HomeMy WebLinkAbout50142_LAMBERT, JERRY_20080225❑ CAMA / ❑ DREDGE & FILL
GENERAL PERMIT Previous permit #
❑New ❑Modification OComplete 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
City
State ZIP
Phone # ()
Fax # (` )
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
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
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
PermitOfficer's Signature
Issuing Date 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 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. h Z
Division of Coastal Management Offices
Raleigh Office
Mailing Address:
1638 Mail Service Center
Raleigh, NC 27699-1638
Location:
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
Fax:919-733-1495
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ 1-888-4RCOAST
Fax: 252-247-3330
(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)
Va
> U/ a-,J,-e Cy 4c
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
r
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGSBOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to ere01 M b-e fi 's
(Name of Property Owner)
property located at
\A�o';�, weCo. ---
(Street Address, Lot, Block, Road, etc.)
on ��---`�,� �n' Sys F �+c`;° E.t�n 2 �`�•�� .�� � N.C.
,
(Wat�e4-body) (Town and/or County)
He/she has described to me, as shown below, the development he/she is proposing at that
location and I have no objections to this 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 have indicated my intentions b 'nitialin below:
I do not agree to waive the 15' setback requirement. a V
(initials)
ED
4"t-p I do agree to waive the 15' setback requirement. F E B a 5 2008
(initials)
------ —-------- ------- ------- —---------------------- —------ ---- A -
DESCREMON AND/OR DRAWING OF PROPOSED D ?, �CdM
(To be filed in by individual proposing development)
✓.1 K— N r
V-
51gnatTe
Print rr "C Name
C// j - 7,fA_- i l_� '1
Le(ephone Number
---------------------
Date: a /.2.2 / 0' 9'
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILLYGS/BOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to Z�e-C V �A )p 4CC 's
(Name of Property Owner)
property located at
`(Street Address, Lot, Block, Road, fete.)
on b ct\ 5 Ui"�in2,r c. \ ri_��� , N.C.
aterbody) (Town and/or County)
He/she has described to me, as shown below, the development he/she is proposing at that
location and I have no objections to this 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 have indicated my intentions by initialing below:
I do not agree to waive the 15' setback requirement.
(initials)
✓� I do agree to waive the 15' setback requirement.
(initials)
- -- - - - -- --------------------------------------------------------------------
DESCRIPTION AND/OR DRAWTNG OF PROPOSED DEVELOPM 5 200$
(To be filled in by individual proposing development'MOrehead city DCM
-------------------------------------------------------------------------------------- ------- ------------------
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Print or Irype Name
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"!'eiephone Number r ------ ----
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Date:
FNUM : JERRY LHMBERT PHONE NO. : 919 894 5777 P01
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Date Time Type
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Applicaol Name
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I certify that 1 have authorized • col
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hchalf, for the purpose of replying for and obtaining all CAIHA Peratits accessary it, �� 2s 5 20
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install or Construct (56ivity) Q_ll� J Alo, �aC
pity �L.
at
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT FOR LAMA
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MINOR PERMITS
I hereby certify that I own property adjacent to & l ra n r t z," G i � #-buys
+ (� (Name of Property Owner)
property located at _�� 1 I �n�k�rQ L-A � R 5 E kg
(Address, Lot, Block, Road, etc.)
on S C, C ACe , in ? UJ ayx S ►x�a'��, ��>�si0c-J , 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.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development)
Signature)
Print or Type Name
Telephone Number (�
Date:`
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FEB 4 2008
Morehead City DCM
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT FOR CAMA
MINOR PERMITS
I hereby certify that I own property adjacent to &-I c'n �'C-hzc'4-N &'�, 's
I n (Name of Property Owner)
property located at� y �J WO CO l -j
(Address, Lot, Block, Road, etc.)
on C �l� , in rj w QVYS 'J�� On <10W Co , 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.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development)
Signa re
L
j Print or Type Name
�/U - 3:'� j -(o Vl6)3
Telephone Number
VV L t '' A U i 5 Date:
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FEB 4 2008
irehead City DCM
INTERNATIONAL MONEY ORDER 054774242 1 75.912
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MERCHANTS _�� O EXPRESS MONEY ORDER COMPANY, INC. S
MEMO MONEY ORDER COMPANY, INC.
MEMO MONEY ORDER COMPANY OF NEW YORK, INC.
U.S.P.O. OX8863 MERCHANTS CAMPPHILL ' PAA 17001/8863 P40T A iD OVER FIVE HUTYDRI'MLI S. DO��-�iRS
(800) 922-8079
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FEB `25 20081 TWO H)NDREY DIli-APS AND 00 [TENTS
PAY TO THE L VE i� Tiwlc'.i o7t5kv/
ORDER OF k riJ� 4P
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SIGNING. PURCHASER AGR TO BE BOUND BY THE TERMS AND CONDITIONS AND SERVICE CHARGE S SET FORTH ON THE PURCHASER'S RECEIPT Z n
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PURCHASER'S SIGNATURE FOR SUER ADDRESS CITY/STATE/ZIP
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