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Home My WebLink About59717_PAGE, L B_20120131UCAMA / ❑ DREDGE & FILL 1 597 fL GENERAL PERMIT Previous permit# ❑New ❑Modification (--]Complete Reissue ❑Partial Reissue 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 O Rules attached. Applicant Name Address City State ZIP -` Phone # O Fax # O Authorized Agent EJ CW ❑ EW O PTA ❑ ES ❑ PTS Affected AEC(s): OEA ❑ HHF ❑ IH ❑ UBA ❑ NfA ❑ PWS: ❑FC: ORW: yes / no PNA yes / no 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 .• . length I - IMEW MM ire MEN 011100 01 NO llllllw� Isom ME .-in max distance offshore channel WEN cubic yards house/ Boatlift h Bulldozing win MINE ME 0 rJ 0 lap M 1110 mo�om No 110 MOMMIM M line Length M not sure yes no bags: not sure yes no os: yes no EPA -III VIR MEN No so 0 0 ME MEMME IN por ON - ■■■■■ail �i�ww�.��:��«r��:�■wr �ul�w� Agent or Applicant Printed Name Signature ** Please read compliance statement on back of permit Permit Officer's Signature Issuing Date Expil•ation 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, certifythat 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/ 1-888ARCOAST 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 A.0plicant: Date: I �l �1 Describe below the HABITAT disturbances for the application. All values should match the name, and unit of rement found in your Habitat code sheet. Habitat Plante DISTURB TYPE Choose One TOTAL Sq. Ft. (Applied for. Disturbance total includes any anticipated restoration or teryp 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 mount redge E Fill ❑ Both ❑ Other ❑ (LR (OKIJAXI 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 Cl Other ❑ _,2 �. :,41COAST ,. •ar,r=.r.rrcc_a�_ ,a ...,�., �.,. Mt_r—w Jan 30 12 03:50p JUNE PAGE 252-393-8275 p.2 Jan 30 12 03:51 p Jan 30 12 10:55a JUNE PAGE Brooks Dredging 252-3 "�-8275 ' p.3 2 52 5044744 p .1 ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIERIMOORING PILINGS/ROATLI,f'VBOATI-10USE) I hereby certify that I own property adjacent to h) �S (Name of Property Owner) property located at pa'o—z"'d 0., _ C (Lot, Block, Read, etc.) flnAU L , in 0, T . N.C. 'aterbody) (Town andlar County _ . He has described to me, as shown below, the development he is p: oposing at that_ location, and, I have no cbj=-tions to his proposal. I understand t%at a pierlmooring pilingsfbeatlift/boathouse must be set back a minimun- distance of fifteen feet (15') from my area of riparian access unless waiv(-,G by me. I dQ not Nv-sh to waive the setback requirement. I dQ wish to waive tha: setback requirement. DIESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPNIEN�T: Cl o be filled in by indii,idual proposing development) I nature Print or Type Na&e 2-5 ; - � 1S - 5(60 Telephonz plumber Dace: Jan 30 12 03:51p JUNE PAGE 252-39�-8275 p.4 Jan 3012 10:55a Brooks Dredgirg 2526044744 PA ADJACENT R.IEPARIAN PROPS, RTY OWNER STATENLCNT (FOR A PIER/MOORING PILINGSIROATLII"TIBOrATII0V'SE) I hereby certify that I own property adjacent to _ .. 4 rZ `s (Natne of Propert_ weer) property located at (Lot, Block, Road, etc.) on o Vi o. ~ , in i-Ai— J - :y.C. VVaterbody) (To,,i n and/or C10 nty) He has described to me, as shown below, the development he is proposing at tha: location, and, ; have no objections to his propo_sa'. I understand tl at a pier,'ntoorinC pilings boatditlboathouse must be set back a minimum distance of fifthen feet (15') From: my aru of ri:)eriar. access unless waived by me. [ o n Ao wish to waive the setback requirement. I d4 wJ'sh tc waive tha: setback recluirernenr. DF,SCRIMON AND/OR DRAWING OF PROPOSED DEVELOPMENT: (To befilled in by individual proposing development,) M- S1hn<:tun �-- Printer Type Name a 6- -L - 3,? J - ;?7-3 'I_ Tclepi.one Number i)ate: 60 -- /0L - ( s )-l) 0 1 + ) 5LZ8-�6�-Z9Z 3!DVd 3Nnr do5,�0 7,6 uer