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Home My WebLink About57943_HENSON, DAVID_20110523❑ CAMA / ❑ DREDGE & FILL GENERAL PERMIT Previous permit # ❑New ❑Modification ❑Complete Reissue El 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 I SA NCAC ❑ Rules attached. Applicant Name Project Location: County Address Street Address/ State Road/ Lot #(s) City Phone # ( )_ Authorized Agent Affected ❑ CW AEC(s): ❑ OEA ❑ PWS: ORW: yes / no _ State ZIP Fax # ( ) ❑ EW ❑ PTA ❑ ES ❑ PTS ❑ HHF ❑ IH ❑ UBA ❑ N/A ❑ FC: PNA yes / no Crit.Hab. yes / no Subdivision City ZIP Phone # O River Basin Adj. Wtr. Body (nat /man /unkn) Closest Maj. Wtr. Body M. �■��■��■■��■��■■per■��■■■�■ ■■■■■■!\■►`�i�i�IEEE■\■■�■■�iN�■Ei!�E►�■!!!■■ ■■■!!■!�!►lllir\IElNE7AlI■■��■NlJNI'LIlE�I■■ NINEIIENIN E■t�■■■■IEl�H■■NNN ENNE ■■EN■Nr■InNO! �uENNEIE®��NN■NNN!!!N!■N iiiiNiiiiiioii■ii�iiiiiiiii�iiii i EENNiNNNNNNN■NNNEENNINNE■EI�■ENS■NNE Agent or Applicant Printed Name Permit Officer's Signature Signature ** Please read compliance statement on back of permit Application Fee(s) Issuing Date Check # 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, 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/ 1-888ARCOAST 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: 252-264-3 723 (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:06J H('�J�ti Date: 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 ternimpacts) 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 ternimpacts) FINAL Feet (Anticipated final disturbance. Excludes any restoration and/or temp impact amount 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 ❑ GJL-802- 20 : ,. °11 •Y:.34,•w'1C'0AS T .. %r.v:.+.,Icc.3In!,..13.n.in _,,,_4,%t n:af ,.—A... A.. i^,) r.;1:'IA ADJACENT RIPARIAN PROPERTY OWNER STATEMENT RECEIVED I hereby certify that I own property adjacent to Doi X4111) S`act./ WY 18 2011 (Name of Property Owner) DCM-MHD CITY property located at 1 �(y D0 C 4:�y (Lot, Block, Road, etc.) on &Clk SOli-� N , in P��%��%t�(iG/ f �� , N.C. (Waterbody) (Town and/or County) a �.2 Applicant's phone #: !I 06 �_ Mailing Address: Mf , N -V He has described to me, as shown below, the development lie is proposing at that location, and, I have no objections to his proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: (To be filled in by property owner proposing development) � o 0 9� (Information for Property Owner Applying for Permit) 2 i 1✓r-l� � w�►N � 9 Mailing Address Pp 4 AW �) C 4 7 ¢ City/Stag/Zip 4)- q6s Telephone Numbe Signature Date A w � �oCAA yS P,tSS"t pk-q,�its (Riparian Property Owner Information) Signature Print or Type Name Telephone Number ��119 Date • MOM ADJACENT RIPARIAN PROPERTY OWNER STATEMENT 8 2011 I hereby certify that I own property adjacent to (Name of Property Owner) DCM-MHDCTTX property located at Ar/ V" 0, -0 �! / (Lot, Block, Road, etc.).) on C G 4 L , in 4 Gl ,e Gc G� a b e) r -', N.C. (Waterbody) (Town and/or County) Applicant's phone #: 7 `%' % 2Mailing Address: / 7�, r �✓�� v. e �i He has described to me, as shown below, the development lie is proposing at that location, and, I have no objections to his proposal. / i $/ ✓t ?� o Pa�fk� � htC�� P DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: (To be filled in by property owner proposing development) t_J ) 4 10- ft" 1PrUffy-4'i � --------------------------------- (Information for Property Owner Applying for Permit) 12-17 Mailing Address City/Sae/Zip ICC- 0233e� Telephone umber /'?�// Signature Date AK .2�� rV 3� fZ- 4, 1 l w);4 j�6S �1�uS (Riparian Property Owner Information) z � ; PL-, e— � �4v/ 1 i ze, 0— — Signature Print or Type Name 7*-7— 7/ 7 2 Telephone Number Date GEORGIE CAROLYN SASSER NC 2776034 PAUL ALLEN SASSER E tT MO NC 28557-3224 / L� MOREHEAD EAD CITY, 5305 66-19/530 NC Z i 3500 Date BankofAmerica ACH R(f 053000196 NP kX Memo 1'� ; _ ____-------_ ,:OS3000 L96,: 0003S32 L 25S8ii'S30S %h PAGE 01 Page! 1�1 05/23/2011 09:46 2524439429 HENSONFUERST • Ta:912524439429 • MAY-2O1.1 13:33 From. QM MHDC7Y C �.,��,C► . Noi th Carolina Department of Environment and Natural Resources Division of Coastal Management Beverly Eaves Perdue, Governor .dames H, Gregson, Director oee Freeman, Secretary Date Applicant N1 Mailing Add T certify tbsit I behalf, for the install or cons' at (location) This cartil Signature act on my i rpose of Opiying for and Wining al CAMA, rernaits necessary to ct (activity) A' is valid-ttir-IL tte) �rt ii 400 Comfieroe Avenue, Morehead Cit Phone; 2 2-808-2808 1 FAX, 252-247-33301 inter An qual opportunity k A rmaifve Action Emplom - 50% North Carolina 29557 wwwmccoastalmanagement,net c,idnd 110% Post CifflUmet Paper