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Home My WebLink About56926_SMITH, MIKE_20101026CAMA / ❑DREDGE &FILL GENERAL PERMIT Previous permit# ❑N.,aW 1:4Modification El Complete Reissue El Partial Reissue /2� Date previous permit issued As authorized by the State of North Carolina, Department of Environment and Natural Resources a and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC O Rules attached. Applicant Name Address City Phone # ( )_ Authorized Agent Affected ❑ cW AEC(s): ❑ OEA ❑ PWS: ORW: yes / 'no si State ZIP Fax # ( ) ❑ EW ❑ PTA ❑ HHF ❑ IH ❑ FC: PNA yes / no ❑ ES ❑ PTS ❑ U BA ❑ N/A Crit.Hab. yes / no Project Location: County Street Address/ State Road/ Lot #(s) Subdivision City_ > cj ;c.,i l t p ZIP 2965'lu Phone # S11, River Basin Adj. Wtr. Body `-' t' E > 3 ~ ' x.? nat man unkn n I Closest Maj. Wtr. Body EMMEEE®■■■■■■■M®■E■IMMEME ■■MIMEN MEMO _-- ■■■■■■■■■■■■■■■■■■■■■■■III■■■■■■■■■■■■■■■ - .... - : M. - E ■■■■■■■■■MEM■EME:■■■�.MMKIN :■■■■ IMMEM ■..■!..■I■I■■®OEM■!M■!�■■E■MM■■■■.■■■.■■ MEMO NEON ■..■■..■■...■■■.®�iii■■ICI■■■. ..■....■...■..EGrrul.■�!!!!.■..MO■...■■■■■ ■M ii�lii■■L::i:■::r�.i�.��li.r::■�Ili�■:' ■■ NONE OMEN ■■M■■M■■■■M■■■i"iij#■(■■■■■■■■■■■■■■■■■■■■■ ■■■E■■■■M■M■M■EEC! I■■■■M■■M■M■■®E■MM■■N ■■■■■■■■■■■■■■■■11■I■■®■■■■■■■■OEM■■M■■■ ■M■NEE■IEEE■I■�1El1Ef �■■■■■■N■E■IEEN■E■■■E MEE■ EEEMEMEEE�:l�M�:E�EEEE■EEEEEE��EEEEM ■EME■■NEE■NEEONI�l1■■■1#MN��`''I i i■Mi■MNIiNI II■SNINNi■IiiM■M■■■N■■WMM■■NE Agent or Applicant Printed Name Permit Officer's Signature Signature ** Please read compliance statement on back of permit ** Issuing Date Application Fee(s) Check Expiration Date Local PlanningJurisdiction e 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 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 NC Division of Coastal Mgt. Habitat Impact Computer SP_ Applicant: Mi1w Smith Date: 10/29/10 Permit #: 56926C 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 amount) TOTAL Feet (Applied for. Disturbance total includes any anticipated restoration or temp impacts) FINAL Feet (Anticipated final disturbance. Excludes any restoration and/or temp impact amount Open Water Dredge ❑O Fill ❑ Both ❑ Other El —impact 144 144 Dredge ❑ Fill O 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 ❑ 252-808-2808 :: 1-888-4RCOAST :: www.nccoastaimanagement.net revised:02/03/10 To : 91C_l^c72 ADJACENT RIPARIAN PROPERTY OWNEIR STATEMENT (FO.R A pf1. R/I KoojuNG PiliNGSIB OA TZ IFTIB dui 7'HO USE) I hereby certify that 1 own property adjacent to �= /\ G � Y�'► % �� (Name of Property Owner)�� -56 Z 1 �rilk �roperry located at (Lot, Block, Road, etc.) SIM) Jkz Az_ [4 5b (Water ody) (Town and/or County) Applicant's phone #: 3 mailing Address: Ke 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 / boatlif.•t / honthou C! ' must be sec back a minimum distance of fifteen feet (15') from my area of riparian access unless waived by me. (l,fyou wish to waive the setback, you must initial the appropriate blank w.) I do not: wish ro waive �.1. do wish to wave that setback requirement. -------------------------------------............----------................------------................------ ---- DESCRIPTION AND/OR DRAWING OF PROPOSED DEVGLOP,,M'ENT; (To be oiled In by lneffi4dual proposing development) .................. ......................................... .............. :t---------------------------- ------- (Information for Property Owner Applying (Riparian Property Owner'Xnformtinrn ) for Permit) )) Mailing Address Stgnar.:"e CitylStuteJZip Telephone Number G' � 16 37 - 2.7ov Telephoneumi?cr Signature D.tle ' FEB-19-2010 11:13 From:DCM MHDCTY To:919103470748 Pa9e:414 .r +6; /� �rDE] R ',r,rh i ,:af ;iina of Environmer'if. �iocl ; •r,-ri.; DiviciDil of Coastai Ikiana-oament i�Fj V1?; J,arn P-S H• Grags-on, Oirector t_-EF -t?erf'wn. Date Applicant Name MailingIn Address �- Tick—SICIIITO f certify that is have authorized (agent) Z�— I'm1'el to Act on n:y behalf, for the purpose of Applying for and obtaining all CAMA Permits necessary to install or construct (activity) r at (location) This certification is valid than (date) Signature /`� . e �-- 400 Commerce Avenue, Morehead City, North Carolina 28557 Phone: 252-808-28081 FAX 252-247-33301 Internet; www.nccoestalmanagcmcnt.net An Equal Opportunity 1 Affirmative Action Employer- 50% Recycled \ 10% Post Consumer Paper Ja V-- ,1 : L�= Fr nni: To ADJACENT RIPARIAN P;R.OPERT'Y OWNER STATEMENT (FO.R A .P.J'.1: R/M. OOPJIVG RUJNGSIBOA TM r, TIB OA T110 USE) I hereby certify that. I own property adjacent to (Name of Property Owner) property Located at 13-8 "-- (Lot, Block, Road, etc.) (Waterbodyy) (Town And/or County) Applicant's phone t#: IML Mailing Address: He has described to me, as shown below, the development he is proposing at that location, and, i have no ob•jeetions to his proposal. I understand that n pier/mooring pilings / bonthft / honthou c must be set back a minimum distance of 1:Ifteen feet ('1.5') from my area of riparian access unless waived by me. (fryou wish to wi►ive the setback, you must initial the appropriate blank below.) 1 do not: wish to Waive .1. do wish to waive that setback requirement. ..................................................------..._........---------------------..........------.-------- -- DESCRIPTION AND/OR DRAWING Or PROPOSED DEVELOPi f NT: (To be fllled In by lnr/lvidual proposing development) (Ynforntation for Property Owner Applying for Permit) — 9zey Y/ztt�'6'- Mailing Address t;ity'Stute/Zip ' (Riparian Property Orvrler'lnformation) l b Print o: qao _sue-5(�-7/ `i'elep lone Number Telephone Nur,,!-!.r Signature Date ,' 4 V 66-7489/2531 1517 11OM392561 DATE T z0 C✓ 0 A Cam' � -<--, L'l DOLLARS n arine Federal Credit Union �.n NC drmWw.oq b,.,.,�, MEMO 1: 2 5 3 171,69 30: I L00000 39 2 SE V'0 15 17 MICHAEL S SMITH 04-06 102 MIDDLE ST. JACKSON�VJIL/-E, NC28546 PAY TO % li' �' AG 1V l w