HomeMy WebLinkAbout56352_PATE, HERB_20100911.�f
❑CAMA / ❑ DREDGE & FILL
GENERAL PERMIT Previous permit #
❑New ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued j
As authorized by the State of North Carolina, Department of Environment and Natural Resourcesf
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
ED Rlifes attached. j
Applicant Name Project Location: County
Address Street Address/ State Road/ Lot #(s)
CityState ZIP
Phone # (�) Fax #
Authorized Agent
❑ CW ❑ EW ❑ PTA
Affected
AEC(s):
❑ OEA ❑ HHF ❑ IH
❑ PWS: ❑FC:
ORW:
yes / no PNA yes / no
❑ ES ❑ PTS
❑ UBA ❑ N/A
Crit.Hab. yes / no
Subdivision
City ZIP
Phone # (_) River Basin
Adj. Wtr. Body (nat /man /unkn)
Closest Maj. Wtr. Body
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Agent or Applicant Printed Name
Permit Acer's Signature
Signature ** Please read compliance statement on back of permit **
Application Fee(s) Check #
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 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
landowners).
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
pli
Date. ant:
Cate:
q)il �0
Describe below the HABITAT disturbances for the application
'ound in your Habitat code sheet.
P'�)" A�� X S
All values should match the name, and units of measurement
Habitat Name
DISTURB
DISTURB TYPE
One
TOTAL Sq. Ft.
(Applied for.
Disturbance total
includes any
anticipated
restoration or
tem-D imp is
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) —amount
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
Dredge ❑ Fill ❑ Both ❑ Other
Dredge ❑ Fill ❑ Both ❑ Other
Dredge ❑ Fill ❑ Both ❑ Other
D edge ❑ 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 ❑
A-1
N
W4
NtOEHR
North Ciamll.na Department of Env(ronmuent and ;`IIutliral Resources
o4 Coastal Mann enment
RECENED
AUG 2 4 2010
Morehead city DLA4
Michae! F. Easie.y: Governor Cihades S• Jones, Director William G. Ross Jr., Secreijry
Date �C' --
Applicant �iaaaae _ 1"
M.aaling Address _ /� Pa p b�� ��-
I certify that I have au liaoa'ized (agent) �et� 1J-��- to act On w'-
behalf, for the purpose c,a applying for and obtaining all CAllIA Per necessary to
install or construct (acti'�'ity) '-t-- R- --6Oi L'P
at(location)
This cer'sAfication is valir tlaa n�clI
Signature
A'Ecw""
UG 2 4 ?Ott)
"forehead Ci
iTY
_ %i=� c[; i' C-=i �- _;,:,t _ f�;;;�! _ � Vim - � � ��� P•I,T� � _
pt•o�('!;' 1Cr._.atcd dC p� I`�D �-i �-r.
Tact,, Road,
on (`(\.p P MAOE CeL)RC_ , it l 1,1�N 1 C C��1���7- N.C.(' 'aterbody) (To-n and/ori ouutr)
He has desc_ibel to me be'ov,, the deve;o�r.�ent he is proPosing at t1;3c
a, lc�,on, and, T nave no ob �' dons to his
J-proposaI. I unde.stand i;hat a pieriuncovere: boat li
trust he set back a minimum distance or n!--Leen rat (15') !rom m jar a or ripariln acc:ss unless
waived by me.
1 do r of wish to w'aiv the seEback rcculrerrtent.
I do wish to waive that setback reauLrement.
-------- -------------------------
- -------------------------------------
DESCR_L O.� ,i —ND/OR DRAII1-2,G OF PROPOSED',DEVELOP?yMN-T:
(?o be P � bi:r,c(propasin; deveZ�tipment) t
F
fel—
/\ I �" IS '
�V
--------------------------------------------- I -------------
V
4'nrt or Tom.- Nam,
RECEIVED
AUG 2 4 201U
Moreheatl City ®CM
4
�y1�9
.+
(FOFI � ?l f R/L�!a� iC0 YJ F F D . 0/,l T l .'per
_0
itCrGG Y` -i-_- .Sl i_ Ir (Itill _!0ui LaQ1,-;�! -t1: r
V ,G'
(L-0t, Bloc'•-., Road, etc.)
on lr( tJ YYt car tJ ft L , s_ C {� cq G��'` (` tv . C
(Fate bl�dv) (? o--n and/or + Count l)
He has desc_-ib---1 to mc, as sho',vn be' -ow, the developr;�ent he is proposing at dt
location, and, I have no objG cons to his proposal. I understand i; at a pieriuncovEre; boat li
rust be set back a minimum distance or riin�n rent (l�') 7om myjarea of riparian ac Gss dens
waived by me.
I do riot wish to waive [he recuiremenc.
I do wish to waive that setback 7CCLIUement.
DESCR=O.,N AND /0R DRAWT-4 G OF PR0POSED I DE EL0P?I'y "I—f --- ---
(?'o be felled iproposing devel�4pnzant) �--�
iIN�-NpPA4�`t_�
�Y i .nC IS
------------- P-1 --- L -----------------
f? 01
I
Stgrzture
Print or Tyv- i\iaine
SAMMIE E. TURNER
MARINE CONSTRUCTION ACCT
252-725-3415
P.O. BOX 1885
MOREHEAD CITY, NC 28557
PA
TO THE
ORDER OF
c7DE-t 4 -
Em
DATE ` - ;? l l o
4844
66-112/531
t osv°,o�
1-800-BANK BBT BBT.com
m BRANCH BANKING AND TRUST COMPANY
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