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Home My WebLink About46023_CORBELL, JESSE_20060627i ❑CAMA / ❑ DREDGE & FILL GENERAL PERMIT []New ❑Modification El 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 Address City State ZIP Phone # ( ) Fax # ( ) Authorized Agent ❑ CW ❑ EW ❑ PTA ❑ ES ❑' PTS Affected AEC(s): ❑ OEA HHF ❑ IH ❑ UBA N/A ❑ PWS: FC: ORW: yes / no PNA yes / no Crit. Hab. yes / no Previous permit # Date previous permit issued ❑ Rules attached. Project Location: County Street Address/ State Road/ Lot #(s) Subdivision --- City ZIP Phone # ( ) River Basin Adj. Wtr. Body (nat /man /unkn� Closest Maj. Wtr. Body Type of Project/ Activity (Scale: ) Pier (dock) length Platform(s) Fing Groi Bulk Basin Boat Boat Othe Shor SAV: Sand Mo Phot Waiver Attached. yes no A building permit may be required by: Notes/ Special Conditions on back regarding River Basin rules. ❑ See note er head i - pier(s) � ! i f n length number iZ ra length P P av distance offshore i max distance offshore T�I i _ _ II I I 1*L channel � � � — � ! '—i— � i i i i �� -•— cubic Agent or or Applicant Printed Name Signature Signature "Please read compliance statement on back of permit" Permit Officer's Signature Issuing Date Expiration Date Application Fee(s) Check # Local Planning Jurisdiction Rover File Name s 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: LI 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 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: Fax: 252-264-3723 Parker -Lincoln Building 2728 Capital Blvd. Raleigh, NC 27604 919-733-2293 Fax: 919-733-1495 (Serves: Camden, Chowan, Currituck, Dare, Gates, Pasquotank and Perquimans Counties) Morehead City District 400 Commerce Ave Morehead City, NC 28557 202-808-2808/ 1-888ARCOAST 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 I HERBY CERTIFY THAT I OWN PROPERTY ADJACNET TO /�44t v►f I " m AME OF PROPERTY OWNER) PROPERTY LOCATED AT 61,44 (LOT, BLOCK, jT ) ON / ,IN NC (WA RBODY) (TO AND/OR COUNTY) HE HAS DESCRIBED TO ME AS SHOWN BELOW, THE DEVELOPMENT HE IS PROPOSING AT THAT LOCATIION AND, I HAVE NO OBJEACTIONS TO HIS PROPOSAL.. DESCRIPTION ANUOR DRAWING OF PROPOSED DEVELOPMENT (TO BE FILLED IN BY INDIVIDUAL PROPOSING DEVELOPMENT) pi, D p0s<>C//#6W auti1�,-Hexft /bj ),- s prin or type name sag--- -3 1 1 I Telephone number __j 2076 � (5-"� ADJACENT RIPARIAN PROPERTY OWN*AOOFPI' RATEMENT I HERBY CERTIFY THAT I OWN PROPERTY ADJACNET TERTY OWNER) PROPERTY LOCATED AT j� 0 (LOT, BLOCK, ROAD, ETC.) ON ,IN �' ,NC (WA ERBODY) (TO AND/OR COUNTY) HE HAS DESCRIBED TO ME AS SHOWN BELOW, THE DEVELOPMENT HE IS PROPOSING AT THAT LOCATIION AND, I HAVE NO OBJEACTIONS TO HIS PROPOSAL.. DESCRIPTION ANUOR DRAWING OF PROPOSED DEVELOPMENT (TO BE FILLED IN BY INDIVIDUAL PROPOSING DEVELOPMENT) f e- o Po signature d . "t- dgA,4fJ print or type name Telephone number DATE a� 2UU I 1740 66_21/530 LARRY G,.ARNOLD o p 0 Box 2277 NC 28557 � Date Morehead City, Pay to the Dollars Order of A n w�,CxovrA .. Wachovia Bank, N.A. wachovia.com For n • LO5466 L894 286i►' L 74 �; 53000 2 L9�.