HomeMy WebLinkAbout57146_HUDSON, JOHNNY_20110307❑CAMA / ❑ DREDGE & FILL 673�/�// / �a
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 15A NCAC
Rules attached.
Applicant Name_ Project Location: County' j
Address
City
Phone # ( ) _
Authorized Agent
Affected ❑ CW
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
a
Street Address/ State Road/ Lot #(s) j
City ZIP
Phone # (_) River Basin
Adj. Wtr. Body (nat /man /unkn)
Closest Maj. Wtr. Body
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Agent or Applicant Printed Name
-r
Signature ** Please read compliance statement on back of permit
Permit Officer'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 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
Apphcan'
�5jy--�
��n�n u
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
tem im acts
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount
redge ❑ Fill [IBoth ElOtherI(nq
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 ❑
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to ,JD 1►rl Yl Lt di6 Yl s
II. '' (Name o Property Owner)
property located at J D � W . O c tIt's S Ali �%` - ,
(Lot, Block, Road, etc.)
on _ ('Yif#�7�� OFF 4L in ✓1 L , N.C.
(Waterbody) (Town and/or Coun )
Applicant's phone #: ��c%' l �`f �P 7� 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.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by property owner proposing development)
Qvj�,J%s�ry
��
)3t
p Wormation for Property Owner Applying
` for Permit)
,--�5-1d- �-ernbiovK _D-r
Mailing Address
yjenitt1, w-- -7s�l
City/State/Zip
q17- Oz�- & 7?1
ATelle Num r
ate
P�
------------------------ ------------- I -----------------
(Riparian Property O)vner Information) �-
1
Signature
Print or Type Name
Telephone Number
Date
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to jb�4 W 4 44 J bs u lu is
(Name of Property Owner)
property located at Z L-). It eL U
(Lot, Block, Road, etc.)
on "o t!1pit COO/9 in AT A&T/c QcP . t r"ae Z� l , N.C.
(Waterbody) (Town and/o Coun )
Applicant's phonei'� 7�'? Mailing Address:
cx=)tIuD f,-U -7 5 I
He has described to me, as shown below, the development he is proposing at that location, and, I
have no objections to his proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
be filled in by property owner proposing development)
l t� e i
--- t----------
(Information for Property Owner Applying
for Permit)
Mailing Address
City/State/Zip
Telephone Number
Signature Date
(Riparian Property Owner Information)
Signature
fj
Print or Type Name
Lf i — � -2 � '2--
Telephone Number
Date
North (-arohria epar rnent of En-vironment and 11,11atural Resources
Dt
;D,*v � s , I
a 1. joij ol Coastal Management
Michael F. Easley, Governor Charles S. Jones, Director William G. RC)85 Jr., Secret jry
Date C;) ) (— I l.
�
Applicant Name 77!&bAW7 440b 61-1
M,affing A( 1dress
I certify Oat I have autliioi-ized (agent) Ppr;'�� to aci On lw-
behalf, for the purpose n. a g applying for and obtaining all CAAIA Peymits necessary to
applying t5
install or coustruct {activity) t-- wr
3��w"-Dpo-s F
at (location,, L'Uts
This certification is val-Ad diru (date)
Signature
SAMMIE E. TURNER 5078
MARINE CONSTRUCTION ACCT 66-112/531
252-725-3415 1 ( f
P.O. BOX 1885 DATE
MOREHEAD CITY, NC 28557
<< PAY
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