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
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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 ❑
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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
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INTRACOASTAL MARINE CONSTRUCTION 2561
3515 WHITE DR.
MOREHEAD CITY, NC 28557
66-112/531
Date
Fasturee`
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BRANCH BANKING AND TRUST COMPANY
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