HomeMy WebLinkAbout56912_MCCOY, AUGUSTUS_20101028�= v Z)
❑CAMA / ❑ DREDGE & FILL
GENERAL PERMIT Previous permit#
❑New ❑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
❑ Rules attached.
Applicant Name
Address
City State ZIP
Phone # ( ) Fax # ( )
Authorized Agent
❑ CW
❑ EW ❑ PTA
Affected
❑ OEA
❑ HHF ❑ IH
AEC(s):
❑ PWS:
❑ FC:
ORW: yes / no
PNA ye / no
❑ ES ❑ PTS
❑ UBA ❑ N/A
Crit.Hab. yes / no
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision
city ZIP�SJ�P
Phone # O River Basin
Adj. Wtr. Body ,inat/man /unkn)
Closest Maj. Wtr. Body
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Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
Permit Officer's Signature
Issuing,Date Expir4tion Date
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, 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 Morehead City Headquarters
Mailing Address: 400 Commerce Ave
1638 Mail Service Center Morehead City, NC 28557
Raleigh, NC 27699-1638 252-808-2808/ 1-888ARCOAST
Location: Fax: 252-247-3330
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
Fax:919-733-1495
(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
Applicant:
Cate:
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
found in your Habitat code sheet.
Habitat Name
TYPE
Choose
Choose One
TOTAL Sq. Ft.
(Applied for.
Disturbance total
includes any
anticipated
restoration or
temp impacts)
FINAL Sq. Ft.
(Anticipated final
disturbance.
Excludes any
restoration
and/or temp
im act amCou/n)t
TOTAL Feet
(Applied for.
Disturbance
total includes
any anticipated
restoration or
tern impacts)
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount
I
e,' Qn42,'
Dredge ❑ Fill ❑ Both ❑ Other
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FORA Pf1 R/MOciRf1YC r-azyGs1Ba4 zurFT.laoArHous&)
i hereby certify that I own property adjacent to -A - 4 '1
erne of Property Owner) /
ro crt located at // G M� r•�
(Lot, Block, Road„ etc.) 4a �®
r� ��O
l" N.C. 0
(Witterbody) (Towki and/or Coun
Applicant's phone #:,AL? balling Address:_./�S�J
Ho has described to me, 8g shown below, tl�e development he is proposing at that location, and, I
hays no objections to his proposal. I wndcrMM that a pi-arinuwiing pilings / bomliR / boatlwuse
must be sct back a minimum distance of fifteen feet (15') from my area of riparian access unless
waived by me. (If you w4h to waive th t, setback, you must initial the appropriate blank
below.)
I 42,W wish to waive
I 1L wish to waive that setback tquirement.
•___-.... - --------------------------- --------------------- -----------------.... ....
DESCRIPTION AND.OR DRAWING OIL PROPOSED DEVELOPMENT:
(To be filled in by individual proposinS developmenQ
? - T I
----- •--------.................. _ ---- ------ ._... ............. ---- ------- ----
(Informatio„ for Property Owner Applying (Riparian Prue Uwner Info" ation)
for Versnit)
Mailing A.ddress l.{ 5i nature
Ile,, k. L, ( ..,g 8 r I L.�
City/SwLe/Zip
,2,L) _, ),FZ —
Telcpbone Number
Signature DRie
i c h Zvi [-'A'i 111 e r
print or Type Name
l�elcphone :dumber
- a j - o/—
Dam
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OCT-21-2013 09: 3a Fr om: DCM MHDC7'f n._�~ n
To:97.2524ASI r0 page::-"2
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PrFRIMOOldiVG PILINGSIZO,4,TLIFTIHOATHOUS)
I hereby certify that I own property Aam-nt to _ '.."j i�//P �. /l�G� S
ame of Property Owner) ,Ion
property located at %4.�� . Ale 4 Z;",r/ ZL /!I G 'C� ®J�
{Lot, Block, Road, etc.) ,
(Waterbody) (Town and/or Coun )
Applicant's phuue #_��� r I� iD Mailing Address. Z
He has described to me, ae shown below, the develepment he is proposing at that locatian, and, I
have no obloctions to his proposal, I undorstand that a pier/mooring{ pilings / boatlift: boatboaso
must be set back a ►nininr4m distance of fift,; rm feet (15) froru my area of riparian, access unless
waived by me. (If you wigh to waive the se b=k, you must initial the appropriate itlank
below.)
I d, o not wish to waivc
I ,die wish to waive that setback mquiroment.
DESCRIPTION AND/OR DRAWING OF ,PROPOSED DE'VELOPMEX'l't
(To befi114d in by indivedewl,(rroposing develvFMent)
(Informatiun for Property Owner Applying (Riparian Property Owner Information)
for Permit)
Mailing Addres9 T Signature
Ci tylState/�fp
Telephone Number
Sign attire
Date
Print or Type Name
7elcpbons Numbes
Date
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` 106 Marys Ln, 2; NC 28556
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NC®ENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue James H. Gregson Dee Freeman
Governor Director Secretary
BUFFER AUTHORIZATION CERTIFICATE
FOR PIER AND DOCKING FACILITIES ACCESS WAY
A riparian buffer authorization is required for pier and docking facilities access ways through the Tar -Pamlico &
Neuse River Riparian buffer per Division of Water Quality (DWQ) regulations 15A NCAC 0213.0233 & .0259,
The Division of Coastal Management (DCM), through a Memorandum of Understanding with the Division of
Water Quality (DWQ) has reviewed your project proposal, determined that the project as proposed complies
with the aforementioned regulations, and made a "no practical alternatives" determination per those
regulations.
Those activities covered by your Coastal Area Management Act (LAMA) permit have received Buffer
Authorization as long as the project is constructed in a manner that continues to meet all of the conditions
listed below. Failure to comply with this Buffer Authorization shall subject the property owner & the party
(contractor) performing the construction &/or land clearing to a civil penalty of up to $25,000 per day per
violation.
1. Crossing is Perpendicular: Pier and docking facility access way must cross the 50 ft. riparian buffer
perpendicularly (which is defined as between 75 and 105 degrees) unless otherwise approved by DCM.
The alignment shall minimize the removal of woody vegetation to the greatest extent practicable.
2. Pervious Materials: All reasonable measures shall be taken to ensure the access way is made of
pervious materials like open -slatted wood or composite, mulch, or grass to meet the intent of the rules
to the maximum extent practicable.
3. Access Width: The width of the pier or docking facility access way shall be limited to six (6) feet.
4. Project Drawing: The drawing on the CAMA General Permit is considered the project drawing of your
property indicating the relative location of the pier or docking facility and any requested access way.
This drawing will be used to aid in compliance and monitoring efforts.
By your signature below you agree to be held responsible for meeting all of the conditions listed above and
verify that all information provided is complete and accurate.
Agent or Applicant Print d Name
A�nt_orApplicant Signa re
Issue Date
CAMA GENERAL PERMIT##:_ '5V Z C
Washington Office
943 Washington Square Mail
Washington, NC 27889
Phone 252-946-6481
Morehead City Office
400 Commerce Avenue
Morehead City, NC 28557
Phone 252-808-2808
An Equal Opportunity/Affirmative Action Employer— 50% Recycled/10% Post Consumer Paper
Version 5, 09/2009
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Tom. r=� •,: , :.
JAMES E. HICKOK
66-7162/2531 6992
LORME M. HICKOK
LIC.4697292 5545112
DATE
252,633-5748
226 CICERO RIGGS RD.
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COVE CITY, NC 28523
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