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Home My WebLink About57197_WILDER, RYAN_20110411❑ CAMA / ❑ DREDGE & FILL GENERAL PERMIT V,y Previous permit# ❑New ❑Modification ❑Complete Reissue El Partial Reissue IA -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 I SA NCAC ❑ Rules attached. Applicant Name Address City State ZIP Phone # ( ) Fax # O _ Authorized Agent ❑ Cw ❑ EW ❑ PTA Affected ❑ OEA ❑ HHF ❑ IH AEC(s): ❑ PWS: ❑ FO ORW: yes / no PNA yes / no ❑ ES ❑ PTS ❑ UBA ❑ N/A Crit.Hab. yes / no 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 MENEM - - ■■■■■■■I.�:■■■I+�i■■■■■■fry■■G�ir■■■■■■■■■■/I■■.!!■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■u■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■ ■■■■■■■■■■■■■■■■■■It■ M■■■ ■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ...:®■i■■■■■■■■■■■■■■■■■■■■■■�ii�■■■■■■■ 3 ■■lll■■■ ■■■■■ ■■■■■■■ Agent or Applicant Printed Name Signature ** Please read compliance statement on back of permit ** Permit Officer's Signature l �/ Issuing Date j 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 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 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 NC Division of Coastal Mgt. Habitat Impact Computer Sheet a Applicant: Ryon Wilder Date: April 11, 2011 General Permit #: 57197C 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 OW Dredge ❑ Fill ❑ Both ❑ Other ® 60 60 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.nccoastalmanagement.net revised:02/03/10 N.C. DIVISION OF COASTAL MANAGEMENT AGENT AUTHORIZATION FORM Date l C ( � Name of Property Owner Applying for Permit: Mailing Address: 7 (2 Sc.AC—A71E, bk- M L G iL-T /,j C, C 1 \ 7 L I certify that I have authorized (agent) >�jQ7� j 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) 2 ($ S '-J& `"' et This certification is valid thru (date) ,-, Signature Date J DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION FORM CERTIFIED MAIL - RETURN RECEIPT REQUESTED I hereby certify that I own property adjacent to _ �} L C' 's (Name of Property Owner) property located at Z► SC h C A'1 L— (Address, Lot, Block, Road, etc.) on / C cJ in P z —a c % , N.C. (Waterbody) (City/Town and/or County) Agent's Name #: Mailing Address: Agent's phone #: He/She has described to me as shown below the development he/she is proposing at that location, and I have no objections to the proposal. --------------------------------------------------------------------------------------------------------------------- DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (Individual proposing development must fill in description below or attach a site drawing) E �,�IsTiw� t;aar cl�-� Lo If you have objections to what is being proposed, you must notify the Division of Coastal Management (DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is available at www.nccoastaimangementneticontact dcm.htm or by calling 1-888-4RCOAST. No response is considered the same as no objection if you have been noted by Certified Mail. (Propfe``ty O ner formation) (Riparian Prop Owner Information) Signature \) Thare Print or Type Namb Print or Type Name 41- Mailing Address "z a 70 City/State/Zip 9 3 � ,-Q�g a22�� D Mailing Address � Z, Cwt ett,T C- Z8T70 City/State2i Telephone Number Telephone Num�jr La , (// � /� (1 r Date Date DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION FORM CERTIFIED MAIL - RETURN RECEIPT REQUESTED I hereby certify that I own property adjacent to 4)k u I k s E e u-y's (Name of Property Owner) property located at � (2 Si- �' 6 �'"� (Address, Lot, Block, Road, etc.) on f C c ✓ in a iLT N.C. (Waterbody) (City/Town and/or County) Agent's Name #: Agent's phone #: Mailing Address: He/She has described to me as shown below the development he/she is proposing at that location, and I have no objections to the proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (Individual proposing development must rill in description below or attach a site drawing) 6 If you have objections to what is being proposed, you must notify the Division of Coastal Management (DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is available at www.nccoastalmangement.net/contact dcm.htm or by calling 1-888-4RCOAST. No response is considered the same as no objection if you have been noted by Certined Mail. (Property Owner Information) Tct�.,) , � - kl,— Signature \ Print or Typb Name Z c 8 S c 4-6 A- -7 t_ "i �L Mailing Address t-= �—,Q , : , &� C.. Z Z l City/State/Zip Telephone Number C( �\ / (( Date (Riparian Property Owner Information) Signature Print or Type Name Mailing Address City/StatelZip Telephone Number Date DENNIS & SONS MARINE CONSTRUCTION, LLC Am109 SEAHORSE DRIVE BEAUFORT, NC 28516 OFFICE: 252-504-6329 PAY A TO THE ORDER OF ` 1-112/531 1712 DATE 00 Security features t inducted. BB&T-BRANCH BANKING & TRUST COMPANY Details an back. MEMO k�'-rt� AUTHORIZED SI NATURE II000 L 7 I'Dim 1:0 5 3 40 1 L 2 11: Q00 5 2L L 84 ?III 13