HomeMy WebLinkAbout56854_HOWARD, SANDY_201001285�/gjtt lSi�
"J_
❑ CAMA / u 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
❑ Rules attached.
Applicant Name_
Address,
City
Phone # (____)_
Authorized Agent
Affected CW
AEC(s): 0 OEA
❑ PWS:
ORW: yes / no
State
Fax # (__)
❑ EW ❑ PTA
❑ HHF ❑ !H
❑ FC:
PNA yes / no
ZIP
❑ ES 0 PTS
O UBA O 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
MENNEN■■►■ZMMMMM■■■IMMM■NMWMMMMM■MINIM
-
M.
��
MEMO
!
M■NN■■■■■■■!lE■■■■■■■N■■■N■■1�■■■■M■NONE
1��t�ia�i�{CIE■�Ei1!■/�M■■■■L:��1�!.'r
■■IINIM61■t:JM1NMM
IlN'I■■INNI■1�N�1�:■N■N■N!i■Its■��■MM■Iml�i�MEN
[�EOOOE■I�OO►�llfiEO■■
■■■iOO!O'SIENI►11�1i■■E®Nib■OOE■
MINIM
t�EEi��IGN•i��1tl�//■NO■EOE�it
�OEI��lE�►,OOE■O■ENO■E
t�I■M�{I".a+►�'I�:+IIII■MM■NMII{��!■ar1M��■■■■M■■NI■N
��II�!!li■E%EN■1L''ENO■■OIE■t��l■■►:EIS■EN■■■I■■I
■j1ln�l�I�I�i�IMINNMi�lII■{�HINrI��■■■■■■NMI■
�It�n�l6�INMIIM■M■■Ili■■t�H■r�!■■■■■NI■IN■■■
�N■■■■■■■INN■■■■■■■■■�■■■N■■■■■■■■■
� _ INN■NNN■NM■MMIIM■N■■NNM■NOM■NME■OI■N
Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit **
PermitOfficer's Signature
Issuing Date
Expiration Date
Application Fee(s)
Check #
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 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 complywith 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)
Washinoton 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
1
RECEIVED
SEP 2 4 2010
Mweneod City DW
1, a l
North C-aroiirna Department of Environment and lkldlatulral Resources
Dpj;sioij �of Coastal Management
Michael F. Easiey_ Governor Chafts S. Tones, Direntor William G. Ross Jr., Secret,,,!
Applicant Naaaae
M..ailing A.d dress
5
certify that i lame autborized (ageant) �460C`e 0 t )V to act on In -
I
behalf, faaa the paaxpose cia applying for and obtaining all CANLk Permits necessary to
install or construct (activity)
at (locatioaa) ` > CAR k-Xtv�lljq
This cea tification ' . °�aIid thru (date)
%� A ► n
Signature
RECEIVED
SEP 2 4 2010
Morehead City 0Cm
Dij _o t`�i .�' %-'�.. _,l=.ali �.i �� �i "'��'rj r-�--^• -a
O; ;t! .Jr C)l.Ti=1i Cr��Cc�t�.
proper"- Icczte� zc 'JD DLD an ySF-W A_a
(—L-ot, B1c-cl,, Road, etc.)
on (il A!N A{ ,, it S.' Ci9l�T��
( aterbody) (Ion and/o County)
He has desc,ibrj to nnc Is silo,,'--n below, the deve.'oornent he- is proposing at that
locati,on, and, I have no obj,�-c Lions to his proposal. I understand ghat a pieriuncover;�l boat li
bust be sec back a minimum distinct or waived by me. Tom mv jarea or ripariln access unless
1 do not wish to waive the setback re uirement.
I do wish to waive that setback requirement.
---------------- ----------; --------------- -----
DESCRLI (D.,N-A-ND/OR DR. IVr- iG OF PROPOSED;DFVELOP?'YM-,-T.
(Ta be jWed iz by irzdivicual proposin; devel�tipment)
RECEIVED
SEP 2 4 2010
Morehead City DCM
_ 4 ' F_J y "1(FOR A rir-1
._ , P, FLU 157 vn .f 1 j
D -
prorr�r (ccated at 3a i
Black, Road, etc.)
on c -R Nflr(, iri c e c T'
CY at�l`bodY) �I Ly,�,
(Tom and/or- ounty)
He has desc.ibri to ne z= shorn be'_ori, the deve!optent he is proposing at tl at
location and, T nave no ooje�tions to his procosal. I understand rhat a pieriuncovere boat Li
must he set back a minimum distance of r'Fc--n.rc--t (I5') from my ar°a or riparian ac�ss unless
waived by me.
T do not wish to waive the se bacs requirement,
I do wish to waive that setback re-cui-rement.
DESCRIPTION, 2: -D/OR DRAW-D G OF PRO POSED;DEYELOP?NMN-T:
(?'o be felled i, COV N 1 prnpasin devel��pment)
LP � �� , ��
I
i
----- ---------- ---------------- --------- -----
Signature
—b�tPitt
Print or T�� i�+anY
SAMMIE E. TURNER 5115
rPAY
INE CONSTRUCTION ACCT 66-112/531
252-725-3415
P.O. BOX 1885
MOREHEAD CITY, NC 28557 DATE `
$�`
DOLLARS ` '
Details on
Bsck.
Bm
RANCI BANKI NG NKAND TRUST BT comMPANY
FOR��� �'lY"- C4 "--71 *L-�
II.0000S L LSol 1:0S3 10 L 1211:000S 210S84066+I'
_�sm