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HomeMy WebLinkAbout54665_ROESCH, JIM_20091027gaCAMA / ❑ DREDGE & FILL GEIVRAL PERMIT ONew' ❑Modification ❑Complete Reissue Previous permit # El Partial Reissue Date previous permit issued 54665 C 11 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 j ❑ Rules attached. Applicant Name -7i cle f`1 Project Location: County Address ; '; I ` C 1 E t Street Address/ State Road/ Lot #(s) City �1(hti LiState�f�ZIPQ Phone # ( (7'7 ~ Fax # (=j` Subdivision Authorized Agent t"�rk. 'r/ 1 - City ZIP 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 Phone # O j River Basin F' Adj. Wtr. Body !, r f I # (nat /man /unkn) Closest Maj. Wtr. Body 41 ' ' '' • ��N■�■■►■ilN��T�if�� ►�v� ��\■%rim■�■!� :■■■■!:: :■:nMENMEM NONE M all H ■:■ :■:�■:■:■■■:■:■::: ■■■■■law■■■�iR:■�/■il �/lIIC�1��■■■■■■■■■■■■■ ■= ■■■■I�Moo�rc!-■■::iil! .. - «'■■■■■�■■■■■■MENNE °MEMO®M■■M■■f/IMNil■Orr■21■■■■■ ■■NA11000 ■■■■■i[r■■■■i ■Oal■�i►aa1■r wIU■LINT■ ■17NiEfla.■! ■■■ i �i �■i�■�alWi N= �`�■■1 i u � di■ IM r'* WOMEN Agent or'Applicant Printed Name Signature Pjlse read compliance statement on back of permit r /'mot. Application Fee(s) Check # Permit Officer's Signature Issuing'Date t Expiration Date E� Local Planning)urisdiction Rover File Name IN 4 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 CarolinaCoastal 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/ 1-888ARCOAST 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) tsn r, Noln.r Ca�oiin Depar meat o- Cnyircmn, mt and Niatu;ai Reso ces Division of Coastal Management Charles S. jones, Direciol oq :Applicant Nam, Mailang N(ldress--- SOtA_� Plcw'n�1~ /\/J 0-70 90 1 ecrtif-c: that I have authorized (ahent) %r t� ��F` !"? % to act on m<< behalf, for the Purpose of applying for and obtaining all CANIA Permits necessary, to install or construct activity) at (location)Ve This certification is valid thm (date) q � � �',� Signature L • �.� - 410 Commerce kvenue, Morehead City, North Carolina 2855' Phone: '252-808-2808 !PAX: 25'2-247-3330! intemefI- www.iicr,cas.aimanagement.ne�L u Ecg�at � pcat�reb E Affuracive klbr E.mplayer — V-O' Re;� gW i IM'= Fvai Cons ih„c-r Fier UNIT EQ+CC� � Al 1,� C PC'm4 • Sender: Please print your name, address, and ZI-1344 M this box • 1Drcc4 fie& -P 0. B-O� �D('O'g I�C a65SIc x 9_� ■ 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 maiipiece, or on the front if space permits. 1. Article Addressed to: , V-A uo Yr e— A. S' ature t 4N aAgent X "" ,Addre 13; Received bynte ffme) C. D �ii>/f 1 �' �1 � D. Is delivery address different from item 1? ❑ Y s If YES, enter delivery address below: ❑ No 3. Se ice Type Srtified Mail ❑ Express Mail ❑ Registered ❑ Return Receipt for Merchandise ❑ Insured Mail ❑ C.O.D. 4. Restricted Delivery? (Extra Fee) ❑ Yes 2.1 I 7007 0710 0001 5273 2356 PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540 ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIER/MOORING PILINGSBOATLIFT/BOATHOUSE) I hereby certify that I own property adjacent to �. 11 m Roesch-'s (Name of Property Owner) property located at - re r �r . Or I C'h 4Tk ( I ! '�I )� (Lot, Block, Road, etc..) J �l on W �ITI(�f�`� t iY�� ,ln �lY� �if� I / PCL/'7i//CD lam• AC. (Waterbody) (Town and/or County) 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. I do not wish to waive the setback requirement. I do wish to waive that setback requirement. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: (To be filled in by individual proposing development) �ro 05td L', k l,oC MA-`01- Signature Print or Type Name Telephone Number Date: 10''//� 7 gAmplol BROAD CREEK CONSTRUCTION (--i -- 1033 PAYROLL TAXES r , Lo 66-112/531 11 CREEKVIEW CT _./ (,� MERRITT,NC 28556-9572 2 -7 `�� r BRANCH BANKING AND TRUST COMPANY 1-800-BANK BBT BBT.com I1tilPntl CIaM^