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Home My WebLink About51026_EVANS, ELIZABETH_20070830❑CAMA / 1-1DREDGE& FILL S-�+� GENERAL PERMIT Previous permit# ❑New ❑Modification El Complete 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 City StateZIP Phone # ( ) . Fax # O Authorized Agent ❑ CW W )41PTA Affected AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ PWS: ❑ FC: ORW: yes / no PNA yes / no ❑ ES ❑ PTS ❑ uBA ❑ N/A Crit.Hab. yes / no Street Address/ State Road/ Lot #(s) Subdivision City F_wJ syr : ZIP Phone # (� ) River Basin =. Adj. Wtr. Body C < c e. (nat /man /unkn) Closest Maj. Wtr. Body f , �� t' ' ■■■■■■■■■■■M■■■■■■■■■■■■■■■■■■■■■■■ �. ■■■MM■■■■■■M■MM■■MEMO■■mom EM■■■■■ME■E■ ,. . M IN ■■■E ■ .. M. :- :.. IMMMMNMMMMEMMMMM■■MM■■■■M■M■ mom ■■■■■■■■■E .............MEM■■■........... NINE■ ®■E■■■■MEN■MMWOM M :■■:■■■■■■ ■■■■■■■■■■■MM■MM■M■MM■MM■■M■MM■ME■MEMENo ■■■■■■■EE■■OEEEE■E■■■■■OMEO�■EEO■■■OEM■ ■EEEE■■■EE■=■■■E■•••■ElEM■E■■■EEO■MOM■■ MENMM�'M MMUN ■OEM■■EOMMMM■■■M■■MMMMMM■EME■M swom ME■MEMEMMEMME■E■E�■MMMMM■M■E ■■Erg■�■M ■■■■■■■■■■■■■■■■■■M■■E■■Mil■■ ■■■■M■■■mom 0 IEEE■� E■E■■■: ■■■■■':■■■■■■■■■■■■■�■■■ Agent or Applicant Printed Name Signature Please read compliance statement on back of permit" a . Application Fee(s) Check # Permit Officer's Signature Issuing Date Expiration Date 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, 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/ 1-888-4RCOAST 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 t ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIER/IVIOORING PILINGSIBOATLIFTIBOATHP.USE) I hereby certify that I own property adjacent to �Z � /� ail S 's . (Name of Property Owner) property located at LnA e cat i o h t O 0 4 Ca A-0 w `r �L,� , (Lot, Block, Road, etc.) �"4r on�'dlir�ie�d r�Du.r' ,in l..V�t��er, C��+�.�i W �ErN,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 I/ I do wish to waive that setback requirement. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: (To be filled in by individual proposing development) 0 f X�s'%cr1c� esszc� d CJw�" E'- Signature Print or Type Name Telephone Number Date: 31 S'\ �- �e`1 PROPERTY OWNER STATEMENT %C.T RIPARIAN tFORA PIER.310ORLYG PIU,VGS,-B0A U11'FIROA HIOUSI') `�<- CA 'o (Lot, Bloclh. Road, etc.) c ,q!� T I- T� t W , (Waterbod�) (Town and', I or County) fie h3,; desc nbcA to Tnt, a-, shown Mow, the devc lopmcnt Inc is propo.q i rig at dia t loc at Ion, and, I hav, no obicclions to his proposal I understand that a piqcr.'nuvrmg pilings I boatlifO boatliou-ic 5� Crom my arca of riparian access unt"s aiuI .i* bt set back a nfimmimi distaticc of fiftocn N-ct (I - waived bymc (If you ivish to %aive the setback, you tnu8t initial the appropriate blank bttow,) I do not .wish to' wall"� I do wish to waive that sc,.back rcquirwrttent ...... ------------------ I ........ DE. CRIPTIO AND OR DRAWING OF PROPOSED DEVELONNIEN71'. ro be filled in bly individjwl proposing developmen o �, 'k �, k"r• q MC'Vt DE Date: Signature Print or Typc Name. Tcicphone Number CERTIFIEWMAIL — RLTURN RECEIPT REQULSTLD • DIVISION OF COASTAL N1,8NAGENIENIT ADJACENT RIPARIAN PROPLR'ry OWNER NOTIFICATIONiNVAIVER YORNI Name of individual appl, ing for Ilke permit: q0"A Address of property, (Lot or stretO, w"f of ro*dj� 40N' I beret)v certify that I own property ad'acent to the above referenced property, The individual applying for this permit has described to me (as shown on the attached draNking) the development they are proposing. A dcscription or drAwing,"Aith d intensions, should be provided with this letter, halve no objectioni to this proposal If you haNe objections to "hat is being, proposed, please write the Division of Coastal Management, 400 Commerce Ave., Morchead City, N'('28557 or call 0$21) $08-2808 within 10 days of receipt of the notice. No response is considered the same as. no objection if you have been notified by Certified Mail. Waiver Section I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift or sandhags must be set back a minimum diAance of 15' From my area of riparian access unless AaiNcd b * y me. (If you �tiIsh to %ai%e the setback. you Inust initial the appropriate blank below.) do vish to%kal%c the I 5'setback requirement do not %i-Ji -,, .%,,tivc the I 5'5ctback rcquirzmcn! Signaturc ate PTIM Narne Telcphcr c Tnunlhrr with area code ELIZABETH E EVANS 6004 Cassowary Lane New Bern, NC 28560-7170 �he der of WACHOVIA SECURITIES Wachovia Bank, N.A. For_ '51 n Z I o I:0 S 3000 2 19i: 400 368 13 S 211 COMMAND ASSET PROGRAM 1002 66-211530 BRANCH 77619 CODE= l00 8 - — 0 / Date '�Obr llars t °^