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HomeMy WebLinkAbout57820_KIRKPATRICK, GEORGE_20110408❑CAMA / ❑ DREDGE & FILL GENERAL PERMIT Previous permit# ❑Nevi ❑Modification ❑Complete Reissue ❑Partial Reissue . Ze Date previous permit issued a 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 State ZIP Phone # (____) Fax # (_ ) Authorized Agent 0 CW ❑ EW ❑ PTA Affected AEC(s): OEA ❑ HHF ❑ IH E) PWS: ❑FC: ORW: yes / no 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 # ( } River Basin Adj. Wtr. Body (nat /man /unkn) Closest Maj. Wtr. Body • •■�i■�i�■■■■■■■■■■w■■�■■■■■■■■■■■�a■mow■■■■�r - .. . :.. - :., _ ■■■■■■■■■■■■■■lll!/I�i1L�lii'�liiTil�i■■■■■■■■■■■■■■■ ■■■■■■■■■III®0�1i�■l�lLtl■�1■■■1:■7■■1®■■■■■■■■■■■ �i■■■ii■■■fu]ii■tiii�■�iii1■�[ii�l�■�r�■�iii■■fi■■■irli■■i■ li■■■■■■■;ii■■i��f�■llJltl■■�1►�■illi■1�■���■■�I■■fll■■■■ ■■■■�■■�!II���N�N��11■�!I(��11�I���fl��■�1■■■III■■N ■■■■�rlil�i���■�r�lueslr��ic,`■`®�������w�i�■i�■■ice■ ■■■�i■■■■■■■■■■�Iw■■■!■■■■■ICI■■■■■■■■■w■■■� Agent or Applicant Printed Name PermitOfficer's Signature Signature "Please read compliance statement on back of permit" Issuing Date Application Fee(s) Check # Local Planning Jurisdiction Expiration Date f 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 252-808-2808j 1-888ARCOAST 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 . — -- 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 11 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 tem im acts FINAL Feet (Anticipated final disturbance. Excludes any restoration and/or temp impact amount 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 ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ w ,�,�-BG,.� ...�v.=s s: �-3�. ,..•. CC3A<>j �,nar,tr...�r_z+n, :al. �:a .,.•..:..,,� ,r:....n�t �.., If WMENK North Carolina Department of Environment and Natural Resources Division of Coastal Management Beverly Eaves Perdue, Governor James H. Gregson, Director Dee Freeman, Secretary Date Z Applicant Name `� U - � s' fie' �,�/� toJ 1��`x ✓1 �. �7 J Mailing Address �✓ /36"x I certify that I have authorized (agent) �/� k Z %= to act on my behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to install or construct (activity) / Li /C :f' 6 kiq ✓" at (location) 60 r t Act V Ov OL,; This certification is valid thru (date) Signature j 400 Commerce Avenue, Morehead City, North Carolina 28557 Phone: 252-808-28081 FAX: 252-247-33301 Internet: www,nccoastaimanagement.net An Equal Opportunity 1 Affirmative Action Employer — 50% Recycled 110% Post Consumer Paper AIDJA ll," ENT RIPARIAPI PROPERTY )WNER STATEMENT I hereby certi ; that I own property adjacent to 6:1: '�� '' Ae ��I - R kc, K 's (', a elf" of Prop E-rty Owner) property located a.t ar' i r ?�V` Ul ' ��" t ,No (/,v, ��d �1 /11 (LA t, Block, Rooad, ,i i.e.) 11— on _ go Pr' e �G U RJ v ' in L Ill � ! C �S C'�� �" A , N.C. ('a terbody) (T- wn and/or Cc unty) Appliicant's phor e #: TO'Li- 2 ) —50 tSMailing Add •ess: � A 6 ` 7 He fins described to me, as shown below, the development: ;e is proposing; at that location, and, I have rto objections ! ) his proposal. DESCRIEV PION AND/OR DR-iMING OF PRC VOSED DEVELOPMENT: !'! o be fdled in by prof i eM owner prop -dng development) 60 1 J j I ' .�r (Information fc,r)?1r,o perty Owner Applying (Ripariai i ."roperty Owner Information) for Permit Mailing.Address / J/ Signature City/State/Zip i Print or Type Name Telephone Nwnbea• Telephone Number Signature ��^ _ E lato Date ADJACENT RIPARIAN r PROPERTY OWNER STATEMENT I herebv certi 'y that I own property adjacent to 6;eu �q rC ,s ("1a a of Property Owner) property located at At- � � �(% ��^ 16U p ) (Ut, Block, Road, a te.) on QU �L _ SG:r ry t0 ` in Lot 4,41 C gScr"L�, N.C. (Way terbody) (Tuwn and/or C— ounty) Applicant's phone #: 70'L/-Jo) -,- LOVMailing Add- ess: (0, o He has described to rne, as shown below, the development ;.e is proposing at that location, and, I have :no objections to his proposal. - -------------------- DESCRUITION AND/OR DRA WING OF PRO F)OSED DEVELOPMENT: ,.Albe filled in by prop erty owner prop E�ing development) ., LA --------------- (Information for four Pro perty Owner Applyi ag for Permit) 41qf _4_'_r'.� S� Mailing Address` � �� ____ City/StatelZip Telephone Number --d f - Signature DaW 13 60 s�` --_- 3 ----- (Riparian "roperty Owner Information) 7 Signature Print or Type Name Telephone umber Date L a...�"- `�1 J ; � � � �� 4 i � � i ,h � �! ,, '� �� � �. • • I f �y �, ICCJ �, � � b , � y ��•� � C 1 � � n_ 1 `• � 2 ��� �� ' i �: �� � .. 0� ° � � �y �J ,, �� �� o��r� � b �� � � � �b� INTRACOASTAL MARINE CONSTRUCTION 2561 3515 WHITE DR. MOREHEAD CITY, NC 28557 66-112/531 Date Fasturee` � Oetella on BRANCH BANKING AND TRUST COMPANY I-800-BANK BST BBT.com FOR <-457 - -� NP _ IL0000256111' l:'0531011211:000s!--91134994311,