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Home My WebLink About52171_JORDAN, HAROLD_20080124❑CAMA / ❑ DREDGE & FILL GENERAL PERMIT Previous permit # ❑New ❑Modification ❑Complete Reissue El 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 Address c L' r City State ZIP Phone # ( ) Fax # ( ) Authorized Agent Affected ❑ Cw ❑ EW ❑ PTA AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ PWS: ❑ FC: ORW: yes / no PNA yes / no Project Location: County Street Address/ State Road/ Lot #(s) Subdivision City ZIP ❑ ES ❑ PTS Phone # ( ) River Basin ❑ UBA ❑ N/A Adj. Wtr. Body (nat /man /unkn) Crit.Hab. yes / no Closest Maj. Wtr. Body . M. ME ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■A■■■■■■■■■�■■■■■■■i■■■■■■■!■■■■■1■ ■MEN 'MMEME:EREEMM ■:K:: :■:■!■■MM ME!■ ■IIl�I■■■C■■�■®E'rsitHJ�l■■■■■■■■■■■■■■■ •■■■■■■!■I■■■■■!ti■■■�IE�■■■■■■■■■■�■ Agent or Applicant Printed Name Permit Officer's Signature Signature ** Please read compliance statement on back of permit ** Issuing Date Expiration Date Application Fee(s) Check # Local PlanningJurisdiction 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, 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. 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 DEC 1 7 2007 I C ��orth C. a i-c-)k 01 M-nnapnnzrt 04 DCM William G Ross Jr. Secret' iry iviichaei != Easiey, Governor Chues . -onss, I Date -7 -2�-7 ,kppjica,ait Narne NUUH,ng AddrP�55 LL uent) to aef On M- I certify that I have autli'03-iz;e(I (a,-- behalf, for the PurPOse app1ying for and obtaining all LAMA Permits necemary to t') install or construct (activiq-) Sa,Q at (location) E-O-,E;;t LCLV\A"r\C, C - vyl-p-�Cj-& —(l -al' This certRficationlis ild thru. ecf4 [ zon F� (date) MA 6 Signature r_- JET ZO) ! r. iLY a `i_ 11i -11 � ij ��1i� ? (FOR A PIER/UIV,- OVERED BOA ' t or® � if r, I hereby ct,- ry that I own proper-; adiac�nt to a-7i s I E 0If rr0p-er-tV �STII�r property Icczted at 5g6 Z 'E Y-o - Lo-v,8 t✓�� c+ (Lot, Block, Road, etc.) on SO-LrrIO aterbody) (Tow-n and/ori County) He has desc�ibe--1 to me, as Shown belouv, the developr7ent he is proposing at tt at location, and, I have no cbj�tions to his proposal. I understand What a pieriuncovered boat LI- must be set back a minimum distance or ri c--n fit (1S') from my jarea or riparian access unless waived by me. / I do not wish to waive the seiback re::uirement. I do wish to waive that setback reGULrement. -------- --------------------------------------------------- DESCR=O- i A-ND/OR DR 'Y-YT G OF PROPOSED; DEVELOPS aN T: (To be filled in by in.diy ual proposin; develbpment) Ad a �e� w a c b C, AMAIeq 5 tM L �,Zr (r\ c � s" q- c �zc - -e cam_ c ;8 b .�sf- LcLrdl nJ CUT' 6-A re. b u L UA'Pier a AAa bock-- dk-� s (M `K-2_, cN\.p 4-� p r , or 4--a --------------------------- Ql S Signature 6- Pn'nc or Type iNi3jne Teiephone Numberr Date: 1- l�-