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Home My WebLink About61041_MATTHESON, ELTON_20121008CAMA / J DREDGE & FILL 2 r NO. 61041 GENERAL PERMIT Previous permit# ❑New ClModification-JComplcte 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 I SA NCAC � Applicant Name (4, 4',1 ' i C i+kip ❑ Rules attached. Project Location: County --tCfyie Address�tr,V,nU Street Address/ State Road/ Lot #(s) City ti^�-r'?i" ; 4,.'(� ',+r. State i ZIP-F`it' Phone # () Fax # (}) Subdivision Authorized Agent h '-Q �^,�e IL _ City_ '----1'� �a I {� t' ZIP _ CW 7 EW 71 PTA ElES ElPTS Affected - Phone # (_ _) i River Basin ❑ OEA I HHF IH ❑ UBA ❑ N/A AEC(s): �� Adj. Wtr. Body- y. u' .. OVA nat Iman /unkn El PWS: � FC: �1 ORW: yes / no PNA yes / no Crit.Hab. Closest Maj. Wtr. Body t1>0 �• yes / no — Type of Project/ Activity Pier (dock) length Platform(s) Finger pier(s) Groin length - number Bulkhead/ Ripraplength avg distance offshore max distance offshore Basin, channel cubic yards Boat ramp 11 � Boathouse/ Boatlift f�, �-A Beach Bulldozing Other 1 -S-)" Shoreline Length SAV: not sure yes no -- Sandbags: not sure yes n -- — - Moratorium: n/a yes no — - - - ---- - -- - - -� - Photos: yes n- Waiver Attached: yes no A building permit may be required by: r�,-,,, r (� 1 Notes/ Special Conditions r - (Scale: i 4-0 ) F See note on back regarding River Basin rules. r it or Applicant Printed Name Permit Officer's Signature Signature "Please read compliance statement on balk of permit ** r Application Fee(s) Check # 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 thatthis 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 howto complywith 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/ 1-888ARCOAST Location: Fax: 252-247-3330 2728 Capital Blvd. (Serves: Carteret, Craven, Onslow -above Raleigh, NC 27604 New River Inlet- and Pamlico Counties) 919-733-2293 Fax:919-733-1495 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) N.C. DIVISION OF COASTAL MANAGEMENT AGENT AUTHORIZATION FORM Date S� - 3- lz-4, Name of Property Owner Applying for Permit: C L' l Z�H Mailing Address: emf-p)Lp ISM 14c I certify that I have authorized (agent) �� t �1`'raB to act on my behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to y install or construct (activity) rs DAO;`r LIFT ,5oJtiD at (my property located at) % b'T hf)rcMlri b Z $C.'F This certification is valid thru (date) 123 1— 1-1 Property Owner Signature (,/i 2 Date RECEIVED r 13 2012 ",s-t�p Or ,p0CGK --NT) t, I r L / -F7, LL_ 2 W R W O R O UNITED STATES POSTAL SERVICE First -Class Mail osta�e Fees Paid uzp Permit No. G40 • Sender: Please print your name, address, and ZIP+4 in this box • Jff/1llllili it(fi111113111111iffl lilfliil fill! Ill) llilj1111111 i t CO UUM • cO For delivery Information visit our website at CrIt11 sP.SC1I l• i••4b T', . D V). 65 (1694 u-) Postage $ m Certified Fee $2 • 95 0! 0 E3 O Return Receipt Fee (Endorsement Required) ' j • 3�� Postmark Here 1:3 Restricted Delivery Fee (Endorsement Required) J'1-1 fit) Q u-) Total Postage & Fees 4-, $ `--------------- is / ?t t1 2 I. It f rq San !/ Street, i � �ly.o/,/ M / L /-- �1. y -- - / ---- �-?... Ci a, ZIP 4 --- -1 -1--�-- PS Form 00 August 2006 See Reverse for Instructions ■ Complete item;, 1; 2, and 3. Also complete A. STO ture item 4 if Restricted Delivery is desired. X ❑ Agent � ■ Print your name and address on the reverse ' ❑ Addressee so that we can return the card to you. B. Received by (Printed Name) C Dee ol elivery ■ Attach this card to the back of the mailpiece, r / or on the front if space permits. D. Is delivery address different from item 1 Yes 1. Article Addressed to: If YES, enter delivery address below: ❑ No / 3. Service Type G �� ❑ Certed Mail ❑Express Mall �T ❑ Registered ❑ Return Receipt for Merchandise El Insured Mail ❑ C.O.D. � 4. Restricted Delivery? (Extra Fee) ❑ Yes 2. Article Number 7011 1570 0000 3560 9878 (Transfer from service /abed PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540 7008 Sound Drive Emerald Isle, NC 28594 August 8, 2012 Timothy Edwards, MD c/o Women's Healthcare Associates 245 Memorial Drive Jacksonville, NC 28546 Dear Dr. Edwards: I am sending you the required notification/waiver form from CAMA. It is a necessary requirement for us to be able to proceed with the changes and improvements we plan to do to our existing dock and pier. If you would be so kind as to complete the form and return it to us in the enclosed stamped envelope we would be most appreciative. Thanking you in advance for your time and trouble. Very truly yours, Elton Matheson Encl: (3) UNITED STATES POSTAL SERVICE '�-rrst-Clams Mail Postage & Fees Paid USPS- - Permit No. G-10 • Sender: Please print your name, address, and ZIP+4 in this box • 1!llllif$11111IfIf if17IIIIIII!i I I IiIa III I I I I l I 17 l J 17 t It t I I/ft 11 (Domestic Mail Only; No h -■ For delivery information visit .11.45 i164 Ln Postage $ frl Certified Fee•��.GS 173 Cl Return Receipt Fee Postmark Here $?,?`i Q (Endorsement Required) Restricted Delivery Fee (Endorsement Required)1 0 L l Total Postage& Fees $'��• 75 r� of _ e�__ Sfree Ap - % p f�- or !' Ci� --+4 — — — — ----- ------ -- ,� -- .� PS Form :ro August 2-006 See Reverse for Instructions ■ 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: �"� V / / #/I P � �/ /� 1111a � 0 �7/i A&1t6waz61VC A�TV A. Signature /� X J%i/� p , CL O j/ /, � Agent (�f� ��- � (�(, ❑Addressee B. Received by ( Printed Name) I C.. �te of Delivery D. Is delivery address different from item 1? ❑ Yis If YES, enter delivery address below: ❑ No 3. Service Type ❑ Certified Mail ❑ Express Mail ❑ Registered ❑ Return Receipt for Merchandise ❑ Insured Mail ❑ C.O.D. 4. Restricted Delivery? (Extra Fee) ❑ Yes 2. Article Number (Transfer from service label) 7 011 1570 0000 3560 9885 PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540 7008 Sound Drive Emerald Isle, NC 28594 August 8, 2012 Wesley Hambright, MD 291 Huff Drive Jacksonville, NC 28546 Dear Dr. Hambright: I am sending you the required notification/waiver form from CAMA. It is a necessary requirement for us to be able to proceed with the changes and improvements we plan to do to our existing dock and pier. If you would be so kind as to complete the form and return it to us in the enclosed stamped envelope we would be most appreciative. Thanking you in advance for your time and trouble. Very truly yours, Elton Matheson Encl. (3) Stir 16 2012