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Home My WebLink About55211_SUMRELL, ELIZABETH_20100226❑CAMA / ❑ DREDGE & FILL."""/ dC4mv=RAL PERMIT F-]New El Modification ❑Complete Reissue ❑Partial Reissue T� 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 I SA NCAC Applicant Name % f" Address City 1J 11 _ (' r` "; State_ ZIP �� Phone # O 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 Previous permit # Date previous permit issued_ E Rules attached. Project Location: County Street Address/ State Road/ Lot #(s) Subdivision City ZIP Phone # O River Basin Adj. Wtr. Body ` i V f L {nat /man /unkn� Closest Maj. Wtr. Body ■■■ ■ ■■� ■■�.-:� s�w■■■w�■■■ ■■■�i ■■■■■■■■ ..... ■■■■■::■:■■■■C®ME .....■■...■■■■■■fi■!■■ ...........■...��..■.■■N■.■..■■■. MEN ■■.■■■.■■■.■. MOORE �r �! pi a■■:■�::�:■� ■' ■■■■■■ ■■■■■■■■�■■■■■■i®f�■ ■■■■■■■■■■■■M ■■r■■■�J .r■■■■■i■f1■ ■■■■■■■■Ei11►■■■ ■■f� 11111111011110 �!■ ■ ■■\■■■■ INN .MEME ■■■■■■fi■4�1.�■■■r%■®ll�t�lhh�■■■`li ■■:■■■■■WR INMEM ..■ C . .simJ ■i. r Agent or Applicant Printed Name Signature ** Please read compliance statement on back of permit rf Application Fee(s) Check # Permit ricer's Signature Issuing Date I �s Expiration Date Local PlanningJurisdiction 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 2S2-808-2808/ 1-888-4RCOAST 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 AT A NCDENR North Carolina Department of Environment and Natural Resources Division of Coastal Management Michael F. Easley, Govemor James H. Gregson, Director William G. Ross Jr., Secretary Date 10 f is 10 Applicant Name Mailing Address el A I certify that I have authorized (agent) N I ODCxV r Le� to act on my behalf, for the purpose of applying for and obtaining all CAM" Permits necessary to install or construct (activity) _� V_W AtjQ pQU—, at (location) 9201 A 0 This certification is valid thru (d te) dl t"l (� jj�—Signature 400 Commerce Avenue, Morehead City, North Carolina 28557 Phone- 252-808-28081 FAX: 252-247-33301 Internet: www.nccoastalmanagement.net An Equal Opportunity 1 Affirmative Action Employer — 50% Recycled 1 10% Post Consumer Paper Appendix A Adjacent Riparian Property Owners Statement (for a bulkhead, dock/mooring pilings) adjacentto I hereby certify that I own property J (Name of property owner) ,t Ail property located at J ,-e Q (Lot, Block, Road, etc.) on �I �t J a �, ��, in �� Z� � �� , NC (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 mdock/mooring of pariah pilings must be set back a minimum distance of fifteen feet (15) Y areaaccess unless waived by me. I do not wish to waive the' setback requirement. I do wish to waive that setback requirement. Description and drawing of proposed development: (_To be f lled in by individual proposm development) Signature Print name -- Address r Date Telephone number A-2 Appendix A Adjacent Riparian Property Owners Statement (for a bulkhead, dock/mooring pilings) /,z' L .i/ rt2rl f/'s I hereby certify that I own property adjacent to tiE' (Name of property owner) property located at 30 (Lot, Block, Road, etc.) Nek-,; � , NC on N �; r✓�:� , in riLr�r� - / ,� (Waterbody) (Town and/or County) He has described to me, as shown below; the development he is proposing a at that dock/ooring location, and, I have no objections to his proposal. I understand pilings s must be set back a minimum distance of fifteen feet (15') from my area of riparian access unless waived by me. i I donotwish to waive th& setback requirement. I do wish to waive that setback requirement. Description and drawing of proposed development: �To be lied in by i I vidual proposing development) p F..... i ....__.._......._.__. 0./ �. 1..._.._. k'0 print name Address -Z G/ L� Date Telephone number A-2 NC Division, of Coastal Mgt. Habitat Impact Computer Sheet Applicant: Elizabeth Sumrell Date: February 26, 2010 General Permit#: 55211C 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 temp impacts) FINAL Feet (Anticipated final disturbance. Excludes any restoration and/or temp impact amount E Dredge ❑ Fill ❑ Both ❑ Other X 538 538 WL Dredge ❑ Fill ❑ Both ❑ Other X 500 500 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 Is ELKS DECKS N' DOCKS CONSTRUCTION, LLC 7175 N... 1483 CRUMP FARM RD. .� NEW BERN, NC 28562 �7 or NEW (252) 637-1595 DL8929001 20 66-112/531 Construction, LLC PAY TO THE /�� s _ v ORDER OF DOLLARS BRANCH BANKING AND TRUST COMPANY 800-BANK-BBT bbt.com 5 FOR :. ---- - �'�'�-''�..---i----_---- ror 110007175ii' 1:053LOLL20:0005195626296n'