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Home My WebLink About58308_WEST, CRAIG_20110808❑CAMA / ❑ DREDGE & FILL GENERAL PERMIT ❑New ❑Modification ❑Complete Reissue El Partial Reissue 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 �ES U PTS I1i.1 LL LJ UBA ❑ N/A Crit.Hab. yes / no rZ, VC Previous permit # Date previous permit issued ❑ Rules Project Location: County Street Address/ State Road/ Lot #(s) Subdivision City j ZIP Phone # ( } �� / River Basin Adj. Wtr. Body (nat /man /unkn) Closest Maj. Wtr. Body ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ' '■■........■.1..Y■ll �.��..:......■.■.►lily ■■■■■■■■■�■■�■r»�■■■■��■■■■■■■■■■■■■■■■■ ■■■ii ■Ili■\■r■■■il■iYi�'■L!!/!�■!�5�L�!`!.�■■■■■■■■■ ■■■■■■� inn■iGi■�■®■�S:■i�r1��-�5�■■■®■■■■■■■■ ■■■■■■■■■i�il��1il��"ii ■irk'■■b■■\l'�l�li■■■■■�■■■■■�! ■■■■■■■■■■■■■■■■''l�1■!l1�1■■i1n1ll•!s!■Il��■■■■!*J■ Agent or Applicant Printed Name Signature "Please read compliance statement on back of permit r 1 � PermitOfficer's Signature) Issuing Date Expiration Date Application Fee(s) Check# Local Planningf 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 I) 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 252-808-2808/ 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 \T/ M. Craig West JVCD.0 2753SOS 6089 4865 12801 Rarefy 12ulge 90ad Po Now 6365 Kalelgh. NC 27628 ---- DATE �C0CA) � - - - — — '7c First Citizens ® Bank firstcitizens i:0 5 3 L00 300i:0008 6 7 6 280 28u■ 0 48 6 5 ,X b AV& NC®ENR North Carolina Department of Environment and Natural Resources Division of Coastal Management Beverly Eaves Perdue, Governor James H. Gregson, Director Dee Freeman, Secretary Date r� ?b - !/ Applicant Name Mailing Address i certify that f have authorized (agent) ISIUe Octfe-`- Ala"-i me- to act on my behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to install or construct (activity) Aui at (location) Nj /d s j6k//ztiO'w 8,.,-k pfl 4-ek 4ane This certification is valid thru_(date) CI - 1 S Signature RECENED JUL 21 2011 ` nCM-MHD CITY 400 Commerce Avenue, Morehead City, North Carolina 28557 Phone: 252-808-28081 FAX: 252-247-33301 Internet: www.nccoastalmanagement.net An Equal Opportunity %Affirmative Action Employer — 50% Recycled 110% Post Consumer Paper ADJACENT RIPARIAN PROPERTY OWNER STATEM T A4 I hereby certify that I own property adjacent to ✓'s (N apiGe of ffro f erty Owner) property located at Lame, (Lot, Block, ad, etc.) l� on —'IawlelrJ Geefc , in :P,CG� , N.C. (Waterbbody) (Town and/or County) Applicant's phone #: 9ff1q —D3 Mailing Address: � C He has described to me, as shown below, the development he is proposing at that location, and, I have no objections to his proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: (To be filled in by property owner proposing development) I �1 (Information for Property Owner Applying for Permit) Mailing Address A e il/G City/State/Z' Telephone Nu er Signature Date RoUle S °� 1 RECEPI%D JUL 2I 20l1 DCM-MID CTTy -------------------- (Riparian Property Owner Information) / /S T /M► (0.% G,o�►e Signature Print or Type Name -fyg -Q s Telephone Number Date ul 19 11 09:10a patricia vassallo 919-881-8501 p.1 dol. IY. LUI1 U:UVW NO. IUD r. L ADJACENT RIPARIAN PROPERTY OWNER STATEKENT I hereby certify that I own property adjacent to v&'s /( ame of Prop ty Owner prOperty located at —ILL Amderr �reel1 4,n 1! , -(Lot, Block, Road, etc,) on P- ill �OI° _ N-C. (Waterbody) (Town and/or County) A /f Applicant's plwne tl;�/_%��`+ Mailing Address: A.D.4 b G y 11e has described to me, as shown below, the deve.lopment he is proposing at thit ](;cation, -V I have no objcctiors to his proposal. ))ESCRJPTION AND/OR DRAWING Of PROPOSED DEVELOPMENT: (To be filled in by property vwner proposing development) (Information for Property Owner Applying for Permit) .Q.�oy -'rVF Mai 'ng Addres CitytStatc/ p ._ / - D3 / Telephone N ignature Date (Riparian Property Owner Information) /1y r.%YiIti Cr*-sit 4dwe- //�� / Signaturc t'ATPic �� V R5sfl-)10 _ rint or Type Name �►�- 8�1- 8s�o r Tele h Number JUL 21 W1 Date DCfA.MHD Cay r ,;oplicant: C Date: IC C Cu Describe below the HABITAT disturbances for the application. All values shoutAn t 7 found in your Habitat code sheet, name, a?rd�, of measurement Habitat Name DISTURB TYPE Choose One TOTAL Sq. Ft. (Applied for. Disturbance total includes any anticipated restoration or ternimpacts FILIAL Sq. Ft. (Anticipated final disturbance. Excludes any restoration and/or temp impact amount) TOTAL Feet (Applied for. Disturbance total includes any anticipated restoration or ternifnpActs FINAL Feet (Anticipated final disturbance. Excludes any restoration and/or temp impact amount Dredge ❑ FiIl4 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 ❑ .sci •;,..✓.... �� .. '$_=.,=3�,- C�UAz>i .. +ar•,r --r.',. 1-1�1.I;.. 1':....r.—'�.}