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Home My WebLink About51894_KING, TOM_20071218❑CAMA / ❑ DREDGE & FILL` GENERAL PERMIT 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 Resources and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC ❑ Rules attached. Applicant Name Address City State ZIP Phone # O Fax # O 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 r� �r�� %�� ...IO2==i�ir r�ir�i��,■ NMEN MEMt ■NIZIU■■■■■■N■M ME .11.E■■M■MEMOMMNM ■■■■EM■■E■MME! i■7f>•maluu11■■■■■MM■■■■EME ■■■■■■■■■■■■�:■MIN■■■■■■■■■■■■■■■■■■■ �> -.. • ... - _ ■■■■■■■■f►��►11\i■■■■INN■■■■■■■■■■■■■■■■■ ■■■■■■■■■LAM■■�QG79�■r1■■■■■■■■■■■■■■■■■■ ■■ ■■■■■ '■�liiiNIAII1 OMMEMEM■EM■ME■■■■■■ ■i■■■■■i�iC�1iS9�1B■■■■■■■■■■■■■■■■■■■ ■ ■■■■■■■■■EN■■■■■■■NNE■N!1■NNEMEMEM■M an 0 ip-NOW AJA'W,1.0 -- .. -oman • OEM WIMMEMEM MEMOMWEEMMEM ■■Et■■■MINE ' ■ ■■■■■ ■Ii'�I ®■■■ ■■■NMIN OMEN �E®■E■ EENNEM0 INN■ ■■■■ ■MOMME■EN MMMMM�":■ Z-;MM Agent or Applicant Printed Name Signature Please read compliance statement onback ofpermit *i Application Fee(s) Check # Permit f0cerls Signature ! I '�-/ I �V 7 . — — 'v ( 3-/n�z Issuing Date `Ex piratonDate 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, 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 LaL,At.i.1\11-.11r-�i�iril�rs�Vr�n11 VVV1rl.K�lAlL�1V11i.1V1 (FOR A PIER/MOORING PILINGSIBOATLIFTIBOATHOUSE) I hereby certify that I own property adjacent toe VZ-- I V 'S r (Name of Property Owner or Applicant) n Mailing address if different from location address 1 L L e &c- L-k w a &6K (town, state and zip) Q t " e K ►^ v ( ( S 11 o S 1 / C_ �- Y ' 1 )- phone numbers you can be reached at property located at y L o LJ 1 d � y Ov- , L—ot 01 K (Lot, Block, Road, etc.) ✓ % on�t1-4in�II.,eL'iC s11eLeS/ v�Qve N.C. (Waterbody) (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/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. initials I do wish to waive that setback requirement. `�mrtiais ------------------------------------------------------------------------------------------------------------------- DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: (To be filled in by individual proposing development) r0�^r.Rgc ,4 Zo, xfo.x 6• Iv ot C'eje o a S X 25' fit-> ate .� c13�,t O Q�Cd�q G oo�i� se ale.., i8k�kt,��P T -------------- ------------------------------ -- - - ------------------ -------------------- ---- L�4 �- Signature Dud(:-�Dr Print or Type Name 25 z z qCI -- Telephone Number — Date: 1. ,� — / www.nccoastalmanagement_nedPermits/ADJACENiRiPARIANPRO PERTYO W NERSTATEMENT. pdf Sou tk asp s cqNG 1 4 ' �'ne f� I)t;J - Ri THOMAS L. KING NCDL 21250105 Teresa S. King NCDL 22650071 104 Beechwood Drive Pine Knoll Shores, NC 28512 UG 5211 �1 67-776/532 (� BRANCH 77482 DATE ,� $ LSCOc in WACHOVIA I/ Wachovia Bank, N.A. wacho�ia.com FOR i:OS32077661:100761976000Sli' S211� UNITED STATES IJOSTAL JERVICE t-irsi-uiass naau Postage & Fees Paid uspsi Permit No. G-10 • Sender: Please print your name, address, and ZIP+4 in this box • !�rlril„lrrlrlrr�IIli rl,lrilrrtlrl�ll„rIII fill rtill rrlr)rlrl ■ Complete Items 1, 2, and 3. Also complete Item 4 If Restricted Delivery Is desired. ■ Print your name and address on the reverse so that we can return the card to you. ■ Attach this card to the back of the mailpiece, or on the front if space permits. 1. Article Addressed to: A Sign to X ❑Agent Addressee B. Reger� by ( Printed Nam C. Date of Delive ,I/ L16 ,V , Y? � (4 D. is delivery address different from Item 1? ❑ Yes if YES, enter delivery address below: ZNO 3. Service Type 916ertified Mail ❑ Express Mail ❑ Registered ❑ Return Receipt for Merchandise 0 Insured Mail ❑ C.O.D. 4. Restricted Delivery? (Extra Fee) ❑ Yes 2. Article Number 7005 1820 0002 4437 6531 (transfer from service laben MAIL. RECEIPTCERTIFIED m uI(Domestic For delivery Information visit our website at www.usps.como rri Postage $ o certified Fee t• . E,` pO Return Receipt Fee •?. j_ ` PostHere (Endorsement Required) Restricted Delivery Fee n-i (EndorsementRequlmd) CO ?� Total Postage & Fees u�l j E.S"i U o Sent To i v10a� u✓t.r� c Iti• ------ -------- or PO Bar Na orPO. bx-No.; �� 1 ------- tJ 1 -- -- aayy�ss v' city, sire, oC_._e, y - � C�-) T , - -- -- --- r1. M Ps Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540