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Home My WebLink About54191_WALLACE, JAIME_20090701-. ❑. CAMA / DREDGE & FILL �# 11 GENERAL PERMIT VV'0 �C Previous permit ,New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued As authorized by the State of North Carolina, Department of Environment and Natural Reso ces and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC _ Rules attached. Applicant Name } �, , V^0 W. �'� o r� Project Location: County -:40 . <: Address gatt, r n .,-t State !. Q Street Address/ State Road/ Lot #(s) �i) ZIP < 1 i 0 Phone # ( ) Fax # ( ) t Authorized Agent Affected —1 CW -] EW E PTA ❑ ES ❑ PTS AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A ❑ PWS: ❑FC: ORW: yes / no PNA yes / ;ho Crit.Hab. yes / no Subdivision r- City , c ZIP Phone # (;' ) 4 �jt. �=',� i `- River Basin ` . i .1 (7 - ^ h Adj. Wtr. Bod(—(nat man unkn Closest Maj. Wtr. Body Type of Project/ Activity Pier (dock) length (Scale: 1-20 • • . .. loom ■:C■■■■■■■■■■■■�■■■�■■■■..■�.■.�.. �i�::�■■■■�i�■■i■ w■■■Iu■■■■ 00111111 ■ ■■■■■■■■■■■■■■■ 1210-1NNI ■■■■■®■■■®■■ 1■■■.■■.■.■........■� 1■■■■■.■■■® ■ ■■■■■■■■■■■■■■®■■■ i■■■■■■■■■■■■■■ ■■■!L■■■■■■■■■■■■■■■� NINE ■\■�■i�■■■■■ ■■■■■■■■■: ■■■■�■■■� ' IN ANNE . ■■■ n■■■■■■■■■■ w" ■ ■■■ or Applicant Printed Name Signature ** Please read compliance statement on back of permit Application Fee(s) Check # Permit Officer's Signature /6 Issuni gDa�te Expiration Date f'. !�' 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, certifythatthis 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. (Serves: Carteret, Craven, Onslow -above Raleigh, NC 27604 New River Inlet- and Pamlico Counties) 919-733-2293 Fax:919-733-1495 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 JUN-23-2009 02:12 AM P.02 AjoA NCDENK North Carolina Department of Environment and Natural Resources Division of Coastal Management Michael F, Easley, Governor Charles S. Jones, Director William G. Ross Jr„ Secretary Date Applicant Name jqlql l° IN q It QC de�— Mailing Address :, Alc- 1i certify that X have authorized (agent) �R-6 0 to act on my behalf, for the purpose of applying for and obtaining All CAMA Permits necessary to install or construct (activity) , c4e "� b •q L I - t � at (location) lQD r�'lT This certification is v ru (datc) ! ~ i `-r r oat 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 110% Post Consumer Paper JUN-23-2009 02:12 AM P.03 ti< ai.t��t�lVV[1LlV[J,CLL1,(VUVJJUAILII''TIBOATHOUsr,'') 1, hereby certify that I own property adjacent to Mailing Address if different fzorn location addres (town, state and zip) phone numbers you can be reached property located at (Lot, Block, Road, etc.) (Name of Property Owner or Applicant.) )43 4 oil , in CQ9C, (Waterbody) ' {Town and��r County) , I -le has described to me, as shown below, the development he is proposing at that location, and, Ihave 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, ini sl ()(—"Ido wish to waive that setback requirement. ini als" --------- --------------------------- DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT; (To bejllled in by individual proposing development) Signature Print or Type Name Telephone (Number Date; (. �/ I www,necoastihanagementnet/Permits/ADJACENTRIPARIANPRCPERT'YOWNERSTA N ENr,pdf IJH-23-2009 02:13 AM P . 04 I hereby certify that I own property adjacent to 73�c,r (- ( L(cee- 's ! I (Name of Property Owner) property located at 3 I { �� o S' (Lot, Bloch, Road, etc.) on (Waterbody) in cc +r �� N.C. (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/boathou.se must be set back a minimum distance of fifteen feet (15') from my area of riparian access unless waived by me. Jdo not wish to waive the setback requirement. 1 I d.0 wish to waive that setback requirement. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT; (To be filled in by individual proposing development) �V Signature �^ Print or Type Name 45;-- 3sa -7 z.,Y Telephone Number C� Date: 9 4 J )ca— D 14 (,pc��,n CO'F'a"ar (0r PGtAEA W A LVACC— UOC-J <� CAPE Po)rr- C APF C -r- gr--r, 0 C� (10 X 2a� L 0-cc, J morPhesel Qfty pp r Ex15Tl+JG- WAS t— J� 0-7 of ,IA q f- SHORELINE PIERS & BOATLIFTS INC. 6895 DBA SHORELINE MARINE CONST 252-646-3212 30 ASHLEY BROOKS NCDL 7666496 BR66-21/66-21/5ANCH 0 580 PEARSON CR p 614 NEWPORT,NC 28570—(� / DATE PAY TO THE ORDER OF / V �/ / V /� f CTE /V / s cw CJC/ 4M K '- DOLLARS Back. WACHOVIA Wachovia Bank, N.A. wachovi c FOR 11000689Slim 1:0530002191:2054E 02557 II■