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Home My WebLink About56321_VAN MEETEREN, HANS_20100908W MA / ❑DREDGE &FILLIV•ERAL PERMIT Previous permit # � ❑New ❑Modification ❑Complete Reissue El Partial Reissue O" 'A 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 Address City ;tom s i ; State ZIPi 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 C_ C.' ZIP '( Phone # River Basin Adj. Wtr. Body -- r" na man unkn Closest Maj. Wtr. Body rvC�� rll■■■■■■■■■■■■■■■■■■■■■■■■■■rl�■■11■MOM ■■M No 111101111MOM M MEIN M OEM ■■■■■ri■■■■M■■11■■■■■!'�1■�ii■■■■■�i■■■■■■■■■■ . ME :.. ■■■■■■■■■E■■M■E■■■■■■■■■■■�■■■��■■■■■■MEN ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ii■■■■■■■■■■ ■■ ■■■■■■■■■■■■■■■ .■■■■■■■E!■■■■■■ ■■■■■■■■■■■■■■■■!■1■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■t�l■■■I7�1■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■1631■■■r■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■1■■■ii■■■■■li'i=■■■■■■■■■■■ •■■■■■■■■■■■■■■■■�0��ii■■■■■■■■■■■■■ •■■■■■■■■■■■■®■■■fir■r■■®■■■■■■■■■■■■■■ Agent or Applicant Printed Name f` Signature "Please read compliance statement on back of permit" Application Fee(s) Check # Permit Officer's Signature j Issuing Date Expiration Date Ya 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 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 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/ 1-888ARCOAST 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 NCDENR North Carolina Department of Environment and Natural Resources Division of Coastal Management Beverly Eaves Perdue, Governor James H. Gregson, Director Dee Freeman, Secretary 1. op USTOM Name of Property Owner Applying for Permit: n o-n Me64eren Mailing Address: -43 U.1 i HC P_S+eFz MaT__ Mwi* N(" I certify that I have authorized (agent) 6. kytom 0-yin. ei Cms+. to act on my behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to install or construct (activity) at (my property located at) an vy4mSidh 40 ah eX1541Y70 DXK �y 3 1Niv� �hcsfev ulrx,tr,PYlcYri�-,IUC . This certification is valid thru (date) V Property Owner Signature Date 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 110% Post Consumer Paper 9 ■ Complete items 1, 2, and 3. Also complete item 4 if'Restricted Delivery is desired. t ■ Print your name and address on the reverse so that we can return the card to you. j ■ Attach this card to the back of the mailpiece, L or on the front if space permits. j 1. Article Addressed to: �I �3 �1 �uc�t�r�r�lU iqy �Cl Cmn, I -IC A. /_j, , ❑ Agent B. Received by (Printed Name) C. late o Delivery '::�a i D. Is delivery address different from item 1? ❑ Yes If YES, enter delivery address below: ❑ No 3. Service Type Certified Mail ❑ Express Mail I E] Registered ❑ Return Receipt for Merchandise '+ ❑ Insured Mail ❑ C.O.D. 4. Restricted Delivery? (Extra Fee) ❑ Yes ( 2. Article Number 7007 2680 0002 8265 1452 (Transfer from service label) f LPS Form 3811, February 2004 Domestic Return Receipt (%� �ZCie ��j 1o2s95-024-11W UNITED STATES POSTAL SERVICE First -Class )Mail , ,1 Postage & Fees Paid LISPS Permit No. t;-10 ° Sender: Please print your name, address, and ZIP+4 in this box • �.��eScc11 (Yio.� (:��• -s-74 Dr �e00-0i Qc 01"M71 AWACENT RIIP.A,RMN PROPERTY OWMIR SrATEMIENT I hereby certify that I own pWerty Mjacaj to ' m \1 wi M(yf ellx.n 's (Name of Property Omer) property located at on �r. Ja i Cff c�, , in rn r o QM 1(0 N.C. (Waterbody) (Town andler Coutiy')' Appticaat's phone#: He has described to me, as shown below, the development he is proposing at that location, and, I have no objections to his proposal. Labc4) k)(Xay E X I,41 n� Dcc'L iPrgxsed I:X v1�i c 1 \Jan f'11 ee--Wen r4TWY ()peg+y y anftrmacton for Property owner Apptp�g for Permit) �) Mailing Address CCitylState/Zip Print or Type Name Telephone Number Sigmame, Dwe ?yf- 33,10-& Telephme Number Date UNITED 0 Sender: Please print your name, address, and ZIP+4 in this box 0 VO fox ;P4 c) r (- e IJC 66D ( : ; I!;; - Jijiji!J.. )1;11 It ). III! 0:11;IIIIJI 1 ■ Complete items 1; 2, and 3. Also complete S item 4 if Restricted Delivery is desired. +. ■ Print your name and address on the reverse so that we can return the card to you. ■ Attach this card to the back of the mailpiece, or on the front if space permits. Article Addressed to: -PAW L-4- 10-3?, `�1C A. Signature -0-Agent ❑ Addressee B. Received by( nted Name) C. Date of Delivery D. Is delivery address different from item 1 ? Yes If YES, enter delivery address below: ❑ No 3. Service Type I$�Certified Mail ❑ Express Mail /❑ 'Registered ❑ Return Receipt for Merchandise ❑ Insured Mail ❑ C.O.D. 4. Restricted Delivery? (Extra Fee) ❑ Yes 2. Article Number 7007 2680 0002 8365 1445 (Transfer from service label) - - PS Form 3811, February 2004 Domestic Return Receipt i�/IA��fo�� 102595-02-M-1540 ADJACENT RIPARMN PROPERTY OWNER STATEMENT I hereby =tify that I own propmV adjacent tD ` AL V6 MeAam 's QUM of Property Owner) property located at on a I 1 Co , in M e r�i-it Pam I I c 0 0) . , N.C. (Wady) (To" and/or County) unty) tt Applicant's phone #: � Addre� //�i z✓ 11, it (1� He has described to me, as shown glow, the development he is proposing at that location, and,I have no objections to his proposal. w E 14ir19 DccL Prqxsed �(In plee+e ren 46voy �P,W1a1L 'PCUQer i y Va;ormaMit ter Properly Owner Applying y owe ) for Permit} Mailing Address itylStawLip telephone Number Signature ,Date Signature Print or Type Name Telephone Number --4�1 �Cll C�I Daft Dinghy Dock 843 Winchester Way B PRESCOTT MARINE CONSTRUCTION PO BOX 874 252-249-0149 ORIENTAL, NC 28571 PAY TO THE ORDER OF 2107 DATE / % �' 66-30/531 472 j d Is 4/ DOLLARS First Citizens Bank; . }-5ZZ firstcitizens.co 7n �� ry FOR j� / v',✓Gz-"S 1 U `-'�' 11100 2 ID 7mv 1:0 5 3 100 3=4DO4 7 1 202 2049 ?III NC Division of Coastal Mgt. Habitat Impact Computer Sheet Applicant: Hans Van Meeteren Date: September 8, 2010 General Permit #: 56321C Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement found in your Habitat code sheet. TOTAL Sq. Ft. FINAL Sq. Ft. TOTAL Feet FINAL Feet (Applied for. (Anticipated final (Applied for. (Anticipated final DISTURB TYPE Disturbance total disturbance. Disturbance disturbance. Habitat Name Choose One includes any Excludes any total includes Excludes any anticipated restoration any anticipated restoration and/or restoration or and/or temp restoration or temp impact temp impacts) impact amount temp impacts) amount OW Dredge ❑ Fill ❑ Both ❑ Other ® 504 504 Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑