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Home My WebLink About56308_ROYY, THOMAS_20100809❑CAMA / I❑i DREDGE & FILL 14ro GENERAL PERMIT - 4 -4 nl/z /J Previous permit # ENew ❑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 15A NCAC 0 Rules attached. Applicant Name Address City State ZIP Phone # ( ) Fax # O Authorized Agent 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 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 Id R = ■■■■■ ■■■■■■■■■■M■■■■■■■■■■■■■■ MEN ■OEM IWOMMMMEM NE■■ ■■.■■■■■■■■ a■■.■■■■�L�S1Ei.!■■......■.. . - ■,L' t■i�r■l E�■�1. ■■ 3■.i'► ■■in■i■� �i�� ■WRE■■■i ■■E.—HE■■■■■CEENLEYESEPNEEMMENINEL!�MMUM ME ■■■r■■Gib■I�:�i■F■■�■�1%■i■■■■1i■t■■■■■ Clio MOMMEMOMM ■■■M■■■■■■■■EM■■■■■■■■■OM■■■■■■■■N■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ Agent or Applicant Printed Name Signature ** Please read compliance statement on back of permit ** Permit Officer's Signature ) Issuing Date Expiration 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, 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 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. Raleigh, NC 27604 919-733-2293 Fax:919-733-1495 (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 :.jplicanr'L1/� 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 im acts) FINAL Feet (Anticipated final disturbance. Excludes any restoration and/or temp impact amount Dredge Fill ❑ Both ❑ Other ❑ __Lem Dredge ❑ Fill ❑ Both ❑ Other ❑ VEC) �1 Dredg,,e ❑ Fill ❑ Both ❑ Other ❑ Dred e ❑ 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 ❑ A 07/30/2010 15:31 2523932463 PAXON HOLZ ° RECEIMPAGE 01 JUL 3 0 2010 !'Aorehe-od ri,,v rx mi (,H'UA A FIBR, INI�VUXI,NG PILI.NGSIBOATLIFTIBoAT'HOUS-F) rt I hereby certify that I own property adjacent to� t (Name of Property Owner or Applicant) Mailing address if different from location address �QFtJVt ( l (town, state and zip) G —" _-' , %jl • �if+ c. phone numbers you can be reached at ig—z S'— property located at tors;*.- p ti, 0C (Loi, Block, Road; et Materbo4ly) (Town andfor County) ' N'c' He has described to rne, as shown below, the deveToprnent he is proposing at flat locatio�a, and, I have no ��bJections to his proposal. I understand that a pier/mooring pilingvboatlift/boathous� must be set back a rniairnurn distance off n feet (151frorn my a3ea o f riparian access unles,� waived by me, . I do not wish to waive the setback requirement, I:[s s I do wish to waive taG setback requirement,�� --------------- MSC:RIPTIQN AND/OR DRAWING OF FROROSFD- ------ •-- --- DEi'ELOPMENT; (To be flted fn by individual proposing devetepment} ------------------------------ riumoa[ s 07/30/2010 15:31 2523932463 PAXON HOLZ PAGE 02 r - RECEIVED A FU�&MV U.li1NGG PILINGSIBOATL&TI.BQATHQ Morehecid I hereby certify that "I own property adjacent to Crty Dt;Np +� (Nance of Property Owner or Applicant) Mailing address if different from location address (town, state and zip) phone numbers you can be reached at property located at k s d �A of D (Lott, Block, Ptokd; etc,) on A q` , In (Wnterboft) , KC (Town andlor County) He has described to me, as shown below, the development he is proposing nt ihat location and, Zhave no objections to his proposal, I understand that a pier/mooring piiings/boatlift/boathouse must be &et back a minimum distance of >'lata feet (I5jorom my area waived by me. —of riparian access unless --- I d� wish to waive the setback rquirement, X44"'� I do wish to waive thaw setback regazrement, rr,rU�- DES C P Ip_ TION AND/OR DRAWING OF PROPOSE1)---------------------------- --- .__ (To be filled in by individual proposing development)LOPDDEVELOPMENT: -. •-.--..--------------a---------------------%--------------- gnature '�•• It Pr1af or Type Name Telephone Number —� -C; GERALDINE M. ROJY 2745 THOMAS J. ROJY, JR. MD. 66-19/530 NC 208 BOGUE SOUND DR. V 8211 CAPE CARTERET, NC 28584-9714 Date P c$��b� t t orde of FpP1uieb Dollars Bank of America ACH R/T 053000196 MemoOft A- PZ41 1:053000 1961: 0008 2006703 1i1' 2745