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Home My WebLink About50110_LIPPINCOTT, PAUL_20080123❑CAMA / ❑DREDGE &FILL (� ''{' �0'' G E,N E RAL 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 Applicant Name_ " 44 Project Location: County Address City Phone # (—)— Authorized Agent Affected ❑ CW AEC(s): ❑ OEA ❑ PWS: ORW: yes / no State Fax # ZIP ❑ EW ❑ PTA ❑ ES ❑ PTS ❑ HHF ❑ IH ❑ UBA ❑ N/A ❑ FC: PNA yes / no Crit.Hab. yes / no Street Address/ State Road/ Lot #(s) Rules attached. Subdivision City ZIP Phone # ( ) River Basin Adj. Wtr. Body (nat /man /unkn) Closest Maj. Wtr. Body ■■■■■■■i■■■■■■®■■.■■■■i'i■■■��1■■■■■■■■■■ MEN ■■■■i■■■[1■■■■■■■■■■■■■■■■i■■■■■■®■■■ .... . ■■■■■■■i■■l�■■■■■■■■■■■■■■■■■■■■■■■■■■■ 1951. M. ■■■■■■■■■■■w■•caw■r!w■w■e■■■■■■■■■■■■■■ ■■■■■■■ ■■■/din..lr<�I..w►1w■■■iti■■rC........1�■■■■■ ■ _ ■■■■■■.■.■■!1■®...■■�■LIB■...■. ■■■■■■■■ . ■■■ ' ICL1fi�!■■■■i■■■■■■■■ ■ ISM Agent or Applicant Printed Name % Signature ** Please read compliance statement on back of permit PermitOfficer's Signature Issuing Date Expiration Date Application Fee(s) Check # Local Planningf urisdiction 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 howto complywith these buffer rules. 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/ I-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) 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 Ann j-. c - Armon W. Williams e6-30/5 9 12432 252 Sea Gate Dnue 728-4104 Newport, NC 28570u— DATE� � PAY TO THE ORDER OF _ m is First Citizens Bank rstcitizens.com FOR K 4—� � kr 1:053L003001:00034790974311' L2432 New North Carolina Department of Environment and Natural Resources Division of Coastal Mcl'agement Michael F. Easley, Governor Charles S. Jones, Dirbaor William G. Ross Jr., Secretary Date _ �—a %-0 !2) Applicant Name Mailing Address Z- s 2 5 pq I certify that I have authorized (agent) �^ / - —jL—Q tti act on y behalf, for the purpose of applying for and obtaining all CAMA permits necessary to install or construct (activity) j (` 1✓1 at (location) �L . --)- S- This certification" is�alid thru (date) Z U Signature ve'v M0 0q i) OTC I � ✓-� L 400 Commerce Avenue, Morehead City, North Carolina 28557 Phone: 252-808-28081 FAX., 252-247-33301 Internet www rlccoastalmanagement het An Equal Opportunity t Affirmative Action Employer - 5o.% Recycled 11o% Post Consumer Paper ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIERIMOO.RING PIUNGSIBOATLIFT/BOAT+UOUSE) I hereby certify that I own property adjacezit to L 0 (Dame of Properip owner orA(nt) Mailing address ifdifferent from location address' (town, state and zip) ve 0 - �% l" . C hone numbers ou can be reached �` �' y l .e Y property located at 6-ct-�c fj off_ Il lk (P (T.,ot, B)ock, Road, etc.) ryPater6ody) (Town an&or ) 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 piertmooring pzli w/boatlift/boathouse must be set back a minimum distance of fifteen feet (IS) from MY -area of riparian access unless waived by me. I do not wish to waive the setback requirement. �a.k - I do wish to waive that setbft& requirement. ___ --DESCRIPTION AND/OR DRAWING OF PR0POSMDEVELOPMENT: (To bulled in by individurtl proposing development) r R AL ra Print Af`rvmName Telephone Number Old AN. 22.2008;; 8:29AM�5772EWACHOVIA INTRACOASTALMARINL[X NO.456 P. 3 N lv -VRppEVxY ,0 R STATFMENT ,A,DJACE (FOR A .PrER1&f0 piNG PXL�TNGSlBOt1 TL�TF 'IBO+�a''�IDrIS . Di, U ( Z p trJ�p 's i hereby ccztify that I own property adjacent to 1 r (Pj to of frorrty owner or U ) Nia.iling address if different frOm locafn ; . (0=, t state and zip) � � O phone numbers you can be zcacbed at� property located at �` Q Tess_ C' (Lot,710 , gold, etc.) l: W � � f � � , N.C. Ozx (Town AA&Dr County) (Mgterboay) at that location, He has described to Xne, as shown below, the developTnent he is °j° /boa�i£tlboathousc and,1have no objections to h_is proposal. Y understand that a laiez/naoo8zea of riparian access unless must be set back a diSt&Dce of fifteen feet (1.5) from my' P waived by me, n_ X doh W to waive the setback zerluirement Z do wish to waive that setback regnir=ent- ini4nP.4 ON ,AND/OR DRAWXNG OF PROW SE10-DEVE1r,OP�NT• -DES (;R i al pb V� I�g met &.Pment) L ( obera'd�nby' 7U V r 7 .Pont or Name 3�r 3 `( %ephune Ham= Daw, . b ; mo I 6, its , ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIERfMOORING PdLINGS/BOA?ZJpT/BOATHOUSL) I hereby certify that I own property adjacent to is (Name of Property Owner) property located at (IAt, Block, Road, etc.) in /�fu�f'aeT , N.C. dy (Waterbo) on G'�2 � ly (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 / boadift / boathouse must -be set back a minimuunt-distance of fifteen feet-(' 5) from my area o riparian access unless waived by me. (If you wish to waive the setback, you must initial the below.) I do not wish to waive ,J AN 2 Z008 I do wish to waive that setback requirement DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT. (To be filled in by individual proposing development) �y Pr?G--< e l,,,-) r}. j co a l t^' l/ t1� 'vC�S 6, G F,V 0 �� Pry 5 ®00% ®GM C t icC 5 �Gl� Signature p Print or Type Name ll _ `/'d r / Telephone Number Date: 1 �6� • ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIER/MOORING PILINGS/BOATLIFTBOATEOUSE) I hereby certify that I own property adjacent to is (Name of Ptloperty Owner) property located at C+ ;�-i P D ` L-Z / ///G /7 (Lot, Block, Road, etc.) on C'62c ' , m 2° P 2: , 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. (If you wish to waive the setback, you must initial the appropriate blank below.) I do not wish to waive VO I D 111ciEl ze I do wish to waive that setback requirement. JA N 2 2008 DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOP11 r h (To be filled in by individual en proposing developmt) 8$Ci City DCM !'RYTk�!�_,,y 6i�� e �i7rJc:.� � fa! '- s+G_d� �"�-.9,•�-�„ .E^,�, �c�.lc..,;,.�-� ^' �:� e , r► ` E 1 �O !� r ^�'� d ��' !�ic�c� l �•^rl !'gym Pa S r rye �,-L.c� PIS 5 fj> �IL 1tJF, m5 VIVA L ---- 1 Signature Print or Type Name Telephone Number Date: