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Home My WebLink About55283_MAREK, STANLEY_20100311❑CAMA / El DREDGE & FILL`l tl,/O t 9GENEPIAA* PERMIT itf, Previous permit# ONew ❑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 D Rules attached. Applicant Name Project Location: County Address ! �? f . '. f Street Address/ State Road/ Lot #(s) City c% a �i State : ZIP "� t Phone # (r1) �j� �� / �?. Fax # Subdivision Authorized Agent City ZIP Affected I] CW ❑ EW I] PTA ❑ ES ❑ PTS Phone # (,) River Basin AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body (nat /man /unkn) C PWS: ❑FC: ORW: yes / no PNA yes / no Crit.Hab. yes / no Closest Maj. Wtr. Body Agent or Applicant Printed Name I i" Signature Please read compliance statement on back of permit r; Application Fee(s) Check # Permit Officer's Signature % IT Issuing Date ,l Expiration Date Local Planning Jurisdiction Rover File Name 4& — h 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 ■ Complete items 1, 2„and 3. Also complete item 4 if Restricted Delivery is desired. ■ Print your name and address on the reverse so that we can return the card to you, ■ Attach this card to the back of the maiipiece, or on the front if space permits. Article Addressed to: /� � 6 3 1O A. Agent of Delivery D. Is deliveryladdress diffefenffrbniWm;1?/U Yes If YES, enter delivery address beloy.. ❑ No 3. Service Type ❑ Certified Mail ❑ Express Mail ❑ Registered ❑ Return Receipt for Merchandise ❑ Insured Mail 0 G.O.D. 4. Restricted Delivery? (Extra Fee) 0 Yam, 2. Article Number 7009 2250 0002 8347 5691r (Transfer from service labs PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540 1 UNITED STATES POSTAL SERVICE First -Class Mail Postage & Fees Paid LISPS Permit No. G-10 • Sender: Please print your name, address, and ZIP+4 in this box • — ' 11 e ��A""' �2 {dill}}}))j{!{iii lii�i}{I1i{{{�{i1tl3F!{if)iil)}{1IF17)i}li� ■ Complete Items 1, 2,.and 3. Also complete Item 4 if Restricted Delivery is desired. ■ Print your name and address on the reverse so that we can return the card to you. 1 ■ Attach this card to the back of the mailpiece, or on the front if space permits. 1. Article Addressed to: 02 A. Si ture X �� ❑ Agent ddre. Received by (Printed Name) Cto of Dell -i � u— (tit A 56.13-� - D. Is delivery address different from Item 1? ❑ Yes If YES, enter delivery address below: ❑ No 3 Service Type ❑ Certified Mail ❑ Express Mail 0 Registered ❑ Return Receipt for Merchandise ❑ Insured Mail ❑ C.O.D. 4. Restricted Delivery? (Extra Fee) ❑ Yes 2. Article Number 7009 2250 0002 8347 5707 (Transfer from service labeo PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540 UNITED STATES POSTAL SERVICE First -Class Mail Postage & Fees Paid LISPS Permit No. G-10 • Sender: Please print your name, address, and ZIP+4 in this box • ?tlt�iliiifil!}43111t1�t1�11}�1�51{��1}!}�lfii7 t:��it?!3�l�I JANICE H MAREK G AR JAN FOR:STANLEY D MAREK 44VAUTTIN RD BEAUFORT, NC 28516 Pay to the Order of 865 66-7172/2531 Date $ L—:�00 J�W�llars COOPERNATWEK BA BEAUFORT, NC-55c�'e� For —4� 1� 1: 2 S 3 17 �0 281. �090008 �3 17 ........... --dU-AWIFN SAFETY* BLUE il -Om-1 0 A NC Division of Coastal Mgt. Habitat Impact Computer Sheet Applicant: Stanley Marek Date: March 11, 2010 General Permit #: 55283C 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 DISTURB TYPE 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 impact amount) TOTAL Feet (Applied for. Disturbance total includes any anticipated restoration or temp impacts) FINAL Feet (Anticipated final disturbance. Excludes any restoration and/or temp impact amount ow Dredge ❑ Fill ❑ Both ❑ Other X 400 400 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 ❑ 252-808-2808 :: 1-888-4RCOAST :: www.nccoastaimanagement.net revised:02/03/10