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Home My WebLink About58111_RICHARD, RUSSELL_20110807_ _ ❑ CAMA / ❑ DREDGE & FILL GENERAL PERMIT Previous permit# ONew ❑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 ❑ Rules attached. Applicant Name Project Location: County Address _ Street Address/ State Road/ Lot #(s) City State ZIP Phone # ( )_ Authorized Agent Affected ❑ CW AEC(s): ❑ OEA ❑ PWs: ORW: yes / no ❑ EW ❑ PTA ❑ ES ❑ PTS ❑HHF ❑IH ❑UBA El N/A ❑ FC: PNA yes / no Crit.Hab. yes / no Subdivision City ZIP Phone # ( ) River Basin Adj. Wtr. Body (nat /man /unkn) Closest Maj. Wtr. Body I��\ ■��■■ice■��i■■■■�■■■�:■■■■!■■■'rife■■ MOMMENEME M. ■■■II■■■■�.i�■■ N■■■■■■■■■■■0 ■■■■■■■■■ 'moo .■!■l�■■■■®■■■■■�■■■No ■■� !■ fj■ mum /J■ ■■\■■■Ili ■■■ ■■ mmo■■■■■m SEEM ■■■��■■■■■■■:■■■:: ■�:�■■ ■■■■■■ MEN ■■■■■■■■.1■J■■■■i7■■■■■■■■■■■■■■■■■■■ ■■Gr■li■■iu■Ziiii'i Si.rr.�ii.rl,�i■■■■■■■G� ®■■ ■■ Agent or Applicant Printed Name Permit Officer's Signature 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 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/ I-888-4RCOAST 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 TR PRESCOTT MARINE CONSTRUCTION LLC 04-08 545 ALLIGATOR LOOP RD 252-745-7135 0857 MERRITT, NC 28556 66,30/531 471 Pay to the Date Order ofzZ Q Dollars First Citizens _ Bank F�r r 1:0 5 100 3001:00 4 7 120 19 4 6 111, OOg57 ti ■ Complete items 1, 2, and 3. Also complete item. 4 if Restricted Delivery is desired. ■ Print your name and address on the reverse so that we can return the card to you. j ■ Attach this card to the back of the mailpiece, or on the front if space permits. 1. Article Addressed to: A. Signature 7 ❑ Agent X ❑ Addressee B. tod by (n dName) C. Date of Delivery 6� D. Is delivery address different from item 1? ❑ es If YES, enter delivery address below: ❑ No �o � — T �,v-y C J! D j4liS l—S Kati cJ d 3. y�ss Se e Type Certified Mail ❑ Express Mail ❑ Registered ❑ Return Receipt for Merchandise ❑ Insured Mail ❑ C.O.D. 4. Restricted Delivery? (Extra Fee) ❑ Yes 2. Article Number (transfer from service label) 7008 15 0 0 3 6 7 3 8679 PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540 i, UNITED STATES POSTAL SERVICE First -Mass Mail . Postage & Fees Paid USPS 111111 Permit No. G-10 • Sender: Please print your name, address, and ZIP+4 in this box • ■ Complete items 1, 2, and 3. Also complete item 4 if Restricted Delivery is desired. ■ Print your name and address on the reverse so that we can return the card to you. ■ Attach this card to the back of the mailpiece, or on the front if space permits. 1. Article Addressed to: y APW 17'y't/%L C ti 7�/ A. Signatu� x B. Receive ( Printed Name) I C. ® Agent ❑ Addressee I �LIS% D. Is delivery address different from item 1?El Yes If YES, enter delivery address below: ❑ No 3. See Type ETCertified Mail ❑ Express Mail ❑ Registered ❑ Return Receipt for Merchandise ❑ Insured Mail ❑ C.O.D. 4. Restricted Delivery? (Extra Fee) ❑ Yes f 2. Article Number 7008 0150 0003 6074 3642 (Transfer from service label) PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540 UNITED STATES POSTAL SERVICE First -Class Mail . Postage & Fees Paid USPS Permit No. G-10 • Sender: Please print your name, address, and ZIP+4 in this box • 1!l�t�ittt3l�l�itit�[lIIl14l1iffi�titltllllfitlillititit!!1lIF ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIER/MOORING PILINGSIBOA TLIFTIBOA THO USE) I hereby certify that I own property adjacent to USS�Ii d- o-1MV% (Name of Property Owner) property located at 3; 11317>-iy e,, , (Lot, Block, Road, etc.) on �8► 1 �`c`C�2.� , in N.C. (Waterbody) (Town and/or County) as �-- Applicant's phone #:T— qiR 15 Mailing Address: He has &-scribed to me, as shown below, the development he is proposing at that location, and, I have no objections to his proposal. I understand that a pier/mooring pilings / boatlift / boathouse must be set back a minimum distance of fifteen feet (15') frorn 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 not wish to waive h`s s he mom+ C1 eke S ()p+ alp ( V I do wish to waive that setback requirement. does of � n ;� i a ti t + 2 ----------------------------------------------------------------------------------------------------------------- DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: {To be filled in by individual proposing development) _r� t�rU posed Qace.�'�oVsr N ��c�s� Wc�\12wo►.+�1 �- IRg{ �u1 rA --------------------- (Info mation for Property Owner Applying for Permit) 1 DT W emA-kA-erby r. Mailing Address MV-OrrkAk, �,)c *.YSS L City/State/Zip (Riparian Property Owner Information) I V, l Vvw Signature Print or Type Nam e Te p e Number tL 2 Signature Date Telephone Number Date USPS.com® - Track & Confirm Page 1 of 1 Customer Service USPS Mobile Quick Toots Track & Confirm GET EMAIL UPDATES PRINT DETAILS YOUR LABEL NUMBER 70080160OW360743642 Check on Another Item What's your label (or receipt) number? Ship a Package Send Mail Manage Your Mail Register t Sign In Search USPS.com or Track Packages Shop Business Solutions SERVICE STATUS OF YOUR ITEM DATE &TIME LOCATION FEATURES First -Class Mail ® Delivered Jury 28, 2011. 10:55 am AMITYVILLE, NY 11701 Expected Delivery By: July 15, 2011 Certified Mail Return Receipt Notice Left July 15, 2011, 5:16 pm AMITYVILLE, NY 11701 Processed through Sort July 15, 2011, 2:41 am FARMINGDALE, NY 11737 Facility Acceptance July 12, 2011, 10:34 am BAYBORO, NC 28515 LEGAL ON USPS.COM Privacy Policy > Government Services Terms of Use, Buy Stamps & Shop, FOIA , Print a Label with Postage , No FEAR Act EEO Data > Customer Service , Site Index OTHER USPS SITES Business Customer Gateway , Postal Inspectors , Inspector General , Postal Explorer, Copynght® 2011 USPS, All Rights Reserved ON ABOUT.USPS.COM About USPS Home, Newsroom , Mail Service Updates , Forms & Publications , Careers , https://tools.usps.com/go/TrackConfimiAction.action 8/2/2011 USPS.com® - Track & Confinn Page 1 of 1 Customer Service USPS Mobile aus scomo Quick Tools Track & Confirm GET EMAIL UPDATES PRINT DETAILS YOUR LABEL NUMBER 70080160000360743642 Check on Another Item What's your label (or receipt) number? Ship a Package Send Mail Manage Your Mail Register! Sign In Search USPS.com or Track Packages Shop Business Solutions SERVICE STATUS OF YOUR ITEM DATE&TIME LOCATION FEATURES First -Class Mail Delivered July28, 2011, 10:55 am AMITYVILLE, NY 11701 Expected Delivery By: July 15, 2011 Certified Mail n Return Receipt Notice Left July 15, 2011. 5:16 pm AMffWILLE, NY 11701 Processed through Sort July 15, 2011, 2:41 am FARMINGDALE, NY 11737 Facility Acceptance July 12, 2011, 10:34 am BAYBORO, NC 28515 I LEGAL ON USPS.COM Privacy Policy , Government Services, Terms of Use) Buy Stamps & shop) FOIA , Print a Label with Postage No FEAR Act EEO Data , Customer Service , OTHER LISPS SITES Site index , Business Customer Gateway , Postal Inspectors , Inspector General Postal Explorer , CopynghtO 2011 LISPS. All Rights Reserved ON ABOUT.USPS.COM About LISPS Home Newsroom , Mail Service Updates , Forms & Publications , Cateers , https://tools.usps.com/go/TrackConfimiAction.action 8/2/2011 -NC- Division of Coastal Mgt. Habitat Impact Computer Sheet Applicant: Russell Richard Date: August 7, 2011 General Permit #: 58111 C 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)_impact FINAL Sq. Ft. (Anticipated final disturbance. Excludes any restoration and/or temp 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 ® 364 364 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.nccoastalmanauement.net revised: 02/03/10