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Home My WebLink About47146_WORTHY, FRED_20070104` m ❑ CAMA / ❑ DREDGE & FILL �, GENERAL PERMIT �, Previous permit # ❑New ❑Modification --]Complete Reissue ❑Partial Rei ue Date previous permit issued As authorized by the State of North Carolina, Department of Environment and Natural Resources and the Coastal Resources C mmission in ap ea environmental concern pursuant to I SA NCAC �0 U b�,V"VY ❑ Rules attached. 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 ❑ HHF ❑ IH ❑ UBA ❑ 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 Pier (dock) length _ Platform(s) T i I I Finger pier(s) Groin length number Bulkhead/ Riprap length avg distance offshore max distance offshore Basin, channel , cubic yards Boat ramp Boathouse/ Boatlift Beach Bulldozing r Other Shoreline Length j SAM notsure 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 Agent or Applicant Printed Name r Signature Please read compliance statement on back of permit (Scale: ❑ See note on back regarding River Basin rules. r Permit Officer's Signature Issuing Date Expiration Da Application Fee(s) Check # Local Planning Jurisdiction Rover File Name 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 (252-946-6481) 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/ 1-888-4RCOAST 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 ' AllJA('LN'1' Kll'�1tt1Ai� 1'lcv►'1,1�>t i< u�� :�►•,t� ,� ►;� � t,:�►►..� 1 ' (FOR A PIF,R/MOORING PILINGSIBOATLI1''11BOlt THOUSIs) I hereby certify that I own property adjacent to FV'L D S Lion. - r (Name of Property Owner or Applicant),`/ Mailing address if different from location address 1 (town, state and zip) N �. 2-1 6 o 9------- ��6' o rl phone numbers you can be reached at property located at (Lot, Block, Road, etc.) Oil �a.,. ��-- mot- ��in 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. initials initials 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 f Iled in by individual proposing development) 0 I01411 �r t=t✓pS L o �-T O ci rL► A- 2' C'►/I* ) 3 I Z o SignZrer j� Wig j6!! .0 A, J I/ Print or Type Name 252.— Zia—_:�7/5 Telephone Number Date: 1 2-_��aL www.nccoastalmanagement.net/Permits/ADJ ACENTRIPARIANPROPERTYOW NERSTATEMENT. pdf AllJAC'l�:i�'1' llll'f�1l1A1� 1'1<ui'h,x► >< t►��,�►,t� ,� 1A t (FOR A PIER/MOORING PILINGS1130A7T1F7Yfl0 i71101'SI:) I hereby certify that I own property adjacent toaRD_W O1ZTh 1904, 401� � (Name of Propert}, Owner or Applicant)" /% Mailing address if different from location address '3 62 _---!`�'�'"`' �__--_ rl�: ^I (town, state and zip) �- P� 11,4. L- Z'7 to `1 -`---- ;� O o 0• 1 1 c1 -1 (�, `3 1` phone numbers you can be reached at � „L- , e. . tol property located at )(;C) (Lot, Block, Road, etc.) on in K 5 , N.C. (Waterbody) (Town and/or County) He has described to me, as shown below, the development he is proposing at that locationl, 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 I do wish to waive that setback requirement. initials ------------------------------------------------------------------------------------------------------------------- DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: (To be filled in by individual proposing development) Q-a�1- Q'�."ri's ` ---, --op 1- INS y S .r �t ►'y It ; •Z�� 3 S —� ------------------------------------------------------------------------ --- r------- ---r-------------- Signature Print or Type Name Telephone Number Date: www.nccoautalmanagement. net/PermiWADJACENTRIPARIAN PROPERTYOWNERSTATENiENT.pdf WORTHY and WACHTEL 919 781 9209 1'2/19/VM 23:03 2527256@79 12120 '06 11:18 NO.485 01/01 DEANBARNES PAGE Cl comftow mb I ftww�md Nibril PmWfc& G �� d itp w pm-4 h :"e. 11w�.� �MY/Y�IA • • i I fy) I Uw salisr�i tam td seta � Mr p:peee of Ow �id abftftt* s3 CAMA rgrwm r aeeeuory so i 3x S�l. re ' C�)r�lC ��t/ f{ c � 5 2.y`7 MIJ i 4W C u Aaw Me it od CV, Pitt Cap** 3M 262-MM 1 FAX: 3*XF-M %MftAwt "N., mawf►WAQrtMrtt.f* AB ftO QMPM* S AftPW* Pies ivftM-ws 1rMod % %0% pu QiINc m •oar 2527266079 => WORTHY and WA�HTEL JEL-919 781 9209 12/19'06 21:28 WORTHY and WACHTEL �f 919 781 9209 12/20 '06 11:13 NO.484 01/01 uc-�MIYDI�KIY�j PAGE �1 Car d En 01 IM IL WVJ fV@tu l PANU M ChMOID i•�r,, DMrr�ler �. nor it., Mai. � i lV. 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