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Home My WebLink About59983_WELKA, BRUCE_20111107• CAMA / ❑ 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 15A NCAC —(Rules attached. Applicant Name �P Address ' ! �%'M 11# r, C. k City $'� { State ZIP Phone # (�;►!:) 37 li 1154 Fax # (--) Authorized Agent Dr O J ? Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS AEC(s): ❑ OFA ❑ HHF ❑ IH ❑ UBA ❑ N/A ❑ PWS: ❑ FC: Ill yes / no Pi yes / no Crit.Hab. yes / no Project Location: County Street Address/ State Road/ Lot #(s) Subdivision City ZIP Phone # ( ) River Basin Adj. Wtr. Body ! ' C ; Y- (nat /man /url Closest Maj. Wtr. Body - ■■■■1111111111■■■ ■■i■■■■■■■■■■■■■■ NOMINEE ■i►T,■■■!■■■■■■■Ili!■■!!■�f r aw ww■■■■■■■■■UM R�� ■■■■■■■■■■■■■■■■■■■ • .. - .. ■■■■■■■■■■■■■■■■■■■■■■■ili��■■■rlF�1f11!1!�!' �■■■■■ i■la■■■■■■■■■■■®■■.■�!� NONE ®■■■�.::.:�i■■■c■■■■■■ ■■■®■■i iei■■■ � � N oll iI'i ■i■i 00 ■■■■■■■ moll ■■■MMEN ■■N■■■■!�■■ ■■■■■N■■i ■ ■■! i ■■,i�11R+iRSi! ■■■■■Si1r Ci.: ■■■■■■■!�■�■■II ■■■�lilii■■ ■■■■■l�!!■■ ■■■■■■f�7■® ■+'■■■■■M■■■■■FI■L ■■■ ■■ .■■.■■■.!■■ ■t'�■1■■■■1a■■ i■■'O■■■■■■■ 17 ■■■■■■■■i�■�i■■■■■■■�i�i■■■■■■■■W.- ill Pill �1111 iiiii� Agent or,,Applicant Printed Name Signature Please read compliance statement on back of permit Application Fee(s) Check # Permit OfBcers.Signature Issuing Date Expiration Date 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 [)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 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. (Serves: Carteret, Craven, Onslow -above Raleigh, NC 27604 New River Inlet- and Pamlico Counties) 919-733-2293 Fax:919-733-1495 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 ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIER/MOORING PILINGSIBOATLIFTIBOATUOUSE) I hereby certify that I own property adjacent to Ll.?11Cr�_ %1fi��f 's (Name of Property Owner) property located at on (Waterbody) (Lot, Block oad, etc.) iniy/J �i.�L� tl'/,fj��%C , N.C. (Town and/or County) He has described to me, as shown below, the development he is proposing at that location, and. I have no objections to his proposal. 1 understand that a pier/mooring pilings/boatlif /boathouse must be set back a minimum distance of fifteen feet (15') from my area of riparian access unless waived by me. 1 do not wish to waive the setback requirement. I do wish to waive that setback requirement. ---------------------------------------------------------------------------------------------------------------- - - DESCRIPTION AND!OR DRAWING OF PROPOSED DEVELOPMENT: (To be filled in by individual proposing development) —1 � I o p %X/Sf rN� Dom. ---------- ----------------- ---------------------------------------------------------------------------- Signatur; Print or Type Natne Telephone Number Date: � •,� � ADJ A C LNT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIER/MOORING PILINGSIBOATLIFT/BOATHOUSE) I hereby certify that I own property adjacent to ��U� %/�f 's (Name of Property Owner) property Imated at Z07- (Lot, on (Waterbody) M lock/Road, etc.) in ��/f>'.(/�L70�..4 �,LG�S��.C� , N.C. (Town and/or County) He has described to me, as shown below, the development he is proposing at that location, -inci, I have no objections to his proposal. 1 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. I do not wish to waive the setback requirement I dD wish to waive that setback requirement. DESCRIPTION AN-D!OR DRAWING OF PROPOSED DEVELOPMENT: (To be filled in hi• individual proposing development) __._..I �-'c , 1 � X je, ---------- ----------------------------------------------------------------------------------- --------- ----------------------------------------------------------------------------------------------------------------- 5 1o33 -o c k Telephone Number Date: 1 p D—O l =008 Altai), Check, 1-800-224-7621 www. adis114checks. CUM Bruce Welka 10"21220 0505 9817 Marx Road l Little Valley, NY 14755 DATE PAYTOTHE s ORDER OF �"' I/ r ' • c � �+'( / ` (JA/ Battles �00�Ia,; J / DOLLARS 8 00 Back, HSBC GOWANDA, NY 14070 lJo�l�' ,� `r c FOR �� "�K�� V _ 1./ ,!' / -�—�� nr i:0220000201:8663L965411' 0505 PRINTED ON RECYCLED PAPER USING VEGETABLE -BASED INKS