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Home My WebLink About57092_JONES, BUCK_20110330❑ CAMA / ❑ DREDGE & FILL ;i w GENERAL PERMIT. Previous permit # ONew ❑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 O Rules attached. Applicant Name Project Location: County Address _ Street Address/ State Road/ Lot #(s) City State ZIP Phone # () Fax # ( ) Authorized Agent ❑ CW ❑ EW ❑ PTA Affected AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ PWS: ❑FC: ORW: yes / no PNA yes / no ❑ ES ❑ PTS ❑ UBA ❑ N/A Crit.Hab. yes / no ZIP Phone # ( ) River Basin Adj. Wtr. Body (nat /man /unkn) Closest Maj. Wtr. Body Subdivision City ' . • ... • ir��■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■i►� ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■�r■■■■■■■■®■■■■■■■■■v■■■■■■■■■■■■■■ ■■■■■■■■■[�i■■■■■■■■ ■■■�■■■�1..■��■■■■■a ■■■■■■■■■n■ ■■■m ■■■■■■ut■■r■■■ MENU■■■■■(■ ■ �a■■ ■ ■■■M■■■■ :.. • ■■■■■■■■■n■■■■■■E MEMEMMINEEMEMEME ■ ■■■■■ ■I■■■i■■■■ ■N■■■■■■n■■■■■■6■ �■i ■iR■ ■■■■■■■■■n■■■■�■moo ■■!��■■�■■■■■■■■■■■■■ ■N■■■■■■■■i■i�■i■i■■■■■■■■■■■■■■■f■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■AI�:n.'■■■ ■■■■■■■■■■■■�■■■■■■■■■■■■■■■■■■■■�■■!�■® .■■■■■■■■■■■■■■■■■■■■ .. = I■■WINE■ ■■■■■■O■i■ WREM■■■■!KIN■Eli ■■■■■■WEii1`9■■■■■■■■Ii��11iN■■■i■■■■■�I■►�■[1■ ■ ■■■■■■■■■■■■■■■■■■ray■■■■■■■■■■■■■a■■■MEMNON MEMENNOMEMMUM MENMEME >�.I Agent or Applicant Printed Name Signature* Please read compliance statement on back of permit Permit Officer's Signature Issuing Date Expiration Date Application Fee(s) Check # Local Planningf urisdiction 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 I) 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 ail 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/ I-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 NC Division of Coastal Mgt. Habitat Impact Computer Sheet Applicant: Buck Jones Date: March 30, 2011 General Permit #: 57092C 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 ® 192 192 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.nccoastalman Nement. net revised: 02103/10 (FOR A PIER/MOORING PILINGSIBOATLIFTBOATHOUSE) I hereby certify that I own property adjacent to 6ack joy y 's (Name of Property Owner) property located at 35 R0 to (Lot, BIock,, RoAd, etc.) on 'D0.WS C>n -tA , in Affo.1D a�fl�. , N.C. (Waterbody) I (Town and/or County) Applicant's phone #: 2S 2 -%i MS1 q Mailing Address: 35 lkb land RA. Amaahp.e. Y) C o28 -w 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. (If you 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 development) 12rr_— r (Information for Property Owner Applying for Permit) 3S Roles Rd J. Mailing Address YAC qgslo City/ tate/Zip (Riparian Property Owner Information) J Signature Print or Type Name 252 - 6-1 o - 357 4 Tele hone Nu ber Telephone Number 2 dim / Signature Date Date (FOR A PIERIMOORING PIL.INGSIBOATLIFT/BOATHOUSE) I hereby certify that I own property adjacent to UGIC 30neS 's (Name bf Property Owner) property located at 35 �OLACI (Lot, BIock, )e Y1 C etc.) 64D on 0CLWSOVn Greek , in AY'o,,,gahoe, , N.C. (Waterbody) (Town andJor County) Applicant's phone #: ),V- g0-39-IS Mailing Address: �15 AOkax"d 'RA AV'4xLk0e C, Q $S( C) 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. (If you 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 Or PROPOSED DEVELOPMENT: (To be filled in by individual proposing development) (Information for Property Owner Applying for Permit) 3S ROICLIC) RJ. Mailing Address Il i.✓a alLoR. 4 C I I D City tate/Zip 2�-00 3574 Tel hone mber Signature Date -------------------------------------------------------- (Ripari r p rty Own ation Signature Print or Type Name 2yq-17 ^� Telephone Number Z� Date NCDENR North Carolina Department of Environment and Natural Resources Division of Coastal Management Michael F. Easley, Governor James H. Gregson, Director 'William G. Ross Jr., Secretary Bate Name of Property Owner Applying for Permit: Mailing Address: S— C -2 IF -Se I certify that I have authorized (agent) /�� 1� {� to act on my behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to install or construct (activity) at (my property located at) �j S /�6 This certification is valid thru (date) Property Owner Sign 2 2)// Date 400 Commerce Avenue, Morehead City, North Carolina 28557 Phone: 252-808-2808 t FAX: 252-247-3330 t Internet www.nccoasWmanagement.net An Equal opportunity 1 Affirmative Action Employer - 50% Recycled 110% Post Consumer Paper BUCK H. JONES KELLY C. JONES PH.252-249-1541 35 ROLAND RD ARAPAHOE, NC 28510 Pay to the Order of 2709 Ul 66-3OA31 ate ....,., a rs First Citizens ® Bank firstcitizens.com For Nr 1:0 5 3 100 3001:00 L 1 18 2 1 79 1 Tin 02709