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Home My WebLink About58115_MCCOY, AUGUSTUS_2011072711CAMA / ❑DREDGE &FILL GENERAL PERMIT Previous permit# []New ❑Modification El 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 1 SA NCAC ❑ Rules attached. Applicant Name Project Location: County Address City State ZIP Phone # (�) Fax # (, } Authorized Agent 0 CW EW ❑ PTA ❑ ES ❑ PTS Affected AEC(s): o OEA 0 HHF ❑ IH I] USA [I N/A a PWS: ❑FC: ORW: yes / no PNA yes / no Crit.Hab. yes / no Street Address/ State Road/ Lot #(s) Subdivision City ZIP Phone # (e) River Basin Adj. Wtr. Body (nat /man /unkn) Closest Maj. Wtr. Body ch Bulldozing_ - ;reline Length : notsure yes no ,dbags: not sure yes no ,ratorium: n/a yes no tos: yes no ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ 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 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 landowners). 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 Morehead City Headquarters Mailing Address: 400 Commerce Ave 1638 Mail Service Center Morehead City, NC 28557 Raleigh, NC 27699-1638 252-808-2808/ I-888-4RCOAST Location: Fax: 252-247-3330 2728 Capital Blvd. Raleigh, NC 27604 919-733-2293 Fax:919-733-1495 (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 Mail 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 xMR A ALLEN MCCOY 125766-112/531 PH. 252-448-1870 BRANCH 01901 1850 10 MILE FORK RD Doll TRENTON, NC 28585-8414 7 owe (90 $ TU/. —sa 0— MCI N AR MONEY BB U BIB &T SMART T MANAGER AGER BRANCH BANKING AND IJ STT CO 14M-SMART 4 U TR636-c0m MPANY NP i:o S 3 10 112 11:000 S 2 900 S813 C3 Fm"a0 12 S ? oMOCnTRACKPatent No, 0365-MOHAF'LA"O Fm CERTIFIED MAIL — RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM Nance of individual applying for the permit: A � , , 4//c, Address of property: v.i .�gi h c (Lot or strcetH, street of road) (City & County) I hereby certify that I own property adjacent to the above referenced property_ The individual applying for this permit has described to me (as shown on the attached drawing) the development they are proposing A description or drawing, with dimensions, should be provided with this letter. �Ehave- no objections to this proposal If you have objections to what is being proposed, please write the Division of Coastal Management, 400 Commerce Ave., Morehead City, NC 28557 or call (252) 808 2808 within 10 days of receipt of the notice. No response is considered the same as no objection if you have been notified by Certified Mail. Waiver Section I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift or sandbags must be set back a minimum distance of 15' From my area of riparian access unless waived by me. (If you wish to waive the setback, you must initial the a ropf ate blank below.) I do wish to waive the 15' setback requirement I do not wish to waive the 15' setback requirement jo/� Print Name s�- 6S - /D-1/� Telephone number with area code CERTIFIED Nib — RETURN RECIyI° REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTMC A TIONi`WAIWR FORM for the permit: %�y ;, �(`U— Name cs€ individual applying Address of property: /lay 'Z-� Ie--- CLat or straeW, stras< of r041S) �11 1�1/" I hereby certify that I own property adjacent to the above referenced property. The individual applying for this permit has described to me (as clnrwr on the attached drawing) the development they are proposing. A description or drawing, with dimensions, should be provided with this letter. � )'/ a��/7 I have no objections to this proposal If you have objections to What is being proposed, please write -the Division of Coastai Management, 400 Commerce Ave., IVlorehead City, NC 28557' or call (?�52) 808-2808 within 10 days of receipt of the notice. No response is considered the same as no objection if von leave been notified by Certified Fait. Waiver Section I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift or sandbags must be set hack a miniYmnm distance of 15' From my area of riparian access unless waived by me_ (If you wish to waive the set'baek, !?Gu must initial the appropriate blank below.) �1 do wish to wai re the 15' setback- requiremgr+t i dQ n t wish to waive the 15' setback requirement 4 Y�f3awre print Name L% Pelemp-honc Number with araa tics ........r 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 Date 7 %/ Applicant Name Xy j , u� t k Mailing Address / j'JO —,,— rw �- AV I certify that I have authorized (agent) j r!� to act on my behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to install or construct (activity) Al at (location) s L ✓� �%LQ/1�%�.T /t%. C-. 2,F S .5 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 190% Post Consumer Paper