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Home My WebLink About59363_MARSHALL, CHARLIE A_20111110p�� aa�� t�A ❑CAMA / ❑ ( DREDGE & FILL ' f cA. I , GENERAL PERMIT Previous permit # ❑New ❑Modification ❑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 / l Ri Project Location: County Address City_. State ZIP `; } Phone # ( ) Fax # (i ) Authorized Agent Affected ❑ CW ❑ EW ❑ PTA AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ PWS: ❑ FC: ORW: yes / no PNA yes / no ❑ ES ❑ PTS ❑ U BA ❑ N/A Crit.Hab. yes / no Street Address/ State Road/ Lot #(s) Subdivision City ZIP Phone # ( ) River Basin Adj. Wtr. Body (nat /man /unkn) Closest Maj. Wtr. Body ■■■■■■■■■■■■■■■■■■■■■■■■■■■■ . � . - �i■m■■I�■■■■■■■■�■Fa�E+��■i■■■■■■■■■■i■ii�iii��3iiRii ■■■ glnMEMEM CIA. ONE m1i No so wq "='ffi on Ed =�E No EN■■■■■■No No mm NO NO EME ■■■■■■■■■■FMOMM ■I�!E r7■■■■■ �■■■■ IBM MR ME EN ■■■SEASON ■■■t■■■■■■■■■■■■■■■■W■■■■■■■■■I■■■■■ .■■■■_i-i0_11•_! •_2�._.AA■L'.GM!!!■OEM'!. Agent or Applicant Printed Name Permit Officer's Signature Signature ** Please read compliance statement on back of permit ** Application Fee(s) Issuing Date Check # Local PlanningJurisdiction 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 Iandowner(s) . The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available information and belief, certifythatthis 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 SAMMIE E. TURNER MARINE CONSTRUCTION ACCT 252-725-3415 P.O. BOX 1885 MOREHEAD CITY, NC 28557 PAYTO THE S, ORDER OF L rt o� e �j; BRANCH BANKING ANU (RUST COMPANY 1-800-BANK 88T BB .com FOR II00000538011' i:053 10 1 1 2 1i:0005 2 10584O6611■ :r 5380 66-112/531 Back. � NP N AP P. Iicant: CWAOA, Date: I Describe below the HABITAT disturbances for the application. All values should match the name, and traits of measurement found in your Habitat code sheet. Habitat Alame DISTURB TYPE Choose One TOTAL Sq. Ft. (Applied `er. Disturbance tclal includes any or tamp impacts) Fi' AL Sq. Ft. (Anticipated final disturbance. Excludes any restoration and/or temp impact amount) TOTAL Feet (Applied for. Disturbance total includes any anticipated restoration or temp impacts) et final . 7Excl'udesany nyanticipated and/orrestoralion t amount Dredge ❑ Fill ❑ Both ❑ Other Dredge ❑ Fill ❑ Both ❑ Other ❑ bredge ❑ Fill ❑ Bolh ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ ' Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ . Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ i2-;3Dill •?';13 ,,7CUA::>i ,. arv:?r.tcr,T,.t:;:ia�l^ra.11.. ...:r::::•r..i..n: } :t.:,,.a. rt � �c;•t; t tz rs UNITED STts!€�:s `� p e • Sender: Please print your name, address, and ZIP+4 In this box • p 6 f x�' Mzg Rr) C- (T Y 74 C c---�5 57 ii ill�l!!ilt3!liili llJii!�2!!it{iF lF�t!'1i IilF li i�!!I!'f �il l2� F t ■ Complete items 1, 2, and 3. Also complete item 4 if Restricted Delivery is desired. ■ Print your name and address on the reverse so that we can return the card to you. ■ Attach this card to the back of the mailpiece, or on the front if space permits. 1. Article Addressed to: 11t\1? �� l L� r� [` L V} 'P t� LEl�, t+ H G 766 A. Signature Agent X ❑ Addressee B. Rec?6Ad b 3ntq�me) C. Dati of D ivery 11�✓1 „i a, D. Is delivery address different from item 1? ❑ Yes If YES, enter delivery address below: ❑ No RECEIVED 3. Service Type ,,&-ertified Mail ❑ Express Mail ❑ Regi0&b&T 4HLMM6furn Receipt for Merchandise ❑ Insured Mail ❑ C.O.D. 4. Restricted Delivery? (Extra Fee) ❑ Yes 2. Article Number 7011 0470 0003 4359 1609 (Transfer from service label) PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540 ■ Complete iterr.s 1, 2, and 3. Also complete item 4 if Restricted Delivery is desired. ■ Print your name and address on the reverse so that we can return the card to you. ■ Attach this card to the back of the mailpiece, or on the front if space permits. 1. Article Addressed to: /V�g CLAY.16t1 INC , ? [ --1-0 A. S' U e El Agent _ ❑Addressee B. ceivej bVPrinted Name) C. Date pf Deftery D. Is delivery address different from item 1? 'LJ Yes If YES, enter delivery address below: ❑ No RECEIVED 3. Service Type PCCertified Mail ❑ Express Mail ipred ❑ Return Receipt for Merchandise L7'Insud NFaiF ❑ C.O.D. 4. Restricted Delivery? (Extra Fee) ❑ Yes 2. Article Number 7009 1410 0000 1146 0541 (Transfer from service label) PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540