HomeMy WebLinkAbout58200_SAWYER. RODNEY_20110801❑LAMA / ❑ DREDGE & FILL
GENERAL PERMIT Previous permit#
❑New ❑Modification El 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 15A NCAC
❑ Rules attached.
Applicant Name ,` 1' F` Project Location: County
Address
City
Phone # ( )_
Authorized Agent
Affected ❑ CW
AEC(s): ❑ OEA
❑ PWS:
ORW: yes / no
State ZIP /
Fax # ( )
❑ EW PTA ❑ ES ❑ PTS
❑ HHF En IH ❑ UBA ❑ N/A
❑ FC:
PNA yes / no Crit.Hab. yes / no
Street Address/ State Road/ Lot #(s)
Subdivision
City ! �� �' ZIP
Phone # O River Basin
Adj. Wtr. Body (nat /man /unkn)
Closest Maj. Wtr. Body
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Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit **
Application Fee(s) Check #
PermitOfficer's Signature --
Issuing Date / t &pirationDat
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, 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/ 1-888-4RCOAST
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
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RODNEY B. SAWYER
1219
DELORES H. SAWYER
P O BOX 683
BEACH, NC 28512
66.1246/531
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North (Garoiit.-12. Department of Environment and ^laturai Resources 16,�'�!�
Dn'-vlsjoi j of Coast2S Management `O
Michael F. Easley: Governor Chades S. Jones, D1rantar William G. Ross Jr., Secret ir!
Date ell —
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Applicant ;Maine7T
— -✓ � idt/C?
Mailing Address ` I / c Y P
i11 O r z e► cjj
to a�ci on 3ni-
f certify that f have authorized (a�t`ent) e
b
behalf, for the purpose ei aapplying for and obtaining all LAMA Permits necessary to
install or construct (activity)---
O
at (locatioaa)
This certffication is thru (date)
'Signature
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Te c'4v e u �Lv c y— is
(Name of froperty er)
property located at 9 6
0 rr-- 0
(Lot, Block, Road, etc.)
on M i Mqt LIE-7 gAC' PA4— , in A 4 at Se 4 N.C.
(Waterbody) (Town and/or County)
Applicant's phone #: — Y7 --?e9lifif ilmg Address: z!Z / / 1le r dl.5 { Or,
_ 620r head 0; 2�.(7 ZASSj
He has described to me, as shown below, the development he is proposing at that location, and, I
have no objections to his proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
ffo�bef" � y pr e �o����osing development)
�'�- L4 t 6
(Info` —nation for Property Owner Applying (Riparian Property Owner'Idormation)
for Permit) SSb ( —
4 2-1 e.!3"f- V Kilo
Mailing Add//ress ' Signature
fit
City/State/Zip Print or T Name
�:Zs'z - --Z y?— a c� � � � l �f �- 9 -3 <. - 3 f l I
Telephone Number Telephone Number
S ature ate Date
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to ! .UC4,z f Is`/�//lj
(Name of ropertyw er)
property located at
(Lot, Block, Road, etc.)
on M'�1 cPt I�FK-- , in /';� f % N.C.
(Waterbody) (Town and/or County)
11�-c%,
b
2�
Applicant's phone #: 4.Z7 47elkailingAddress:
-e/2 / �i`r�C
r �S
/-J►-,
tor-h.eaca�
C�,` �`.,+
iU,C- 2YSS j
He has described to me, as shown below, the development he is proposing at that location, and, I
have no objections to his proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(T'o�be filled in by pro owner p osing development)
e(SS I 5
�f� �G�
\2
i3 a ��
CIPIB I I [^
fV1 '
b
(Inf anon for Property Owner Applying (Riparian Property Owner )
for Permit) S a
SiSnat m,
Mailing Address
print or a Name
City/State/Zip
Telephone Number
*Siature
c1- V Z 7— a (y -/
Telephone Number
Date
j
W
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11 pZ 8 Z 10I,
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applicant:
Date:
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)
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
lem2 im acts
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount
redge ❑ Fill ❑ Both ❑ Other
redge ElFill ElBoth El Other4,
,
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 ❑
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