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Home My WebLink About57198_WESTMAN, MARK_20110406❑ GAMA / ❑ DREDGE & FILL oEN New oMRALon Po R pMITSSUe ❑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 I SA NCAC Applicant Name_ Address City Phone # (_)_ Authorized Agent Affected ❑ CW AEC(s): ❑ OEA ❑ PWS: ORW: yes / no State ZIP Fax # ( ) ❑ EW ❑ PTA [I ES ❑ PTS ❑ HHF ❑ IH ❑ UBA ❑ N/A ❑ FC: PNA yes / no Crit.Hab. yes / no //mil 15 KS i Previous permit # Date previous permit issued ❑ Rules 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 Type of Project/ Activity (Scale: ) Pier (dock) length Platform(s) Finger pier(s) Groin length number Bulkhead/ Riprap length avg distance offshore max distance offshore Basin, channel cubic yards Boat ramp Boathouse/ Boatlift Beach Bulldozing Other I ' } t' t Shoreline Length J. SAV: not sure yes no Sandbags: not sure yes no Moratorium: n/a yes no Photos: yes no Waiver Attached: yes no P A building permit may be required by: See note on back regarding River Basin rules. Notes/ Special Conditions Agent or Applicant Printed Name Jr` 41-11- Permit Officer's Signature J Signature ** Please read compliance statement on back of permit ** Issuing Date Application Fee(s) Check # Local Planning Jurisdiction Expiration Date 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 Morehead City Headquarters Mailing Address: 400 Commerce Ave 1638 Mail Service Center Morehead City, NC 28557 Raleigh, NC 27699-1638 252-808-2808/ 1-888-4RCOAST 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 NC Division of Coastal Mgt. Habitat Impact Computer Sheet Applicant: Mark Wertman Date: April 6, 2011 General Permit #: 57198C 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 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 temp impacts) FINAL Feet (Anticipated final disturbance. Excludes any restoration and/or temp impact amount SB Dredge ❑ Fill ® Both ❑ Other ❑ 2,325 155 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 ❑ 252-808-2808 :: 1-888-4RCOAST :: www.nccoastaimanaciement.net revised:02/03/10 NCDENR North Carolina Department of Environment and Natural Resources Division of Coastal Management Beverly Eaves Perdue, Governor James H. Gregson, Director Dee Freeman, Secretary Date Name of Property Owner Applying for Permit: Mailing Address: I certify that I have authorized (agent) ��` �`�°O� sG ``� to act on my behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to install or construct (activity) at (my property located at) a ° 3 This certification is valid thru (date) Q— Property Owner Signature Date 400 Commerce Avenue, Morehead City, North Carolina 28557 Phone: 252-808-2808 \ FAX: 252-247-3330 \ Internet: www.nccoastalmanagement.net An Equal Opportunity \ Affirmative Action Employer - 50% Recycled \ 10% Post Consumer Paper DIVISION OF COASTAL MA_►'�TAt�EME1�T ADdACEN7T RIPARIAN PROPERTY O'S-NER fi OTMCATI4NIWAIYER FORM h Name of individual applying for the permit: 4m1& L'U'r 7?�+r� J Address of property_ (Lotorstreet�, sweerafroad) ", C- d (City & County) I hereby cerfify that I own property adjacent to the above referenced property- The individual applying for #his 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 Ietter. I have uo objeciians to this proposal If you have objections to what is being proposed; please write the Division of Coas-u-11 Management, 400 Commerce Ave., Morehead City, NC 28557 or call (252) 808 2808 within 10 dugs of receipt of the notice. No response is considered the same as no objection ifyoa 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 appropriate blank below-) I do wish to waive the IS setback requirement I do not wish to waive The 15' setback requirement 7,,G 111 t�tature . pate Print Name Telephone number with area code CERTIFIED MAEL — RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM Name of individual applying for the permit:l¢� Address of property: 4-to (Lot or street&, street of road) C2ici L rC a-UC�t.l ii�� - ors., r_ �,........ 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. E t 'T% Cl/� '�-I have 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 appropriate blank below.) I do wish to waive the 15' setback requirement do not wish to waive the 15' setback requirement 3�� 7� Telephone number with area code fry /f / v a(l Ov9(l f -d Q. Z #1 xr� --Y7t((v7 T 1 BOBBY CAHOON WACHOVIA BAND NA MARINE CONSTRUCTION AND LAND DEVELOPMENT APEX, NC 27502 09788 DBA BOBBY CAHOON CONSTRUCTION, INC. 66-021/530 6003 NEUSE RD. GRANTSBORO, NC 28529 0 PH (252) 249-1617 PAY TO THE ' M ORDER OF DOLLARS r- 7,�� 57Iq� MEMO �' JI (VS(� �, 0,�-4ry\a� nr Ila00 9 788ii' I:0 5 3000 2 191: 20000 L 7 68 48 2ano