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Home My WebLink About57047_WADE, ELIZABETH_20101229�� j � I��Ij o ► �� ❑ CA -MA / ❑ DREDGE & FILL GENERAL PERMIT )/Previous permit # ❑New ❑Modification El Complete Reissue ❑Partial Reissue /'lip 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 I SA NCAC ❑ Rules attached. Applicant Name Address City State ZIP Phone # ( ) Fax # Authorized Agent ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Affected 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 zip Phone # (�) River Basin Adj. Wtr. Body (nat /man /unkn) Closest Maj. Wtr. Body - N■■i■■ ■■■■■■■■■■■■■■■■■■■■■ ■■■■■■Muir■■ ' - Ir ■■■■■■■■ ■■ .■....i�■►..■■■.■d..■i711L1i11■`■►�■■■■■■■■■■ :n■■G■ENMEMEMEMEME■N■■:■:■MMENME■■EEM M ........................................ MMMM EME M■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ MOM OMENS ■� ■■■i■■■■■{�■■■■■■■i�■�■■■■■■■■►TON■■■N ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ E■■■■■E■E■ENE■■N■E■■■■■■■E■E■■■■■■■■■N■ - ■■■■■■■■NEE■■■■■■■■■E■■E■■■■■■■■■■■■■■ Agent or Applicant Printed Name Permit Officer's Signature Signature ** Please read compliance statement on back of permit* f Application Fee(s) Issuing Date Check# Local Planning Jurisdiction Expiration Date Rover File Name M 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 252-808-2808/ I-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 Applicant: Elizabeth Wade Date: December 29, 2010 General Permit #: 57047C 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 ® 120 120 Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ A" NCDENR North Carolina Department of Environment and Natural Resources Division of Coastal Management Beverly Eaves Perdue, Governor James H. Gregson, Director Dee Freeman, Secretary RECEIVED Date DEC 2 8 2010 Applicant Name Mailing Address i certify that Y have authorized (agent) _ u �j �3 , /� j 1)r S>aS to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary to install or construct (activity) If — at (location) J J s� I-c,O K LoLoli This certification is valid thru (date) Signature GJ � 400 Commerce Avenue, Morehead City, North Carolina 28557 Phone: 252-808-28081 FAX: 252-247-33301 Internet: www.nccoastalm'anagement.net An Equal Opportunity 1 Affirmalive Action Employer — 50% Recycled 110% Post Consumer Paper ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIER/MOORING PILINGSBOATLIFTBOATHOUSE) , C'9 r I hereby certify that I own property adjacent to £Casa ha-) C e nE de (Name of Property Owner) �Cit.' property located at c• rz 1 ' (Lot, Block, Road, etc.) on CAwAL, ,in KC� ,N.C. (Waterbody) (Town and/or County) Applicant's phone #:�1 .3�� Z3 Mailing Address: `31 Z'31-'-1 1 1--, ,i 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. (If you wish to waive the setback, you must initial the appropriate blank below.) I do not wish to waive I do wish to waive that setback requirement. --------- ------------------------------------------------------------------------------------------------------- DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: (To be filled in by individual proposing development) I L., .r i ----------------------------------------------------------------------------------------------------------------- (Information for Property Owner Applying (Riparian Property Owner Information) for Permit) ,312-:S�I�, `N L0L,E:: Mailing Address W,4J) in , )i .2.--)6 !S City%State Zip+ G A 30Z Z 30o Telephone Number Signature ��oti vJl��SS Print or Type Name ZS--�-' 22 - _3 E j Telephone Number Signature Date Date 40 ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIER/MOORING PILINGSBOATLIFTBOATHOUSE) I hereby certify that I own property adjacent to saw }, 4 v n n 's (Name of Property Owner) property located at 5 -T IL (Lot, Block, Road, etc.) on tv a L— , in Pk S , N.C. (Waterbody) (Town and/or County) Applicant's phone #:'T i 1 '3 JZ Mailing Address: 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. (If you wish to waive the setback, you must initial the appropriate blank below.) I do not wish to waive I do wish to waive that setback requirement. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: (To be filled in by individual proposing development) / S-5 S 1-30rzc I r J�Ja (Information for Property Owner Applying for Permit) Mailing Address City/State/Zip 49- 1 Cl 130-Z- 2300 Telephone Number (Riparian Property Owner Information) Signature Print or Type ]`dame ,�</'0%— 6� o �O Telephone Number Signature Date Date IM L1 MUD BUCKET DREDGING INC 4744 507 HEDRICK BLVD 66-112/531 MOREHEAD CITY, NC 28557-3045 Date ` 1 Pay to the Order of a Fea <; BRANCH BANKING AND TRUST COMPANY r 1-800-BANK SBT BBT.c0m - -C , 1110000474411' 1:053 10 L 1 2 11:0005 293 2 18341110