100 2 1
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