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Home My WebLink About50658_ADAMS, RICHARD_200803283 25-6 S-456 ❑LAMA / ❑ DREDGE & FILL �J� .; ��' ".J x :` 54f S GENERAL PERMIT Previous permit # []New L]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 15A NCAC ED Rules attached. Applicant Name ice, ?T ; ': ' t r' ,—T-- Project Location: County Address Street Address/ State Road/ Lot #(s) City State ZIP �' 1 Phone # —� (�) Fax # O • Subdivision r' Authorized Agent I City ( `• ZIP Affected ElCW ❑ EW ❑ PTA ❑ ES ❑ PTS Phone # O River Basin AEC(s): ❑ IDEA❑ HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body { '• (nat /man /unkn) El PWS: ❑FC: ORW: yes / no PNA yes / no Crit.Hab. yes / no Closest Maj. Wtr. Body ■■■■■■■■■■■ ■■■■■■■■■■ ■■■■■■■■■■■■■■■■ ENMEMEMEME . • ... .. MEMO ■■■■■■■■■■■■■■■■■■■MEN ■■■■■■■■■■■■MIEiC■■ MEN ■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■W"' ME■■■■■■■■■■■■■■■■■■■ NOON ■■■■■■ NOi■EM■■■■■■■■■■■■■■■■■■■■■ ■■■ME ■■■■■�ra■■ ■■►UMW\!M■EMM■MM■■E■NM MEN ®®■1WV MW MOM■■■■■■■■■■■■ No i ME■ESI f®■■EMEN EME■■EN�."IMFru11 MOMMEN■■■ EMEE■E■■■■■ N■O1Rluf'1■L:oil■■E■iME■IMM 'IO■ SOMEONE ■NOON ■■�■ ■ OMOL::�.�.I� RE■UME■■■■M E■NOON■ ■■■N■. ■■ NONE ■■1■EiOE ■ EMER■■■EEO■!■■11ft11i■■■■EEMEMEME■MENEMEME NC■■MEN EOEM E■!■IN] NEE■■n■■MENNEN■MMEEMEMO .■ I■EMM000■:7l■' MEOMO0 M■MEMNE■■EEMEME OO■■■l■■■■!f M 91%0 ENEE■ENEE■E■■EE■E■■ENE■E EEMOMME■ENMEN■ CNNN■■O■11■:►JIIE■!■INN■■EN■EE■ ONOEElIr'1!IEE■I.E ■■...Of ■■�■■■■■■■■■■■■■■ .■.aalRE M I■■■.■E■a.■.■■■■■■■E■■■■■■ ■■■■In Eii �s■OEEc!!l.■rNVINAMMMM■EN■OMEM ■m ■■■E■nl.NiffWNEEMME■M■NOMEE • OMEN ...EEI/MEEEEEMO ...EEO. • O■■■■ 7■N■■■■■■■■■■ENMEEN■ ■NOMEOnoEEM■■EEEEEEOEEEEEEE _ EEEMEM EMOON■ ■■■■■■■■■■ ■■■■■■■■�■■ Agent or Applicant Printed Name J Signature Please read compliance statement on back of permit Application Fee(s) Check # PermitOfficer s Signature Issuing Date Expiration Date Local PlanningJurisdiction 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, 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/ 1-888-4RCOAST 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 HCDEHR North Carolina Department of Environment and Natural Resources Division of Coastal Management Michael F. Easley, Governor James H. Gregson, Director William G. Ross Jr„ Secretary Datc 3 — vZ'� — v `b Applicant rime R l C H A/Q ,D e*7 S \ Mailing Address 1 G�J �� %� 4,¢!�C g �. Gc I certify that Z have authorized (agent) Tmc�ck 1 &C- P,e. � 1 \ to act on my behalf, for the purpose of applying for and obtaining all CAIMA Permits necessary to install or construct (activity) 2`,� S Q o t.J L •{-- , at (location) Ia WV'A' �rt- no, k This certification is va' thru (date) Signature 5�/ /l - 2 41 - og 400 Commerce Avenue, Morehead City, North Carolina 28557 Phone-- g � 808P280 � XIS 47 33301 Internet: w�vw avaaia#�aa�e��paam yew It 3 p++ Peel Wu *p 'std9sul ukul Tema Vale 7CJp It w peed eJols An Equal ()p¢nrlinrty i Altrnatw? Action Errt~V, Recjacd l 10% Post Consurner Pape- 'daeys 10 al= aw of aiwitene swiq jo legwnu aia e�npal 'ea.le 6uuallem 10 bugool Oul call kwi Jeyu% aaoetd aq ueo Spop Ni-pesealoul aq of peau Sew £ d V699-Ect--747 _.. - ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIER/MOORING PILINGSBOATLIFTBOATHOUSE) I hereby certify that I own property adjacent to (Z�d, o,,c A, A"S 's property located at (Name of Property Owner) (Street Address, Lot, Block, Road, etc.) on I -,:ye- omX< ,in S VeA, 0 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) Sf°-�— 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) ------------------------------------------------------ ---------------------------- - I[ Jn Sigi ire QbK-- Cat V V Print or 'Cype Name Teleplion Number Date: -3 A y o g ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIER/MOORING PILINGSBOATLIFTBOATHOUSE) I hereby certify that I own property adjacent to Q; kk a rok (A"S IS (Name of Property Owner) property located at � \ L� e✓ o-.* 4�V,o$ (Street Address, Lot, Block, Road, etc.) on in S 4 LAVA ,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/boatlif Uboathouse 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: 1 do not agree to waive the 15' setback requirement. (initials) (/ ' I do agree to waive the 15' setback requirement. fiats) DESCRIPTION AND/OR D G OF PROPOSED DEVELOPMENT: (To be filled in b individ proposing development) -4- m (� f N � k x k� Q � • Q&-'t/4 l�' / �" Signatu A-1� --- Print or 'Cy Na • me ---�-- 12 --�� S "1 e(eplione Number Date: First Citizens Bank First -Citizens Bank & Trust Company Raleigh, North Carolina Pay to the �t 1 Lj n Y\ 1 1 order of �� ///,Q c � l it — Personal Money Order I 6 66-30/531 Branch No. 342 05346559 Date_March 2 20_2008 NOT O ,00 t�lj �Q�J �V S�I�OOO,OOt;f Iv' 7D ER DAYS $200. 00 �O � � Dollars Memo _..._ OS ]0070R(12/06) - Remltt�T_. - -_ 603438 12599MOCK1 ll60S346SS911' I:OS31003001:980799499011'