HomeMy WebLinkAbout53607_THOMAS, BELL_20090416❑LAMA / ❑ DREDGE & FILL 41
GENERAL PERMIT
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rmit ermit #
II.Ww ❑Modification El 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
❑ Rules attached.
Applicant Name j c .{ L
Address
City \ ft 1l'1 _State ZIP
Phone # (') f Fax # ( )
Authorized Agent
ElCW ElEW ❑ PTA El ES ❑ PTS
Affected
fected ElOEA ElHHF ElIH ❑ UBA El 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 f r
Type of Project/ Activity
i
(Scale:
)
Pier (dock) length
Platf
Groi
Othe
Shor
SAV:
Sand
Phot
Waiver Attached. yes no
A building permit may be required by:
Notes/ Special Conditions
❑ See note on back regarding River Basin rules.
orm(s)
� - —�
r pier(s) _
n length
I
number
head/ Riprap length
avg distance offshore
max distance offshore
I
channel
cubic yards
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ramp - i--- -- -- - — � - -- —i-- - —� - = --- 1
house/ Boatlift
I I I I i
h Bulldozing � I
i
eline Length
i I
i
not sure yes no
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bags: not sure yes no
atorium: n/a yes ,no
os: yes no
I
Agent or Applicant Printed NarVe
Signature Pleas a ompliance statement on back of permit
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Appl"icafion Fee(s) Check #
f;
Permit Officer's Signature
Issuing Date Expiration Date
Local PIanrtingJurisdiction fiver, i�lel�ame
Agent or Applicant Printed NarVe
Signature Pleas a ompliance statement on back of permit
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Appl"icafion Fee(s) Check #
f;
Permit Officer's Signature
Issuing Date Expiration Date
Local PIanrtingJurisdiction fiver, i�lel�ame
446
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, certifythat 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/ 1-888-4RCOAST
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
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49
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a 5;;::4-
I lGili! L Q01lI!�epar inelli of Cnvi,on-ment and IKytural RoSOI!rGAc
ivlichze! F Easley, Governor
hwies S. Jonas, Diractor William G. Ross Jr., SecreL,r
Date -q - Ct —aC� —
Applicant Naaue
l LIL- l P b M)AS
Mailing Address �$ oi D G l)E55tD
� D
C- a'-7 '-�t
certiiv that lime a$i�tlan�;-izc;a (agent)�U Vim- t act �:� Rxa7
behalf, fa;i- tlae purpose Of appiyiiac for and obtaining all CA1� Permits necessary to
install or construct (acth'at.y) S1!5-4:�LJ A LL ---
at (lcacatioaa) _ a 14 `1
This certification is v aal-ad thru (date)
�ininaitaii'c
ADJACENT RIPARIAN PROPERTY OWNER STAMMI— ;Y
(FOR A PIER/MOORING PILINGSIBOATLIFTIBOATHOUSE)
I hereby certify that I own property adjacent to l L"t- —r He t S ,
(Name of Property Owner or Applicant)
Mailing address if different from location address
(town, state and zip) _4 2 U-sf11 FZ y(�;
phone numbers you can be reached a�—�� ! `f141-0-
property located at a `� y ��-� V,$ CJ �� �D a
(Lot, Block, Road, etc.)
on _M� C1 64 T 6 Aq 1 , in P'C L-A fJT l C, i3 C C 1- N.C.
(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/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.
I do wish to waive that setback requirement.
initials
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DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
oprLt-1
-- ------------------
( Signature
tSTJ H6—wRdti�� Diu
s v�4 W Pe L L Print o Type Na
J-4 2&3fS-
Telephone Number
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGS/BOATLIFT/BOATHOUSE) r
I hereby certify that I own property adjacent to B LLL —rl4 t Ym (�E 's
(Name of Property Owner or Applicant
Mailing address if different from location address r1 S'a b 6 u S P.h
(town, state and zip) P ) L L5 g Li F-oy G P
Cphone numbers you can be reached
roperty located at ot I ( .
QL/ b
a lb q'7
L (Lot, Block, Road, etc.)
on 00.yt5p Q 6 J+-r 8 A-y << , inol LANT(c BC4-1 , C, N.C.
(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/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.
tlals
I do wish to waive that setback requirement.
initials
----------------------------------------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
PIS �C�61_
S—i )
Signature
RliCLRp 1kRPIE
Print or Type Name
-736 07e6 �
Telephone Number
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P . O. Box 1885
Morehead City, NC 28557
252-726 1253
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