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Home My WebLink About32954_PETERSON, RICHARD_20030123�P CAMA / C DREDGE & FILL GENERAL PERMIT Previous rmit# ❑New 0-Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued As authorized by the State of North Carolina, Department of Environment and Natural Resources j and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC ❑ Rules attached. Applicant Name Address State ZIP Phone # (,) Fax # O Authorized Agent Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS AEC(s): ❑ OEA '❑ HHF ❑ IH ❑ UBA ❑ N/A ❑ PWS: ❑ FC: ORW: yes / no PNA yes / no Crit. Hab. yes / no Project Location: County Street Address/ State Road/ Lot #(s) Subdivision_ ZIP Phone # () River Basin Adj. Wtr. Body (nat /man /unkn) Closest Maj. Wtr. Body _ - ■■■■■■■■�■■■■■■■■■■■■■■■■■■■ ■ ■■■■■■■ ■■ ■■■1I1lIll�i■■■■■■■■■■■■■■�'i ■■■■■■■■■ ■■■tll!■■■■■■■■■ ■■■■OEM ■■■■■■■■l01FAM■■\\■■WE2 'rii i■ ■■■■MMMMFA= No WA M .. ■■■�■■ ■■ ■■■■■■■■■►l M■wSi■■■■■CMG ■■ ■■■I■II M-91M■■■0■■�'�, ■■■■■■■■ ■■■■■■M!■ ■■■■■� ■■■■■■■■■■■■®J ��11■ fir■■■■!■■■■■■■■ ■■■ s■so■■■■■■■■■■►I OEM �\■■■■■■■■■■■ ■■■■■■■■■/■ 1�!l�■■■■�1■■■■■■■■■■■■■ tt��RISEN= I�Iti■■■■■\\■■■■■■■■lil■■■ ■A■■■■■■■■■■rm ■■■■■■■■■m /JI■■■■■■■■■■%■ /�/�■■■■■■■■■■11■■■■ 1�FEE=■■tS■■■■■■1®■■■a i■MME ■■`'=MU iiM1- low Ui■MENN■N ME ■i■IlEffilil■■ I1MEMI■M Ii3■■■QEMINM i�■■■■■■■■■ ■ � lit/ E= : 11101 �i�i ■r■■r�nl■■ice■■■ ■i■■■i�%E■i■1N,A■■■■■■■■■■■■■■ ■■ M■■■■■■ ■■■■■®■■■ ■■■M��i`i■■ Agent or Applicant Printed Name Signature Please read compliance statement on back of permit Application Fee(s) Check # Officer's Signature Issuing Date Expiration Date Local Planningjurisdiction 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, certifythat this project is consistentwith 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 (910-395-3900) for more information on how to comply with thesebuffer rules. Division of Coastal Management Offices Central Office Mailing Address: 1638 Mail Service Center Raleigh, NC 27699-1638 Location: Parker -Lincoln Building 2728 Capital Blvd. Raleigh, NC 27604 919-733-2293 / 1-888-4RCOAST 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) Morehead City District 151-B Hwy. 24 Hestron Plaza II Morehead City, NC 28557 202-808-2808 Fax: 252-247-3330 (Serves: Carteret, Craven, Onslow -above New River Inlet- and Pamlico 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 910-395-3900 Fax:910-350-2004 (Serves: Brunswick, New Hanover, Onslow -below New River Inlet- and Pender Counties) www.nccoastalmanagement.net Revised 10/05/01 ks Ll � �v Y— Ile 27� 25� II Pay to the Order of RICHARD ALLEN PETERSON DL 6417956 PH 910-326-2182 106 HAROLD AVE. SWANSBORO, N.C. 28584 //G ACAK 66-30/531 2187 01 /95 341 -3 Date +)o FIRSTCITIZENS 3^1oman j y( $04 ,W,nB�boro,NC285 For. �/� � - - --- - - - - - --- -- - - - - .. ,,-n 5 3 100 3001:00 34 I76488 38115 0 2 l8 7 tilwrYe ilm�r+nn k ADJACENT R PARL-�N PROPERTY OWNTR STATEMENT (FOR A PIER/MOORING PILINGSIBOATZIFTIBOATHOUSE) I hereby certify that I own property adjacent to9Ae lr�m''/ ,S rY (Name of Property Owner) prope.y located at A� (Lot. Block, Road, etc.) / on b-el 110 S CPS K , in (070 iy/S/�D1�� , N.C. (Waterbody) (Town and/or County) He has described to me, as shown below, the development he is propos -_ at that location, and, I have no objections to his proposal. I understand trio_ a pier/ moor-,nC piii;,as; boatlif-Jboathouse must be ser back a minimum distance of fri.een fw: (�) Fom my area of npa-,an access unless waived by me. I do nnt wish to waive the setback requirement. I �n wish to waive t�.at setback recuirement. DESCRIPTION AND/OR DRAWL" G OF PROPOSED DEVELOPNfE\-I': (To be filled ir by individual proposing development) y � 6✓/CeF � �� li0n � �{�7� 2-7 / J 113� Z5/ .3b ��/,--------------------------- ------------- -------------------------------------- I FmJ-, Siznature DAV I D QA N K Print or Type Name 910--32/.-4092 Telephone N urnbe- D ae ADJACENT R- PARL N PROPERTY OWNER STATEME]LN'T' (FOR A PIER/MOORING PILINGSIBOATLIFTIBOATHOUSE) I hereby cer-dfy that I own property adjacent to /2�G�/ � 47—c�a--) 's (Name of Property Omer) prope.,7 located at lz,2-t,!� (Lot, Block, Road, etc.) nn c�Q�t/�✓1 S � c/Gc— , in c�(/l/CtY? 5bd/L U , N.C. (Waterbody) (Town and/or County) He has described to me, as s<<own below, the deve'.opmer,t he is propos-_ a: that locar�on, and, I have no objections to his proposal. I unders�:d tha_ a pier/ moonnQ piii;,as;boalirJboathouse must be ser back a minimum distance of fif-�eea fee: (i 5) from my area of rpa ian access unless waived by me. 41-'lF-r- I dn nnt wish to wai%-e the setback requirement. I fin. wish to waive t ..at setback recuiremenl. DESCRIPTION AND/OR DRAWD G OF PROPOSED DEVELOFNIE`T: (To be filled ir by indiv&aal propose; developmenr) �v r, SianaturAe J^/ Print ^o(�rt'�Type Name 2/6 - 3..G - Telephone Number Dace: /_a/— 6-3