HomeMy WebLinkAbout56344_ROUTT, JOHN_20100823' ❑AMA / ❑DREDGE &FILL
GENERAL PERMIT �7 Previous permit# {
New LIModification ❑Complete Reissue ❑Partial Reissue /i Date previous permit issued j
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_
Address _
City
Phone # ( )_
Authorized Agent
Affected ❑ CW
AEC(s): ❑ OEA
❑ PWS:
ORW: yes / no
State ZIP
Fax # ( )
❑ EW ❑ PTA
❑ HHF ❑ IH
❑ FC:
PNA yes / no
ES ❑ PTS
❑ USA ❑ N/A
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
Type of Project/ Activity
(Scale: )
Pier (dock) length
Platform(s) I
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore. a
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
-
J7
n
—
_
f
A
w
.6 -
I
1
3
�
I
Shoreline Length
SAV: not sure yes no
Sandbags: not sure yes no
Moratorium: n/a yes no
Photos: yes no
Waiver Attached: yes no
A buildingre
permit may be required b : y
Notes/ Special Conditions
El See note on back regarding River Basin rules.
Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit **
Permit Officer's Signature
fs ,
X .
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
Iandowner(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 complywith 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
2010,-08-23 09:49
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P 1/3
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2010,- 08- 23 04: 44
I 'hezeby Certify that I own rropzrty adjacent to
P 2/3
QV2me cr Yropvrtj 0-ti-a z- or PIkant.)
ylaalie� adclras4 if: difietc zt: fraui laciAtioz� �uldAess�• Itoo C,6.0 /LI-_-.,
(t(>1i+n, state: r-d Ap) -�I� i� 21(Z.
phone rittiK►ae-xs you o= ce =cW at.�� l � ...�-� � or) Ci
property lncatLd al 0 CLz/.
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(Lot, [34pck, Road, ctc.)
on c�G 1 c� u ..r� 1. �._. �tl / (� L. CA 12- L- E-7- 57 - N .0 '
(Waterbodj) ('.lawn an&6r County)
He has dPScrigGd tQ mz . as sh-owa below, tn.e devel0pxnertt he is eropnsin9 at tr-at location,
and, I have no objections tQ his proposal. Xunderstand that a piezIiilooriug pitings/boatlift/boathouse
must be set back a rainim,tun distance of fifteen feet (5) from.:ny area of riparian access unless
waived by me.
I do not wish to waive the setback requirement.
W;izls
I do wish to waive that setback regWtes'ter_t.
bWa[s
--- —---- ------- --------------
D-C, S cTjnjoN ,AIN DIOR DRAINING OF PROPOSED DEVEILOPNIENI T
(To be filled in by individual proposing development)
t r Gg Print or Type name
5
Talcphone Num-be;
Dam
w.nccomta]mutogea=t.ncJPermialADJ-:r.Tv".WPA214�1PY0.PEP YO*%N R.STA: Z
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2010-08-23 04:44 1 "UiCA ('11*lC/LfVV1[1lYtr! t�.ueu��►�vrai�+eA ciu•��x�.� •-�•�
r 1 nereby certify that I own property adjacent to 6wly
P 3/3
(Name of Property OwIler or Applicant)
Ma,iliag address if differmrt front location
(town, state and zip)
phone nuinber.s you caa be reached at. % `�� o
prnl7erty locat:ci i:t y // D, �.•Gt��D.�,c"2r CrA /aC- � /�ly� k2 E F' ��-,..—.,
(Lo4 Block,.toad, etc.)
on oG Uc C vUt,N in CA %�� CA t? T' GZ N.C.
,., (W aterbody, (Town and/or CottRty)
fie has described to me, as shown below, the development he is proposing at that locauzon,
and, l bave no objections to his proposal. I understand that a piezJrmooring pilings/boatlift/boathouse
must be set back a minimum, distance of fifteen feet (15) from my area of riparian access witless
waived by me-
_ I do not wish to waive the setback requitement.
initials
I do wish to waive that setback requirement
initials
Dl~;SCRII''S'ION AND/OR DRAWING OF PROPOSED )DEVELOPMENT:
(To be filled in by individual proposing deV&Pmeret)
Ll
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---------------- ---- - '-- 0.--- _
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Print or Type Namt
Telephone Number
Date:
.� t�MF��I i.D�
w'ww_n=O;Uta M&m..Menc.MUPenmimfAl)Jt.CEN'ri,IPARW4PROPEMOWNERST
JOHN W. ROUTT, JR. ��Q �66-7704/2531 3315
THE1ww-----\ LIC.5703027
CGofYen Circle 804 FEDELON TRAIL PH. 734-4722
/ GOLDSBORO, NC 27530 DATE J
v CLUB kft'tc
e PAY TO \V�—� J
THE ORDER OF J�
L^ �K G (� DOLLARS
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State Employees' Credit Union®
Goldsboro, North Carolina r ,
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MEMO I (O _ - -- � --- -
t: 25317 70491:08606 2704C3E, LS
SPEGNIrvtEupv
;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
im act amount)
TOTAL Feet
(Applied for.
Disturbance
total includes
any anticipated
restoration or
ternimpacts)
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount
Dredge Fill ❑ Both ❑ Other ❑
9
�aO
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 ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑