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HomeMy WebLinkAbout54316_SMITH, RALPH_20090724CAMA / ❑ DREDGE & FILL\ q( GENERAL PERMIT Previous permit # ❑New ❑Modification []Complete Reissue El Partial Reissue Date previous permit issued As authorized by the State of North Carolina, Department of Environment and Natural Res ces and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC ❑ Rules attached. Applicant Address City State ZIPS Phone # ( ) Fax # (`) 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 ; r ., ZIP Phone # (4r) r River Basin.``i { 1„ Adj. Wtr. Body i< ,,, f e ,a �(nar /man /unkn) Closest Maj. Wtr. Body,, Type of Project/ Activity (Scale: Pier g Platf Finge Groi Bulkl Basir Boat Boat Beac Othc Shor SAV: Sand Mon Phot Wain r pier(s) length 10111IMMEMEMMINI1:::■ :1■C■■■■:MO■11■■■■ ■■■■■■��■■■■■■■■■■■■■■■■m■■■■■■■■■■■■ number ■11::■:1::::::■� ■■■ M ■"::■::::■a■ avg distance offshore- ■■■ ■■■■■■■■■■■:■■■■■■.■■■■■■■■■■1 ■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■ ■■■ max e mom MOM ■ ..■■....■..........■■.I.■®.■.■■■■�■ ,channel V cubic yards ramp 1■:■■ni i■■��i ii1■■�■:■®:■��� ■ ■W■ -i Bulldozing ■■■■■■■■. i■■■■■■■■■ ME ■■■■1■■:::: �:■1®■■■�■■■®■■■�: MEN . ....... .■.[!.■... ...■...■■...®. • ■■ ■■■■■:■■ ■WEMO MM■ ■■■■■■■■■■■■■■ ■■ • ■■■■■■■■■■■■■■.■■■ ■■®■■■■■■■■■ ■■■■■■ A building permit may be required by: i-+ Notes/ Special Conditions Agent or Applicant Printed Name Signature ** Please read compliance statement on back of permit ** Application Fee(s) Check # ❑ See note on back regarding River Basin rules. Permit Officer's Signature Issuing Date Expiration Date Local Planning Jurisdiction Rover File Name f 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 (252-946-648 I) or the Wilmington Regional Office (9 I 0-796-7215) 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/ I-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 ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIERIMOORING PILINGS/BOATLIFT/BOATHOUSE) 1 hereby certify that I own property adjacent to �`\ �J� ifs' ��% ` 1 's (Name of Pr perty Owner or Applicant) Mailing address if different from location address �, r , (town, state and zip) phone numbers you can be reached at G . property located at 9 / 21�fD V t= -��?'�,'F L� (Lot, Block, Road, etc.) on OFE 5a J Nb , in cam' r li-l.6 -�� , Cftlzrtf-r (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/bo must be set back a minimum distance of fifteen feet (15) from my waived by me. am. o not wish to waive the setback requirement. initial y I do wish to waive that setback requirement. JUN_ 2009 DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: (To be filled in by individual proposing development) .�oQ� S•aJN41r> I R1 JUL .I 4' 2009 rV UM"(012d Cif,► DOM ------------------------------------------------------ 1----I---- Print or Type Name Telephone Number ' CM I ADJACENT RIPARIAN PROPERTY ONVNIER STATEMENT (FOR A PIERIffOORIAIG FILINGSIBOATLIFTIBOATHOUSE) I hereby certify that I own property adjacent to R4 CUP4 5YY1 JT-�V 's (Name of Property Owner or Applicant) Mailing address if different from location address -t;--�0Z (town, state and zip) ,/0', /'/. _, /U. C -770 phone numbers you can be reached at / % 959 --- 7 / 71 property located at / 4 I -;k -L-) F-1y e Q-s (Lot, Block, Road, etc.) on V�e_ St�6 N In -11�fTer=A CA L.C. aterbody) (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. lal I do wish to waive that setback requirement. in(4Is ------------------------------------------------------------------------------------------------------------------- DESCRIPTION AND/OR DRAWING OF PROPOSED DENIELOPMENT: (To be filled in by individual proposing development) g's6UL� �_'I C�� -b � —^'m`4- JUL 1 6 2009 INate"aad 01ty DOM 1 ------------- Skt,,, Print or Type Name C)k�'� -g(�5 Telephone Number � t Y d . s a'`A. No Lh C.ar011re Department 01 Eavi uiil e it and Nratillul RQSOLirces gqr anagsrinent Nlichze! !_. Easley, Governor Charles S. Jones, Diractor William G. Ross Jr., Secret,ry Date j�, pplicant Janie- - r 9'1" s dII� . Mailing Add n _ P � Ao �� I eertii'y that I have aut>r prized (ages , P� �( to aci on inn behalf, for the purpose cif applying for and obtab ing all CA'-'A� PerMW necessary to. install or construe', (acthity) �..�� L 1 � � - �� L -b s LF7 at (location)��-- This cer A�ication is � aj.-d 1-hru (date) Siriaatiire _ P9 FaIVED Morld 01ty QM RALPH L SMITH JR FARM ACCT PH. 242-5235 PO BOX 26 FREMONT, NC 27830-9584 C� BRANCH --r G AN. BCOMPANY �1 •B00•BA2NK BT B Bi. com -- --- __ -- ':053101 1 211:00010530B6 --__-�.-- 744u■01 265 1265 66-112/531 BRANCH 70601 ate ` $ '_7 cjf% cac' 3 Y oeuuv on eecx. ur"