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Home My WebLink About57811_IVEY, BOB_20110331rU10 ❑ CAMA / ❑ DREDGE & FILL GENERAL PERMIT ; i.uspermit# ❑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 15A NCAC ❑ Rules attached. Applicant Name I Project Location: County Address CityState ZIP s Phone # ( ) Fax # () Authorized Agent Affected ❑ Cw ❑ Ew ❑ PTA AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ PWS: ❑FC: ORW: yes / no PNA yes / no ❑ ES ❑ PTS ❑ URA ❑ N/A Crit.Hab. yes / no Street Address/ State Road/ Lot #(s) Subdivision City ZIP Phone # ( ) River Basin Adj. Wtr. Body (at /man /unkn? Closest Maj. Wtr. 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NINI NIIG'I�iINIiEC."�..""."isGIE�'3'E'1iiiilEr�iNIEr■NINIENI■NI■Etl■■ 'lll�la''�i�Jr�IEE®ENI■■NI�JE■■ i�i/GE■NINIEl1E/�Qi�i�,t®EliII�IEEENI■NIEI�E''r��ll "FAN■Ei Vlmm LN >!E� I■iiEiENI►�NININIiiiNI■ ■EE■■OWNWEE■EE■NI_ IN IEEltiEEEEnNS!EiNIE 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 Planningf urisdiction 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/ 1-888-4RCOAST 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 ;applicant: Date: Describe below the HABITAT disturbances for the application. found in your Habitat code sheet. V / V') Ame V, All values should match the name, and unment 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 im act 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 $—j lid Dredge Fill ❑ Both ❑ Other ❑ 1 7 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 ❑ ADJACENT RIPARIAN PROPERTY OWNEIZ STATEMENT (FOR A PIER/.,MOORING PILLYGS/BOATLIFT/BOATHOUSE) 1 licreby ctrt.ity that I own property ',i( iaccut to So.6 �v _ (Name of Propel• y Owner) property located .n (Lot, Block, Road, etc.) onTAH ions Grwwl� , in 9�A �o►L�^ — N.C. aterbody) (Town and/or County) Applicant's phone #:a 1 714�&IJo Mailing Address: �0O5 L-d G,*lcjb�, atr_,�.2�530 IIc has desclihod to me, as shown be1mv. the development he is proposing at ihaf loc,ition, ancl. I have no ohjec:tions to his proposal. [ undc t-stan(l that a pier/mooring piliut;s / boa! ift / hil-)'it1 onlsc must be set back a rnininuun distatuc of- I�iftceu I+ to (1 S') from illy area of rip a ian acecs.� ��lc;s waived by nic. (If you wisli 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 ANTVOR DRAWING Oh PROPOSED DEVELOPMENT: (To be 1111ed in by individual proposing development) ! . I 1G 2�r� iSx 3 � JCS- `fps z' 41 ouS O sdr Pzt,k e-- 26 +9 Z / O ` 1 1441, "l7 J- kJ Qjz I ----------------------------------------------------------------------------- ------------------------------------- (Information for Property Owner Applying (Riparian Property Owner Information) for Permit) 6c)'5 L-06--s b a&k- V,44,* Mailing Address 6o Id bo!! � << 2"7'> 3 City/State/Zip Telcp. one N tuber n U Signature Date 3• 19. 244tSg3 hi __ Signature G VL F- P int or Type Name Telephone Number Date 140<-'-'0S ADJACENT RIPARIAti PROPERTY OWNER STATEMENT (FOR A PIER/_-1VIOORTVG PILL GSBOATLIFTBOATHOUSE) I hereby ccrt.ify that 1 own property adjaccut to S.c> 6 j�v ap _ s (`iante of Proper y Owner) property located at 2y"6 '9-vaq.£] (Lot, Block, Road, etc.) on TApt lost-S -r�K` - --- in ��Q -�o�T� -- -- N.C. (Waterbody) (Town and/or County) Applicant's phone #: 1 i9 7�� 3J10 Mailing Address: 6 0 5 L.a — xv �.- Go )C/ b I Ic has described to nle, its shown below, the development he is proposin,; at that locution, and, 1 have no objections to his proposal. I urulc i-stand that a pier/tnooring, pillog's / boatli (-t i ho,111louse must be sct back a niuminitll dlslancc ol;' h[tcco 1'cct (15') rrom lny area of riparian acccs.� artless waived by rne. (Ifyou 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 developmient) T 4 1 pU S Va c- >� yv,.„ `rP5 o a►z��5 e- 1,�-f (LE a o J (Information for Property Owner Applying for Permit) e,05 L—,qIccS h anE �r ---- Mailing Address GoIrk6�!,e ,_J,,C_.2 5,1q City/State/Zip Telepho e Number W 7414tS43 y0`--y0S q* (Riparian Property Owner Information) Signature Print of Type Name Telephone Number Signature Date Date A NC®ENR North Carolina Department of Environment and Natural Resources Division of Coastal Management Beverly Eaves Perdue, Governor James H. Gregson, Director Dee Freeman, Secretary Date 3 25 . I I Applicant Name 1� � h i— Mailing Address (. 05 Lq ►e- I-. „ Or I L5 G -6)C) 6�V�.4 N. I certify that I have authorized (agent) Sto act on my behalf, for the purpose of applying for and obtaining all LAMA Permits necessary to install or construct (activity) ID 2 ( J 5L�c— v ,.. d L , f} s , at (location) Zc, c c L This certification is valid thru (date) Signature 400 Commerce Avenue, Morehead City, North Carolina 28557 + Phone: 252-808-28081 FAX: 252-247-33301 Internet: www,nccoastalmanagement.net An Equal Opportunity 1 Affirmative Action Employer — 50% Recycled 110% Post Consumer Paper MUD BUCKET DREDGING INC 507 HEDRICK BLVD MOREHEAD CITY, NC 28557-3045 Date q - ` ' I 4923 66-1121631 Tay to the all sa„ , order of 1 A Gi I Dollars R BRAN H BANKING AND TRUST 1-800-BANK BBT BBT.cpmMPANY FOR 00001,9 2311' i:053 LO L L 2 11:0005 293 2 LE134 1t1' a_