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Home My WebLink About48135_WILLIS, DONALD_20070308i 0 CAMI4 / ❑DREDGE &FILL � GENERAL PERMIT Previous permit# ❑New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issu As authorized by the State of North Carolina, Department of Environment and Natural Resources (117 and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC C] Rules a hed. Applicant Name Project Location: County Address Street Address/ State Road/ Lot #(s) City State ZIP Phone # () Fax # () Subdivision Authorized Agent City ZIP Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Phone # ( ) River Basin AEC(s): ❑ OEA ElHHF ❑ IH ❑ USA ❑ N/A Adj. Wtr. Body (nat /man /unkn) ❑ PWS: ❑FC: ORW: yes / no PNA yes / no Crit.Hab. yes / no Closest Maj. Wtr. Body Type of Project/ Activity (Scale: ) Pier (dock) length Platform(s) Finger pier(s) Groin length - number Bulkhead/ Riprap length avg distance offshore ` max distance offshore Basin, channel " cubic yards i.' Boat ramp Boathouse/ Boatlift Beach Bulldozing -- Other - J} Shoreline Length SAV: 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: ❑ See note on back regarding River Basin rules. Notes/ Special Conditions Agent or Applicant Printed Name PermitOfficer's Signature Signature Please read compliance statement on back of permit Issuing Date Expiration Date Application Fee(s) Check # Local PlanningJurisdiction Rover File Name a ,. 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/ 1-888ARCOAST 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 ADJACENT RIPARIAN PROPERTY OWNER STATEMENT ` (FOR A PIER/MOORING PILINGS/BOATLIFT/BOATHOUSE) I hereby certify that I own property adjacent to 's (Name of Property Owner or Applicant) Mailing address if differenr fi-nm lncatinn arlrire.cq (town, state and zip) hone numbers you can be reached at ram, ��Oy d'% � � " �7 P Y d�� property located at e (Lot, Block, Road, etc.) on �C/� V LAC' -,in (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. initials S I do wish to waive that setback requirement. MAR 8 ZOO? initials - --------------------------------------------------------------- { [� - tpo tow-c- try DESCRIPTION AND/OR DRAWING OF PROPOS'tD DEVELOPMENT: (To be filled in�b�y individual proposing development) wit(" Ff r� t'qlleg M1b� Signature 1\12\ I.0G U P n19QfQ Print or Type Name Lc,) Z) W9` 35a ! Telephone Number Date: 2). � 3 1 o 3 --�n.ktlls ADJACENT RIPARIAN PROPERTY OWNER STATEMENT ` (FOR A PIER/MOORING PILINGSIBOATLIFT/BOATHOUSE) 4 I hereby certify that I own property adjacent to6,�&,� 's (Name of Property Owner or App 'cant) Mailing address if different from location address (town, state and zip) d _ �1 ��G�d„ phone numbers you can be reached at property located at (Lot, Block, R d, etc.) on �� f' , in �� `' _ It , 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 ri�a�i a. less waived by me. I do not wish to waive the setback requirement. in IYIrK d ,j I do wish to waive that setback requirement. v initials L1ij��'e�eaQ DGM ------------------------------------------------------------------------------------------------------------------- DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: (To be f.11e�i y an victposing development) c...�-��. ual ! pro �� ppodpoao�d0 5 AIH6 Pr �r � e1 a/ C f-i UI L �� ---------.------------------------------------------------------------------------------------------- - nature <;55-�"R rint or Type Name Telephone Number Date: -,I e. — 4®L Z _ fl ,q FOR ul a .. . ........... RONNIE CHADWICK CHADWICK CONSTRUCTION COMPANY 524 CEDAR RIDGE DR WINTERVILLE, NC 28590 252-728-4504 PAY TO THE ORDER OF 11079 66-112/531 BRANCH 02302 DATE BMU BRANCH BANKING AND TRUST COMPANY 1-800-BANK SOT OBT.com 1100001107911s :0 S 3 10 1 1 2 1':000 S l l00 9 3 C3 26,10 -LARS D.. 1. w MONITORING & COMPLETION REPORT [CAMA Major Development & State Dredge & Fill Permits] PERMITTEE' S NAME: DQ n J Willis PERMIT # q gf LOCATION: lob m o,�G k bf66F,& b r• FIELD REP. l7- e den 4toart. NC cMl PHONE: -7. g14� DATE OF INSPECTION DATE REPORTEDLY COMPLETE: Mp T 1) Do the cured dimensions of the development differ from those indicated in the permit and workplat? Y�circle one]. COMMENT: 2) SEDIMENTATION -&--,EROSION CONTROL: Has Perm ittee seeded, grassed, or otherwise stabilized all disturbed areas? O [circle one] COMMENT: 3) FUTURE MO RING & ENFORCEMENT ACTION: Is further investigation or enforcement action needed? YE O circle one]. COMMENT: 'AMA / REbGE & FILL ' GENERAL PERMIT Previous permit# '�&ew ❑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� Q� l V'Rules attached. Applicant Named Project Location: County 'ldrj� 'T 1 Address C / Street Address/ State Road/ Lot #(s) Citytz- State' ZIP OS%(O Phone # (� Fax # () I Subdivision Authorized Agent �� ii Ls_�Lr�CityZIP Affected ElCW XEW El PTA ElPTS Phone # ( }� i ' L River Basin L- () ElOEA ❑ HHF ElIH ❑ UBA ❑ N/A AEC s : Adj. Wtr. Body man unkn ❑ PWS: ❑FC: ORW: yes no) PNA y!7 / no Crit.Hab. yes / no Closest Maj. Wtr. Body Type of Project/ Activity (Scale: Jkd fi ) Pier(dock)length Platform(s) Finger pier(s) Groin length number l Bulkhead/ Riprap length avg distance offshore max distance offshore Basin, channel cubic yards_ Boat ramp Boathouse/ Boatlift Beach Bulldozing Other Shoreline Length SAV: not sure yes 4121b) _ Sandbags: not sure yes no. V Moratorium: n/a yes Photos: yes no Waiver Attached: yes no A building permit may be required by: Notes/ Special Conditions 1 �L11•E� ` � C: Agent or Applicant Printed Name r`'iyl Signature * Please read compliance statement on back of permit *� rl .l v % ❑ See note on back regarding River Basin rules. re Y ►� !1 B Rover File Name