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HomeMy WebLinkAbout51120_PARK, JOHN_20080528-0 bla6 DCAMA / F-1 DREDGE & FILL N? 51- 12 CC GENERAL PERMIT Previous permit 4 — [--]New E]Moclification ElComplete 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 Project Location: County Address Street Address/ State Road/ Lot #(s) City State ZIP Phone # Fax # O Subdivision Authorized Agent City ZIP Affected El CW El EW D PTA El ES [:1 PTS Phone# O River Basin AEC(s): El OEA [I HHF El lH El UBA El N/A Adj. Wtr. Body El PWS: EJ FC: ORW: yes / no PNA yes / no Crit.Hab. yes no Closest Maj. Wtr. Body IMMEMINIMENIMMEMMIMME■MOMMEMINSMIMME NO • IMEMEM NEE N MIEFENIMMINERIKIN MEE NEENAH ommosm MEMO NM MIE■MEmsM IMMMMMMIMMI IMEMEMEM! MEMEEMEMEMME IMMINIMMEMOMMIMIN IMMEMMIMEM MIMEMMEMOMMI■MINEEMI■IMMEEMENIMME No■NEE IMMENIMEMIMMEM■ NEE MEMEW.7d WINE101=1■SIMMEMEMEMIME MMUEEMOOMMIN tam MEMERSEME IMEMEMIMEM RMMIUM�m ZZMMIHMMMMIMM■on IMMEMMIRME MEMEMMINSIMEMEMME■IMMOMMIMMIMMEME IMMIMEMEMEMEM M■ E-41MEMOMMOMME! NEE■NEE ImMEEMENNEIMEEME MIMEMIMEMEM MENEENNINCENEENOMMEN ONE IIMEMEM MORAMURIMMEME. 111MUMMIN ONE■M■ MMEMIN.......®...■................®.. OEM M MMUMEMME Agent or Applicant Printed Name Signax ure . "Please read compliance statement on back of permit" Application Fee(s) Check # Permit Officer's Sjgnature Issuing Date ExpiraVl6n Date 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, 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 (252-946-648 [)or the Wilmington Regional Office (9 I 0-796-7215) 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 k ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIER 3110ORING PILINGSIB OA TL.[F, TIB OA TFIO USE) I hereby certify that I owrr property adjacent i.o Zr,;,- Li SA G ow— s ( Sarno of Property Owner) property located at 3-153 10 y r.-,_ m{- r4mot (Lat, Block, Road, etc.) on a ppm5 e�g= , in Ca' , N.C. (Waterbody) ( own 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 (I T) from my area of riparian access unless waived by me. (If you wish to waive the setback, you trust initial the appropriate blank below.) I do not wish to waive I do wish to waive that setback requirement_ MAY 2 3 2008 ------------------------------------------------------------------------------------------------------- DESCRIPTION AND/OR DRA`VING OF PROPOSED DEV� O (To be filled in by individual proposing developmen t`)1 .� t c 1-i r 00 A , prr yo X-f cfteNG po 6,l1- � City uum ' ,m� �S f -----1111-------------------- '------------'---------------------- - �iL11%fit Signature Z (�j Print or Type Name Telephone Number Date: V �� llf! .Gdi`-Jwl Depa !II''iKU: Michaei ` Easley, Governor Chafles S. ,cones, Mractor Wiliam G. Ross Jr., Secret iry Date Applicant Narae _ -yQ 0 Mailincr Address 1 C r. a MAY 2 3 2008 - 5-1y 1 F rehear L;ity CCM 7 7 �,, pp ( i - to act on M—v ,Y-ertify that A have autLL2oe i��;a �`d�e�l L) �.j•o- �,�r• .-•i/`? % �iJ �f• =-S behalf, for the purpoSe as applying for and obtainbain cr all CAMA. Permits Recessary to install or eaxastruct f actil ity) 01ir at i This ceriRzication is valid t ' I i MAY�JE1 - uteri .vi ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIERNIOORING PILINGSIBOATLIFTIBOATHO USE) is iV I hereby certify that I owa property adjacent +.o J&, 1-1S,9 G'A, IS (-vame of Property Owner) property located at �6 (Lot, Block, Road, etc.) on A pAg5 (r-gods = , in 4O N.C. (Waterbody) ( own 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 I boatlift / boathouse must be set back a minimum distance of fifteen feet (15') from my area of ripan' waived by me. (If you wish to waive the setback, you must initial the appro Fh below.) i I do not wish to waive MA.Y 7pQ8 I do wish to waive that setback requirement. ------------------------------------------------------ DESCRIPTION AND/OR DRANVING OF PROPOSED D (To .be filled in by individual proposing develop Iq L- Ap 4.1 pT' 71� ----- -!4)- �-- G morah d city U G M Signature Print or Type Name 31 - 3 9 cog Telephone Number Date: 5 - 2/ 1 i