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HomeMy WebLinkAbout57104_TALBERT, JERRY_20110207'�-A /S ❑CAMA / ❑ DREDGE & FILL GENERAL PERMIT 6CtyPrevious permit# ❑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 Applicant Name Address City State ZIP Phone # ( ) Fax # (_) Authorized Agent ❑ CW ❑ EW ❑ PTA Affected AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ PWS: ❑ FC: ORW: yes / no PNA yes / no Rules attached. Project Location: County Street Address/ State Road/ Lot #(s) Subdivision City ZIP ❑ ES ❑ PTS Phone # (_) 'River Basin ❑ UBA ❑ N/A Adj. Wtr. Body fat /man /unkn) Crit.Hab. yes / no Closest Maj. Wtr. Body IN -ME wwwww"-wOMMEP '■'■'■ . , ��'.■■'■'■:'.:'. !'.'■'■'.'.'■'■'■'.N_0MUSUMM: AWE NF ■i■ENME�®� ai�iii�i: ®®®���:i■■■ uY■u■■■■■■■■■■■■■O■■■■■■■■■■■■■■■■■■■ ■moll ■■■■ mom ■i■�■M■M■■■■■■■ii■ai■i■■■ OMEN ■■■■■■■■■■■■■■■■a■■■■■■■■■■tee■■■■■■ ■®■■■■■■■■i.■■!�Ilti �111iiiilr7■■■�i■i■■■■■■■■ �±11111■IIIIi■■■■■■■■■■■■■ IMEMEMME■■■■■�:.... ■■■■■■■■■■■I!■ �I�n■�,►��■■■■■■■■■■��■ .■■■■■■■■■■■.7l�■■ .. !ll��,�I�mli�■■■■■Ill■®■q■�■ ■■■■■■�1■■■■■■■ill■■■■■■■i■il■■■tli�Tii6■■■■ .... -■■■�'iiii®■■.�Tii■iiil/1i■■i■■■=■■�!"i.'.!�:li��'iYY.'ii■■■ Agent or Applicant Printed Name ')�i� n\�'V Permit Officer's Signature Signature ** Please read compliance statement on back of permit ** Issuing Date Expiration Date Application Fee(s) Check # Local Planning)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 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 complywith 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/ 1-888ARCOAST 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 Cit r�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 nQF Iicant: Date: 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 tem im acts) 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 1 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 ❑ .. I-;5S,3--;RG,OAS ..,r•.;a�;r.rcr_a��:a1:,��..,,.....,A _Ma+ �:,»,x.....t:, nor :t :��� PECEIVED ADJACENT REPARLAN PROPFRTY OWNER STATUMMIiT JAN 31 2011 ,MoieheudCih,DCM c I hereby ertify that I own property adjacent to Tc-1 (Nalwe of PMW-Fty Owner) property located at— 10 FAG r d do-r (fit, B%dL, Road, etc.) on lad Urrae e-Aci in Muxtritfap Cirf N-C. I (Wady) (Town am"r ebunty) Applicant's phone #.- 72 4 - )X'e 2 Ding Address: 2-v3 6-Fv,1(-t4 AliF ML&Af Pfjf 0 6/., Al 2 He has described to me, as shown below, the development he is proposing, at that location, and,. I have no objectiom to his proposal- . A I Y -tr- 14,4 W C j)Afb6,,w6 DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: (Tohejilted in by property owner proposing development) 0 eft IT FR CP F,-, (,.," (1nf1DrM21b0U for Property Owner Applying for Pew) lu-3 FGta Ave Mailing Address 144"ef o'E'4 P owstatezip TeICAIDne Number Si a L,AS Date (Riparian Ptvp" Owner lw&nuation) l/,-7 -44,-,11� 1 / Signaltze PriuFo; Type Name Telephone Number [DIM., AWACENT RJUP�N PROPERTY OWNER. ' TFUMEN i�ECCIVE'r' to `" BAN 3 1 2011 (Nsde arpmperty (lw=erj property l+o►:awd a£ 2c'3 6 L-c*Lt a iyi . ek--) on & Z LE-rt Ele 4COL IE * in MUxCYE4,0 C r-q I NrC. Appliemrs pie #: 72 4 - X' k 7 Kzifimg A&hvsL- - 2-U 3 / a !yl ,W EAP L-Lu _ AL 2kSl2 ;— He has described to me, as .shmm below, the development he is proposing at that location, and. I have n a objoatiums to his proposal_ NAI yF,V,44Cr Frk -.FL&t do t DESCRIPTION ANDfOR DRAWMG OF PROPOSED DEVELOPMENT: (To befiZW is -by property owner Propos*gpit) 6 ,A&L'Ilt-e (Ar., " • v 3 Lam_`„, �'•� `.,� V � _� i - .� ohs (Inforffiati(d for PropertyOwnerApplying (RiparianPropmly Owner Is tion) for Permit) �U� (,NE=rdifrta �G� Mailing Address CitylStatewip 724- 2U �-7 Telep pne Sigfigur nM Jo c� cy) ,J i, 1, r(-A `j Prhtt or jW Name TelcPhone Number IM 0 JERRY W TOL13ERT 12-06 203 GEORGIA AVE. MOREHEAD Crry, NC 28,%7 1325 66-1259/531_ SW . _ u C :: WOODFOREST - n�G, y N A T f O N A ­ B A N e o 2t HaR err tnc e.cw.�: o" J v W-Wo,odf,. ark 226-6724) , 053112,921: 1325u■iBi63i� BO u■ "� F�- s