HomeMy WebLinkAbout41709_EVANS, MARTIN_20050516CTCAMA /! 1 DREDGE & FILL ,R19 G
GENERAL PERMIT Previous permit#
❑New L-Modification _lComplete 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
D�R'ules attached.
Applicant Name j / i (_. �' .,1 t Project Location: County
Address a ' i l ` Street Address/ State Road/ Lot #(s)
City State 4'J< ZIP J
Phone # ( ) Fax # ( ) Subdivision �.
Authorized Bent
Affected El CW
AEC(s): ❑ OEA
❑ PWS:
ORW: yes / no
❑ EW it PTA
(_i HHF ❑ IH
1 FC:
PNA yes / no
Type of Project/ Activity
Pier (dock) length
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length_
avg distance offshore_
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozi
Other
City `- ). 1 1-0./ / - ZIP
❑ ES C PTS Phone # ( ) River Basin
C UBA ❑ N/A
Adj. Wtr. Body < nat /man /unkn)
Closest Maj. Wtr. Body—/
Crit. Hab. yes / no"
Shoreline Length
SAY: not sure
yes no
Sandbags: not sure
yes no %
Moratorium: n/a
yes no
Photos:
yes no
Waiver Attached:
yes no
A building permit may be required by:
Notes/ Special Conditions
Agent or Applicant Printed Name
r
Signatur Please read compliance statement on back of permit
Application Fee(s) Check #
(Scale: )
_ See note on back regarding River Basin rules.
Permit Officer's Signature
Issuing Date
Local Planning Jurisdiction
Expiration Date
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:
L! Tar- Pamlico River Basin Buffer Rules Other:
L_] 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 I) or the Wilmington
Regional Office (9 I 0-395-3900) for more information on how to comply with thesebuffer rules.
Division of Coastal Management Offices
Central Office Elizabeth City District
Mailing Address: 1367 U.S. 17 South
1638 Mail Service Center Elizabeth City, NC 27909
Raleigh, NC 27699-1638 252-264-3901
Location:
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293 / 1-888-4RCOAST
Fax: 919-733-1495
Fax: 252-264-3723
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Morehead City District
151-B Hwy. 24
Hestron Plaza II
Morehead City, NC 28557
202-808-2808
Fax: 252-247-3330
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico 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
910-395-3900
Fax: 910-350-2004
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)
www.nccoastalmanagement.net
Revised 10/05/01
MAY-10-2005 11:37 PM SHORELINE MARINE CONST. 1 910 326 8523 P.01
z
Shoreline Marine Construction, Inc.
Floating Docks -Piers -Sea Walls -DEALER for "' Iaao Boat Lifts
ahr�h ooks I (alec.ruom
fax 910 - 326 - 8523
m 252-646-3212 Fax Cover Sheet
Fax `}
t�
TO /qy4lj
Ftm f �st4cay j?ltDa,-s 'VIO(ehead City DCM
a F e i�c imroved
Notes : ki-
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MAY-10-2005 11:39 PM SHORELINE MARINE CONST. 1 910 326 9523 P.02
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSIBOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to M "rlli &_ %IP S ,5
'"',me of Property Owner)
property located at aZ C Leh IS iJ
(Lot, Block, Road, etc.)
on in Af6 CN.C. .
(NiTaterbody) (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.
wish to waive the setback requirement.
1 dD Wish to waive that setback rggwrement.
----------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPNIENT:
(To be filled in by individital proposing derelOpme110
�iKIS'r.+JG► Pa u a �
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Signature
Print or Type Name
Ceiephone Number
MAY-10-2005 11:38 PM SHORELINE MARINE CONST. 1 910 326 8523 P.03
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSIBOATLIFTIBOATHOUSE)
I hereby certify that i own property adjacent to N/A' tbtrtOj Is
a of Property Owner)
property located at
(Lot, Block, Rond, Pt,','
on RO G4 Q.t�(/� %rr��l� , in
(W N.C.
terbody) (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 nie.
1 i14jat wish to waive the setback'requirenient.
1 d� wish Co ��,aive that setback rgquirement.
—�- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ------- - - - - - - - -
--. DESCP,1i' 10\' AND/OR DRAWING OF PROPOSED DEYELOF'N
(To be fillet! in by individual proposing development)
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Sig ature
Print or Type Name
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Telephone Number
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SHORELINE MARINE cowsT'oC,w/5o°
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