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Home My WebLink About51056_DAVIS, FLOYD_20070912❑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 i O Rules attached. Applicant Name I + ram; T t `� Project Location: County �! Address i,;; i.,tY..� i_ ' Street Address/ State Road/ Lot #(s) City j State ZIP Phone # O Fax # O Subdivision Authorized Agent, r :.f' City ZIP Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Phone # ( ) Ii `+ I - 70L 2 River Basin ❑❑❑❑❑OEA HHF IH UBA N/A AEC(s): i�.'. t Adj. Wtr. Body r !" 1( `� (nat /man /unkn) El PWS: ❑ FC: ORW: yes / no PNA yes / no Crit.Hab. yes / no Closest Maj. Wtr. Body :.. M. :.. M. ■■■■■ ■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■i■■■■■■■■■■■ ■■ ■■■■■■■ ■■■■■■■■■■cry■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■ ■■■ocia■■■.■■■■■■■■E■■■■■■■■■■■■■■■ iii iii�■i■■■i■■i■■�n�i■iii■i■■ice■■■ ■■ ■■1�VI■■■M■=■■6�il�FGtY"■R MEM■■■■■■■■■■■ ■■■■■ ONI EM IN■ ■■��■r�rr►�■■■■■■■■■■■■■■■■ ■■■t■i��l■i�0-14iEE■■■■■MMMS■■■■■■■■■■■■■■■ ■■■■■`li■film■r■■.■■■lmmummom■■■■■■■■■■■■■■ C■■■�■■■EN■■■■.,■.■.v.■■■■.■■■.■■■■■■■■■■ ■■:'■M:■'■::E: MOM M ■■■■■:■::■:::E:MIN■■■ ■■■mmommwuma�mo■■■■■■■■■■■■■■■■■■■■■■■ IMMMM�:�:�iQAA ;�;..::: ■■■■■■■■■■■■■■■■■■■■■■■■■ C■■■■■■MMMM �M■■■..........■.■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■®■■■ :o■■:■'::::::■:C:EM:::::::::::::■:■■:: Agent or Applicant Printed Name Signature "Please read compliance statement on back of permit Application Fee(s) Check # Permit Officer's Signature j 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. 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/ 1-888ARCOAST 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 ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIE&MOORING PILINGSBOATLIFTIBO/ATIIOUSE) I hereby certify that I own property adjacent to �D d ��y� s -s (Name of Property Owner) property Iocated at /-?, / IV, SIV R C U R • = , (Street Address, Lot, Block, Road, etc.) i�o ja e- Sau,uc/ /� on 1-'CCe ss � �/F� �- _,in_ Ai-�'9/L4/'C, A19-C'A �, N.C. (Waterbody) (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/boatl�ft/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. AUG 3 1 2007 (initials) Morehead City I)CM I do agree to waive the 15' setback requirement. �/ DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: (To be filled in by individual proposing development) ��Kir► /� AX A,1 7 &'s /'o /' f,v C e, roc rpwM (3ce _y��5G1(IfLCP Z �S� Azks: �6- U lvi5'ye- L Fy-- Il Z 'CZ 3WOA-z -- � Print or Typ Name �2 - Vn- Telephone Number VDate: l ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIERIMOORING PILINGSIBOATUFTIBOATIIOI/SE) I hereby certify that I own property adjacent to _- Q � . (// S s ,, / (Name of Property Owner) property located at 2—/V / , Sh 01C E �k • —E (Street Address, Lot, Block, Road, etc.) Qo on e ss C/f FJ- L_ , in A/1/ti✓t1 c, 132 Fq C A N.C. (Waterbody) (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 beset back a minimum distance of fifteen feet (15') from m 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. (Wtws) AUG I do agree to waive the 15' setback requirement. (initials) Morehead City DCM DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: (To be filled in by individual proposing development) • 5r C 1.5-/3 RqC S� ��z ems' ,V/ C, -2 7Y;Y� 2 f t)r rsdSf 2' /-e-16-6 ISM 1ST 2 _ uSO� lyeps ------------------------------------------------------- Signature Print or Type Name Telephone Number U-Date: NCDENR North Carolina Department of Environment and Natural Resources Division of Coastal Management Michael F. Easley, Governor Charles S. Jones, Director William G. Ross Jr., secretary Date 15� ' 30 1 O,-? Applicant Name �� ►� 11/. ��+5 Mailing Address I G 14 2 w va CI �,� de ,_,�� 19,1 91 I certify that I have authorized (agent) Uj ?)V kj� to act on my behalf, for the purpose of applying for and obtaining all CVIVIA Permits necessary to install or construct (activity) 1 r t'—jf r, at (location) 2 No P4 h S h JK_c I V Y f-)4 i A --/4 ..,c- 1�7 p�h N L . 'Z'V512 This certification is valid thru (date Signature 400 Commerce Avenue, Morehead City, North Carolina 28557 Phone: 252-808-28081 FAX: 252-2+7-33301 Intemet: www.nccoastalmanagement.net Consumer Paper An Equal Oppcq pity 1 Arirmabve Action Employer — 50% Recited i to% Post Patricia G. Davis Floyd D. Davis 7614 Firewood Rd. 336-449-7002 Gibsonville, NC 27249 Pay to the C � �V \ order o / 66-46/531 6862 00001 a2M9W Date z , -) 0 Dollars 8 �� m SVNixtV51 ACH RT 061000104 NP For— o _ a®0 5 3 L00 k 6 5,:0000 b8 2 38 3 9 5 3++' 686 2