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Home My WebLink About57055_WHITLEY, THOMAS_20101223❑CAMA / ❑ DREDGE & FILL GENERAL PERMIT Previous permit# QNew ❑Modification ❑Complete Reissue ❑Partial Reissue /Z— 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 Project Location County Address City State ZIP Phone # ( ) Fax # O Authorized Agent ❑ Cw ❑ Ew ❑ PTA Affected AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ PWS: ❑ FC: ORW: yes / no PNA yes / no ❑ ES ❑ PTS ❑ UBA ❑ N/A Crit.Hab. yes / no Street Address/ State Road/ Lot #(s) Subdivision City ZIP Phone # ( ) River Basin Adj. Wtr. Body (nat /man /unkn) Closest Maj. Wtr. Body IMEMEM':■■■:■:■■■■:■■:■:::■■:■:■■■■:■■■ . MENOMINEE ■:■:■■1■■1'■11■11■1■■■1■111 MEN ■NM■M■M■■■M■■■■■M■■■■ ■OMIRVIENA 1■■■C■■::■:: ■■:■:■i■E■■■■■:■■■:■:!::::: Agent or Applicant Printed Name Permit Officer's Signature t Signature -- Please read compliance statement on back of permit * 3 Application Fee(s) heck # Issuing Date o Expiration Date 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 I) 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 ❑ Neuse River Basin Buffer Rules ❑ Other: 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/ 1-888ARCOAST 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 Aaplicant: / Date: a1 a3 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 cts) FINAL Sq. Ft. (Anticipated final disturbance. Excludes any restoration and/or temp impact avouno TOTAL Feet (Applied for. Disturbance total includes any anticipated restoration or temp im acts) FINAL Feet (Anticipated final disturbance. Excludes any restoration and/or temp impact amount Dredge ❑ Fill ❑ Both ❑ Other (1 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 ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ �o,�-G�w•��... � �-�? �v''�YJA_>i :: �,r.�r-;tr.nzc��.�x�l��...1....� .,r,r:f..nr�t ,t:,,-t, r� r�'e;a,� Eric Ellis Marine Construction DOCKS • SEAWALLS *BOAT LIFTS DECKS & REPAIRS Phone & Fax: 252.726.6775 Cell: 252.342.6775 205 Nottingham Lane Morehead City, NC 28557 3 2010 C r i o A T /! a; of12 1 27, �r N �S f G PC, GCJ o 0 of ADJACENT RIPARIAN PROPERTY OWNER STATEMENT � DEC 2 3 2010 I hereby certify that I own property adjacent to �s �/�' `�/E=� s (Name of Property Owner) property located at �`�� Zn, w F "') —�� (Lot, Block, Road, etc.) on e -,- / , in 146/ ,Z,41 C 9C--4C 4� , N.C. (Waterbody) (Town and/or County) AppIicant's phone #: S-a Mailing Address: )00 X3;< /O o C7 He has described to me, as shown below, the development he is proposing at that location, and, I have no objections to his proposal. ---------------------------------------------------------------------------------------------------------- DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: (To be filled in by property owner proposing development) 1?rl) /i&-?�- ------------------------------------------ (Information for Property Owner Applying for Permit) Mailing Address City/State/Zip Telephone Number Signature Bate (Ri arian Property Owner Inform Signature PG,rry Print or Type Name Telephone Number //Zx� bo Bate ADjACE.N T RIPARLAN PROPERTY 0 W-NER STATEMENT I hereby certify that I own property adjacent to • %:z,,,� i¢s Gc��fi/�� (Name of Property Owner) property located at �� " CxJ S 7L- (Lot, Block, Road, etc.) on <2— i , inL/ , N.C. (Waterbody) (Town and/or County) Applicant's phone #: Mailing Address: ZOO SOX /'o G Err f�+o e/ I416, AM s--20 He has described to me, as shown below, the development he is proposing at that location, and, I have no objections to his proposal. --------------------- ---------------------------- ----- -- --------------------------------------- - - DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT • RIVED _ (To befilled in by property owner proposing development) DEC . 2 3 2010 -------------------- (Information for Property Owner Applying for Permit) Mailing Address City/State/Zip Telephone Number Signature Bate (Riparian Property Owner Information) Signature Print or Type Name Telephone Number Bate ERIC B. ELLIS JASA M. ELLIS 205 NOTTINGHAM LN. 252-726-6775 MOREHEAD CITY, NC 28557 4340 / 13 3 Date Pay to the �� A $ ado, cy� Order of 4 o �f-r✓N�rc= Dollars ®First Citizens Bank fiirrstci�tizeens.com For 1:0531003001:00131744878011' 04340 1—