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Home My WebLink About56840_MITCHELL, COURTNEY_20100923❑CAMA / ❑ DREDGE & FILL GENERAL PERMIT Previous permit # ❑New ❑Modification [-]Complete Reissue El Partial Reissue M As authorized by the State of North Carolina, Department of Environment and Natural Resources/ 1 and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC_ I: Applicant Name Address City State ZIP Phone # O Fax # ( ) Authorized Agent Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A ❑ PWS: ❑FC: ORW: yes / no PNA yes / no Crit.Hab. yes / no Date previous permit issued Project Location: County Street Address/ State Road/ Lot #(s) Subdivision ❑ Rules attached. City ZIP Phone # River Basin Adj. Wtr. Body (natJman /unkn) Closest Maj. Wtr. Body .. � . . , •- . ■■ill■■■i■i■■■■■■■■■i■■i■i■iiii■■■■■■■■■ M. ...................................... C�::■:_:::I:N:■:■:■::■EE:■:■ NEMENEMEN ■■■■■■■■■i■■■■■■■■■■■■■■■i■i■■■■■■■■ii ■ib■■1•iiii■isv�:■ii7■Gi—i�iiii^■i■■■■■■■■■■■P` ■ii■■■■i■i■■i■■■■■■■■Li■il■■■■■■■■■■■■■■ ■■i■■■■■■■■Ei`.iE■i■Y■il■■�ii/J■■[!i®�Ii■i■■!!�! � ■ii■■■■i■i■■■■■�11%iii!Ifil■■■■i■■■■■■■i■■\:■ Agent or Applicant Printed Name Signature ** Please read compliance statement on back of permit 46 Application Fee(s) Check # Permit Officer's Signature j Issuing Date Local Planning Jurisdiction Expiration Date 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 consistentwith 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/ I-888-4RCOAST Location: Fax: 252-247-3330 2728 Capital Blvd. (Serves: Carteret, Craven, Onslow -above Raleigh, NC 27604 New River Inlet- and Pamlico Counties) 919-733-2293 Fax: 919-733-1495 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: Date: vt"q D 1 i 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 Dredge ❑ Fill Both ❑ Other ❑ l�J 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 ❑ I":a$. Adp"COAST 7'��i:fi z^s tG 2;'1; X,1v North Carolina Beverly Eaves Perdue, Governor Date 9 . Z i , 1 0 NCDENR Department of Environment and Natura Division of Coastal Management James H. Gregson, Director Resources Dee Freeman, Secretary RECEIVE[ SEP � 3 Z010 Applicant Name ��`' ^ r �' �'�`"Z` `-� Morehead City DCM Mailing Address I certify that I have authorized (agent) q L� to act on my behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to install or construct (activity) ✓J- ' at (location) w w This certification is valid thru (date) Signature 400 Commerce Avenue, Morehead City, North Carolina 28557 Phone: 252-808-2808 \ FAX: 252-247-3330 \ Internet: www.nccoastalmanagement.net An Equal Opportunity \ Affirmative Action Employer — 50% Recycled \ l o% Post consumer Paper RECEIVED ADJACENT RIPARIAN PROPERTY OWNER STATEMENT �E!' (FOR APIER/MOORINGPILINGSIBOATLIFTBOATHOUSE) // of rehepdCitt,DCMI I hereby certify that I own property adjacent to (�s�Z.� 's (Name of Pr erty Owner) property located at (Lot, Block, Road, etc.) __ on !� �^ L , in A iL & ,A- i c �� b �pp) , N.C. (Waterbody) (Town and/or County) Applicant's phone #: �Z S Z �Z I y !, Mailing Address: '50 1 111, k , N 1,J �w v P 4-L. o wel- i t R w'-�, Z) -,►u1 C. 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 inky individual proposing development) (Information for Property Owner Applying for Permit) Mailing Address City/State/Zip -z s z s •z ( S( a C- Telephone Number (Riparian Property Owner Information) Signature Y3 /R /1 6 ✓E lti' A/ S `' ( q 1%�-0 Print or Type Name —S-'7(I-r) Telephone Number 2- Signature Date Date ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIER/MOORING PILINGSBOATLIFT/BOATHOUSE) 4Q' ®�® I hereby certify that I own property adjacent to —� Is 1911eQa0'jY®C (Name of Property Owner) property located at ,5,3 L,:. c--- (Lot, Block, Road, etc.) on Cf'✓ -Y , in � � '> o �� IL , N.C. (Waterbody) (Town and/or County) Applicant's phone #: Z5L S7i 22-l"i 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 (IT) 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) c.,�,.� .. - --�- � - k-� 4: 11..E --J�p (Information for Property Owner Applying for Permit) Mailing Address City/State/Zip 25 -z. S z / Telephone Number (Riparian Property Owner Information) �i Signature ojj��( C Print or Type Name �70 T-3� Telephone Number 17-- ( r0 Signature Date Date MUD BUCKET DREDGING INC 507 HEDRICK BLVD MOREHEAD CITY, NC 28557-3045 4579 2 66-1121531 ` 1 Date Pay to the 1� C nj 2_ Orrlerof i {�%ter; feaiurre� BRANCH AND BANKING +.�'. TRUST COMPgNYr ` 1-800-BANK BST BBT,Cam f FOR 1)9 00004579III i• •053 10112 1 000S 293 2119 :r