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Home My WebLink About54147_WILLIAMS, ROBERT_20090615E] CAMA / 1:1 DREDGE & FILL I/ r- A 1, AY V GENERAL PERMIT Previous permit # []New []Modification []Complete Reissue Ll 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 Project Location: County Address City State ZIP Phone # Fax # Authorized Agent Affected El CW D EW [I PTA El ES El PTS AEC(s): 1:1 OEA E HHF El 1H El U BA El N/A El PWS: El FC: ORW: yes / no PNA yes / no Crit.Hab. yes no Street Address/ State Road/ Lot #(s) Subdivision City ZIP Phone# River Basin Adj. Wtr. Body (nat /man Closest Maj. Wtr. Body NONE MEN No 1110 ME ON MEMO M. M. 11111010 111M NINE ME 1110 ME SOMME ■ I MINN= MEN limmmmm mommoom is Mm�lllllm ON moomm mimmsessolimm�mm NINE ME 0 MENNOMMEMEMENE 9JENEW, No limommommimmu IS EMENNEE IN limmommmmsiom sim�ommmolm�m III simmmommommimom mimmmmmmmmlim� simommommoolim� limommmmonimmimom limommommimmimmm all lmmmmmmolmmiimmm NINE MINN IINNEEMENEENIMMEN INEENNEEMENIN oil limm=Emmmlm IMEN limommmomolmmiimmm 00 mimmmmmmmmimmiimmm 1110111111111 Y'- ent or Applicant Printed Name Signature ** Please read compliance statement on back of permit" 2, Appli'c`ation Fee(s) Check # Permit Cifficq&. gnature Issuing Date Ekpiration Date A Local PfakningJuriscliction j Rover File Name of 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 consistentwith 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/ 1-888ARCOAST Location: Fax: 252-247-3330 2728 Capital Blvd. (Serves: Carteret, Craven, Onslow -above New River Inlet- and Pamlico Counties) Raleigh, NC 27604 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: 9 10-395-3964 (Serves: Brunswick, New Hanover, Onslow -below New River Inlet- and Pender Counties) Revised 08/09/06 ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIER/MOORING PILINGSIBOATLIFTIBOATHOUSE) I hereby certify that I own property adjacent to �o`„-� , n, �„ s 's (Name of Property Owner) property located at 15$ —SLAy%x OeXJ g .1i '�D "" (Lot, Block, Road, etc.) on 09 cce Cu,...� in Le4cr �t>-"+� (Waterbody) (Town and/or Coun ) Applicant's phone 343- 44ta2Mailing Address: 1.50 ag594 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) % Oct. r�Vke%A.5 Ib ------------------------------ U' ---------------------------------------------------------------------------------- (Information for Property Owner Applying (Riparian Property Owner Information) for Permit) 5�s !YY Mailing Address Signature Order &, PC Cityi StaieiZip Ps';-373- Te umber 6hF, 7 Signature Date Print or Type Name As -a- 34 3 - e t s-? Telephone Number — l Z— 2cwo Date F4CDENR North Carolina Department of Environment and Natural Resources Division of Coastal Management Beverly Eaves Perdue, Governor James H. Gregson, Director Dee Freeman, Secretary Dates?�' L Applicant Name Mailing Address 2_*- Y IS certify that I have authorized (agent) S (� r o act on my I fy (� ) c� behalf, for the purpose of applying for and obtaining all LAMA Permits necessary to install or construct (activity) 9 at (location) / This certification is L & id thru (date) E C Signature 400 Commerce Avenue, Morehead City, North Carolina 28557 Phone: 252-808-2808 \ FAX: 252-247-3330 \ Internet: www.nccoastalmanagement.net An Equal Opportunity \ Affirmative Action Employer — 50% Recycled \ 10% Post Consumer Paper ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIER/MOORING PILLYGSIBOATLIFT/BOATHOUSE) I hereby certify that I own property adjacent to �jp�--� lt;�,'s (Name of Property Owner) property located at Sid' (Lot, Block, Road, etc.) on , in , , N.C. (Waterbody) (Town and/or ounty) Applicant's phone #;,�i -.393 -14462Mailing Address: 15rD9" Su-A,5� Dry 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) AC (Information for Property Owner Applying for Permit) /S-f/ `k "�r Mailing Address T City/ stalt /zip Z�S�fl Lf (Riparian Property Owner Information) Signature Print or Type Name '-w'J A --z f r-f L- L,-�_/ -- \, {; 5 DR. KAREN J. ARMSTRONG 252-393-4462 158 SUNSET DR. CEDAR POINT, NC 28584-9314 Pay to the Order 2020 &?4=Date 66-19/530 NC 62 1$ - ��,, CAIDollars �; •• Bankof America Bank of America Advantage® ACH R/r 053000196 NP For 1:0S3000 L9El: 000691?07 IS 2no 20 20 Sa srs3+ r J • a