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Home My WebLink About56801_MIMS, JEFF_20100910❑CAMA / ❑ DREDGE & FILL M GENERAL PERMIT 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 - i l 1 and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC L1 Rules attached. Applicant Name_ Address City Phone # O_ Authorized Agent Affected ❑ Cwi AEC(s): ❑ OEA ❑ PWS: ORW: yes / no State ZIP �= Fax # (-_._ ) ❑ EW ❑ PTA ❑ HHF ❑ IH ❑ FC: PNA yes / no ❑ ES ❑ PTS ❑ UBA ❑ N/A Crit.Hab. yes / no Project Location: County Street Address/ State Road/ Lot #(s) Subdivision City ZIP Phone # ( ) River Basin Adj. Wtr. Body (nat /man /unkn) Closest Maj. Wtr. Body ■■■■■■■■■■■■H ■■■■■■■■ :■■■■■■�■ :■■■■ ME :■ ■■■■■■'.■■■■■■■■■■■■■■ ■�■■■■■WM■■■■� ■ ■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■ NINE 1rENNNE M It ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ NEI ■■■■■■■■■■■■■■■■■■�I■■■■■■■■■■■■■■■■■■■■ t i Agent or Applicant Printed Name Signature ** Please read compliance statement on back of permit Application Fee(s) Check # Permit Officer's Signature % issuing Date Expira 'on 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, 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 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/ I-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 ADJACENT RIPARIAN PROPERTY OWNER BOATSTATEMENT T E N'T (FOR A PIER�fOORI�VG PILINGS`B I 1 '1� I hereby certify that I own property adjacent 's to (Name of Proppiy,,Owner) property located at onCAOI( (Waterbody) REC&VED SEr 72010 Morehead city Dcfw (Lot, Block, Road, etc.) _ , kPD1in 1 9,V5.c- (Town and/or County) e �� Applicant's phone # ( " � Mailing Address: 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_ (If you wish to waive the setback, you must initial the appropriate blank below.) I do not wish to waive I do wish to waive that setback requirement_ - - - ------------------- ------------- DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: (To be filled in by individual proposing development) (Information for Property Owner Applying for Permit) zroo W Un s+ Mailing Address ity/State/Zip Telephone Number (Riparian Property Owner information) / Signature T Print or Type Name Telephone Number 0/' 0/0 . �� Date Date ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIER11V00RING PILINGSBOATLIFT/.BOATHOUSE))/ �'�l►� 15 I hereby certify that I own property adjacent to �s (Name of Property Owner) 1 t d at SU 72010 "Orehepq City OCAR property oca e (Lot, Block, Road) etc.).. �N.C_ on �1 ' ��^��' C.� , in (ii�aterbody) (Town and/or County) �i 1o'iailing A : W�� Applicant's phone #: ! d ess 4-- He has described to me, as shown below, the development he is proposing at that location, and., 1 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 (I T) from my area of riparian access unless waived b e. (If you wish to waive the setback, you must initial the appropriate blank be. ON . I do not wish to waive ly I do wish to waive that setback requirement. ----------------------------------- DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: (To be filled in by individual proposing development) 1) >� (Information for Property Owner Applying for Permit) 21oc> Mailing Address City/State/Zip �O Jr Telephone Number Si tore Date (Riparian Pr Owner Information) I Signa re � II Print or Type Name 71 Telephone Number 7 Date FIRST CITIZENS BANK 4114 OUTER BANKS MARINE CONSTRUCTION, INC firstcitizens.com 66.30/531 1501 FIRST AVE 137 MOREHEAD CITY, NC 28557 (252) 240-2525 PAY TO THE m ORDER OF **200.00 R d 0 DOLLARS D.E.N.R. U C �� dl MEMO ;5 v >3 0 I [in 004 1 141" l:0 5 3 100 300':00 13 1 2 1B 2 :t SIGNATURE m. LL NOU-14-2008 15:20 From:DCM MHDCTY To:92476332 Paee:1�1 A7-A. I NGDENR North Carolina Department of Environment and Natural Resources Division of Coastal Management Michael F. Easley, Govemor James H. Gregson, Director William G. Ross Jr., Secretary Date 9-1 l C) Name of Property Owner Applying for Permit: W- W Im5 Mailing Address: T I certify that I have authorized (agent) ` 1 ��Z-.1 �''��S to act on my behalf, for the purpose of applying for and obtaining all CA.MA Permits necessary U install or construct (activity) at (my property located at) l28 l�-o�C�c��►� n `this certification is valid thru (date) t Cam- H C) 400 Commerce Avenue, Morehead City, North Carolina 28557 Phone: 252-808-28081 FAX: 252-247-3330 i Intemet: www.nccoastaimanagement.net An Equal Opportunity\ Affirmative Adion Employer— 50% Recycled 110% Post Consumer Paper ----' JDl I . SAS t FIRST CITIZENS BANK firstcitizens.com OUTER BANKS MARINE CONSTRUCTION, INC 1501 FIRST AVE MOREHEAD CITY, NC 28557 (252) 240-2525 4116 66-30/531 137 9/13/2010 PAY TO THE ORDER OF D FN-R _ $ **200.00 D.E.N.R. MEMO C - (.; AUTHORIZED SIGNATURE li'00 4 1 i Gul i:0 5 3 100 300i:00 1 3 1 2 18 2 Ili' DOLLARS U l0 m C O NC Division of Coastal Mgt. Habitat Impact Computer Sheet Applicant: Jeff Mims Date: September 10, 2010 General Permit #: 56801 C Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement found in your Habitat code sheet. TOTAL Sq. Ft. FINAL Sq. Ft. TOTAL Feet FINAL Feet (Applied for. (Anticipated final (Applied for. (Anticipated final DISTURB TYPE Disturbance total disturbance. Disturbance disturbance. Habitat Name Choose One includes any Excludes any total includes Excludes any anticipated restoration any anticipated restoration and/or restoration or and/or temp restoration or temp impact temp impacts) impact amount) temp impacts amount SB Dredge ❑ Fill ❑ Both ® Other ❑ 900 180 Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑