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Home My WebLink About58117_HORGAN, TOM_20110714t ❑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 I SA NCAC I] Rules attached. Applicant Name, Address City Phone # O_ Authorized Agent Affected ❑ CW AEC(s): ❑ OEA ❑ PWS: ORW: yes / no State ZIP Fax # r-, ❑ 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 # O River Basin Adj. Wtr. Body (nat /man /unkn) Closest Maj. Win Body •NOON ' NOON■■ ■■■■■ ■■.■.■■■■MEN■■■■■■■■■■■I■■■ ■■�■■■■■ ■■■■`■■■■■■■■ ��■ MEN ONES ■■■■■■■■■■■ ■■■■■:_■■■■■■■■■■..■■■■■■ ■■■■■■■■■■■■■■■.�,■.■®�..■.....■........ ■■■■■■■■■■■■■ ■■■■■■■ N MONO 1LOMMEME MMMMMM■.OM■■ ■!►E■■■E■■■■■■O■■�1■■N■ili■■■■■■■■■N■■■■■■■ MMMMN■■M■■■■�■■:I�■■■N■M■.:■M■M■■■M■MM■ ®■■O■■■■!I■NOON■®11O■■O■■■■■■■■■■■■■■■■■■ ■■■O■■■■'lINO■■O■■11■■■■O■■■t�Si.O■■■■O■■L ■■■■■■■O■■■■■O■�i�1■■■■■■■N■■■■■■■■O■O■■■ ■■■■■■■■■■■■■■■'-I�'■■■■■■■■■■■�■■M■MR . NOON■■■■■■■■■Na�1■O■■O■■■■■■OLNOO®!N■ .. = ■■■■■■■■■■■■■i■O■■■■■■■■■■O■■■■UL!�rl■■■ O S 04 ;i Agent or Applicant Printed Name Signature ** Please read compliance statement on back of permit i� Application Fee(s) Check # Permit Officer's Signature Issuing Date Expiration 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 [)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 U/(1JJ Lull L0. YO L'JLYYI Ll UY Ftt�]F3: _ F!!L 25 3153i2 TO: 4472104 �- 1 NT ,ARUN PaMRL Y aw?" STATFbwql =%WAWOO 's I hataby crxti Y tt t I own PmVcdy ed # et ii p ki a as •..�• (LOW *=Oor causes►) � s�awra t�etow, �a ssev�etesrt !�a He ri no his "OW. I uendecstmad tt a PiWftodria$ lort►tion. �. X b� �o ob�oati to waived by Me. distance o� fitkoett �iect (1 �') fi�am �filbustbm MW be eat beck ous miciMM P�' �weas vnlcsa my area of r.��iart I do not w4h to waive tba aeftek requin=O L do wish to waive tint eeda~ck t'm4ufteowit OESCgWnQN ANbOR D �� F ljkD pMMNT: fm be_(," bg Ay � . �I13 ��.r !%! z�' � tel' Foley &Folay Comte tm, mac. Phow#: (252) 636-2515 PLO. (252) 636.3127 r (W V, .Epp' Asa yY? - 56 30 Telapbm Number and Date ADJ NT RIPARIAN PROPERTY. OWNER STATEMENT (FOR A*R/1VIDORI PHVVGSBOATUFTBOATHOIISE). I hereby certify that I own property adjacent to d J 's (N"e of property owner) property located at 1 g� 1? (Lot, bloc road, etc.) ;� uk e- z on �tJJ� I�iyR � , in f�8 �.01NS • ,N.C. (Water :body) (Town and/or county) 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. I do not wish to waive the setback requirement. I do wish to waive that setback requirement: DESCRIPTION AND/ORDRAWING OF PROPOSED DEVELOPMENT: (to be filled in by individual Proposing devet0PMCn0 ' Foley & Foley Contractors; Inc. Phone#: (252) 636-2515 lSignature Fax#: (252) 636-3127 Print or Type Dame ;Lrt• tN LI?• 4'SyI— Telephone Number and Date North Carolina Department of Environment Resources - Division of Coastal Management Charles S. Jones, Director Beverly Perdue, Governor William G. Ross Jr., Secretary Date .-r'*— // Applicant Name IZfAO) Mailing_ Address y % �� 1#we 10 I certify that I have authorized (agent) Foley Contractors, LLC to act on my behalf, for purpose of applying for and obtain (activity) . at locati This certification is all CAMA Permits necessary to install or construct thru (date) 1 year 400 Commerce Ave. Morehead City, North Carolina 28557 Phone:(252) 828-2808/ Fax(252)247-3330/www.nccoastalmanagement.net An Equal Opportunity/Affirmative Action Employer Cno/ DcMirlcri /1 no/ Dnct rf%nc, imcr Dnncr N0 Division of Coastal Mgt. Habitat Impact Computer Sheet Applicant: Tom horgan Date: July 14, 2011 General Permit #: 58117C 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 ® 609 609 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 ❑ 252-808-2808 :: 1-888-4RCOAST :: www.nccoastaimanagement.net revised:02/03/10