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Home My WebLink About59366_SAULMON, JEAN_20111025-CAMA / t DREDGE & FILL GENERAL PERMIT ❑New ❑Modification ❑Complete Reissue ❑Partial Reissue 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 Previous permit # Date previous permit issued 0 Rules attached. Applicant Name &A ,jal'i Project Location: County Address ;,� ,, 2- Street Address/ State Road/ Lot #(s) . City_ State ZIP Phone # ( ) Fax # (_) Subdivision Authorized Agent jte r (&I,, ; ii`��.�Q �pnfi��lClvvn City zip ElCW ❑ EW ❑ PTA El ES ElPTS Phone # (�) Zt(I - 114' j River Basin Affected ElOEA AEC(s): ❑ HHF ElIH ElUBA El N/A f�'1 Adj. Wtr. Body •:fo ffi , nat /man /unkn ❑ PWS: ❑ FC: ORW: yes / no PNA l� yes / (nd Crit.Hab. yes / no Closest Maj. Wtr. Body Wn . - . .. ■■■■■■■■!��■■fill I■■■■■■■■■■■■■!1MMUNI ■■M U •■■■C� ININEEMENE ■■■B■■�■�■■■�■�■■ ■��■w■■■�n P`■■■ram■■■®■■■■■■■■■®■■■■■ NNNIVIFA::■:��■■■n ■■■ :■■■: ■■■ :■■■■■ p■��■■■■■�n�■■ ■■■�.nw■■■w■■�••�■•�■® ®■11■■■■■■HIMIME �!r!!■ ►�■■■'r�r�■sr�■■r�® �'..�i■■■■■■IIL!+'�!� rum �iiv■■■f■ii1`I■!'I�® —a 0 N■■■■■■■■\."!� [liiltWN �E■■ ■L �■■Il��■� ��jj�IN�■■MR RLNRII INN ■■■■■■■■�■■■�■�■ram■� ■■■■ ■■■■■■■■■■■■■[+li��l■■■■■■ram■■■■®■■■■ Agent or Applicant Printed Name Signature "Please read compliance statement on back of permit" Permit Officer's Signature j Issuing Date _ Expiration Date Application Fee(s) Check # 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, certifythatthis 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 (910-796-7215) 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 FIRST CITIZENS BANK 4661 OUTER BANKS MARINE CONSTRUCTION, INC 66-30531 1501 FIRST AVE 137 MOREHEAD CITY, NC 28557 (252) 240, 2525 11/12/2011 Y I � PAY TO THE c ORDER OF n.F N R. I*200 00 0 v Two Hundred and DOLLARS D.E.N.R. U MEMO T I)v 0 0 4 6 6 L II' 1: 0 S 3 L 0 0 3 0 01: 0 0 1 3 L 2 18 2 L 2 7 „■ AUTHORIZED SIGNATURE u ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIERIMOORWG PHRVGSBOATLIFTBOATSOUSE) I hereby certify that I own property adjacent tom- �O � (Name of Property Owner) property located aAwo ' `� — L� (LoBlock, Road, etc.) t, c�) �4 , iny , N.C. on (Waterbody) (Town and/or County) Applicant's phone - ding Address - He has described 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� from 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 I do wish to waive that setback requirement. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: (To be filled in by individual proposing development) — c,--� 2-c6 'SZO (Information for Property Owner Applying for Permit) �(- 41?� Mailing Address OCT 10 2011 DCM-M11D CITY (Riparian Property Owner Information) Signature Print or T e Name 3"na- -) City/State/Zip 2- 7 r I 3 Telephone Number Telephone Number i:a�d �� /I I � J Signature Date Date ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PLERIMOORING PLERVGSIBOATLIFTIBOATHOUSE) I hereby certify that I own property adjacent to Y1 �-� -�� 's (NameofProperty Owner) property located at (Lot, Block, Road, etc.) in �`� ,N.C. on (Waterbody) (Town and/or County) Applicant's phone #-t-M'1Bpb1 Mailing Address: •�-"I ^� He has described 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 pierlmooring pilings / boatIift / boathouse must be set back a minimum distance of fifteen feet (15D from 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 I do wish to waive that setback requirement. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: (To be filled in by individual proposing development) �,� Sob►• RECEIVED (Information for Property Owner Applying for Permit) 0 1S2- ailing Address Pn,v,5 A/L c OCT 10 ZQ11 DCM-MHD CITY (Riparian Property Owner Information) Signature City/State/Zip 226Print or Type Name Telephone Number Telephone Number qL)z 1i Signature Date Date FIRST CITIZENS BANK OUTER BANKS MARINE CONSTRUCTION, INC 1501 FIRST AVE MOREHEAD CITY, NC 28557 (252) 240-2525 10/9/2011 4620 66-30/531 a 137 m 0 PAY TO THE *200.00 ORDER OF D F-N_R- 0 Twn 1-4undred and 00/100*� *********************************************************** DOLLARS D.E.N.R. 1 / I a c MEMO / I%l m J/--- II'00I 6 2011' 1:0 5 3 L00 30011:00 L 3 1 2 L8 2 III SIGNATURE