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Home My WebLink About45108_GALLAWAY, DAVID AND PEGGY_20060427CAMA / ❑ DREDGE & FILL If GENERAL PERMIT QNew ❑Modification ❑Complete Reissue ❑Partial Reissue 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 Applicant Name ' I '; ; J l i ._ t` �. `. Project Location: County Address ` j ( i)g� J E �k T, Street Address/ State Road/ Lot #(s) 1 City t ,:t ; ' �,? �� "> State ZIP Phone # (?)r�36 Fax # () Subdivision Authorized Agent ------ City ZIP Affected ElCw D.EW ,PTA Res ElPTS Phone # ( ) River Basin AEC(s): ❑ OFA ❑ HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body ❑ PWS: ❑ FC: ' ORW: yes / no PNA yes / no Crit. Hab. yes / no Closest Maj. Wtr. Body Type of Project/ Activity Pier (dock) length _ Platform(s) Finger pier(s) Groin length number Bulkhead/ Riprap length( avg distance offshore max distance offshore Basin, channel i cubic yards Boat ramp Boathouse/ Boatlifti `r Beach Bulldozing Other Shoreline Length SAM 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 Previous permit # Date previous permit issued (Scale: j ) r ❑ See note on back regarding River Basin rules. ;; , , , APR 2 8 2006.9 Agent or Applicant Printed Name Permit Officer's Signature Morphparl Signature Please read compliance statement on back of permit Issuing Date Expiration Date ApplicationFee(s) Check# Local Planningfurisdiction 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, 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 Central Office Mailing Address: 1638 Mail Service Center Raleigh, NC 27699-1638 Location: Parker -Lincoln Building 2728 Capital Blvd. Raleigh, NC 27604 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) Morehead City District 400 Commerce Ave Morehead City, NC 28557 202-808-2808/ 1-888-4RCOAST 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 910-796-7215 Fax: 910-395-3964 (Serves: Brunswick, New Hanover, Onslow -below New River Inlet- and Pender Counties) Revised 06/29/05 ADJACENT RIPARIAN PROPERTY OWNER STATEMENT ` (FOR A PIER/MOORING PILINGSBOATLIFTBOATHOUSE) r I hereby certify that I own property adjacent to �7 �0IC3 �a// s (Name of Property Owner) property located at 17.7 PIn E (Street Address, Lot, Block, Road, etc.)` �� _ �1PR 1 9 2006 on /%'&Za �'/ , in r , N.C. (Waterbody) (Town —and/or CountyMOrehead City DCM 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 be set back a minimum distance of fifteen feet (15') from my area of riparian access unless waived by me.4 have indicated my intentions by initialing. below: I do not agree to waive the 15' setback requirement. (initials) I do agree to waive the 15' setback requirement. (initia s) DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: (To be filled in by individual proposing development) /111dcle ec,16W I- / 7y pr��rry v ��a1a`i 3v 0� ve i�o� 7-,C, ��✓ � �� l�r.��,� 7 Te/,r l�AC'G �eTs..v�' ----- -- - - ------ ---------------------- l� Signature %irc/a Print or Type Name Telephone Number Date: CERTIFIED MAIL — RETURN RECEIPT RE DIVISION OF COASTAL, IIA_i AGEVIENT ADJACENT RIPARIAN PROPERTY O�V.N_ER NOTIFICATIOtiAN'AIN' R FORM -dame of individual applying for permit: A2v1Zzil ot/�e(TV' � rd � 41Dc� Address of property: 1 !77 rey�� (!ot or street, street or road) '-(City & County) I hereby certify that I own property adjacent to the above referenced property. The individual applying for this permit has described to me (as shown on the attached drawing) the development they are proposing. A description or drawing, with dimensions, should be provided with this letter. I have no objections to this proposal. If you have objections to what is being proposed, please write the Division of Coastal Management, 400 Commerce Ave., Morehead City, NC 28557 or call (252) 808-2808 within 10 days of receipt of this 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 sandbags must be set back a minimum distance of 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.) /J I do wish to waive the 15' , setback requirement. I do not wish to waive the 15' setback requirement. W4,4d 4 J,164 17� Signature Date 16a,'ax al:Lreti Print Name ; -, �- 0 15- F6 Telephone Number With area Code DAVID K. OR PEGGY A. GALLOWAY 64-7131/2610 PH. 252-504-2338 000000781345 177 JENNIFER DR. -� HARKERS ISLAND, NC 2853311 Date Pay to the ///C'Cola,".r�/ct ,ryy,� Order of (/ �y 141 20 4�5� 1�77� ptr-1 �ti,„ -Dollars (� Delta Community ATLANTA, CINCINNATI Credit Union SALT LAKEAL LAKEASIFTWORTH, SCITY Memo - to A 1 (k�_7— ------ /� — — — -- - — NIP 1: 2 F. LO 7 L 3 L Si: 000000 ?8 13 4 So 0 14 DAVID K. OR PEGGY A. GALLOWAY 54-7131/2610 140 PH. 252 504-2338 000000781345 177 JENNIFER DR. 4 U6 HARKERS ISLAND, NC 28531 Date 20_ Pay to the ��__..... Order of— $ l �• Delta Community ATLANTA. CINCINNATI DALLAS/Ff. WORTH, Credit Union SALT LAKE CITY ' nA.DD ItaJLI �j Memo- 1: 2 6 L0 7 L 3 L Si: 000000 ?8 131, Sill 0 L 40 r� MONITORING & COMPLETION REPORT [CAMA Major Development & State Dredge & Fill Permits] , r PERMITTEE' S NAME: LOCATION: PERMIT # FIELD REP. PHONE: L?5 C�� DATE REPORTEDLY COMPLETE: (� L' DATE OF INSPECTION-6 Cc 1) Do the _measured dimensions of the development differ from those indicated in the permit and workplat? YES[Nt� [circle one]. COMMENT: 2) SEDIMENTATI disturbed areas? COMMENT: )SION CONTROL: Has Permittee seeded, grassed, or otherwise stabilized all [circle one] 3) FUTURE MONWORING & ENFORCEMENT ACTION: Is further investigation or enforcement action needed? YES [circle one]. COMMENT: