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Home My WebLink About47632_FAULKNER, RUTH_20060726❑CAMA / ❑ DREDGE & FILL �❑ GENERAL PERMIT revious permit # ❑New ❑Modification ❑Complete 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 Applicant Name Project Location: County Address Street Address/ State Road/ Lot #(s) City State ZIP ❑ Rules attached. Phone # O Fax # ( ) Subdivision Authorized Agent City ZIP Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Phone # () River Basin AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body (nat /man /un ❑ PWS: ❑FC: ORW: yes / no PNA yes / no Crit. Hab. yes / no Closest Maj. Wtr. Body Type of Project/ Activity Pier (dock) length ^ i Platt Finge Groi Bulk Basir Boat Boat Beac Oth( Shor SAM Sand Mor Phot Waiv (Scale: ) o n r. rm(s) r pier(s) f length number i � I head/ Riprap length avg distance offshore ---.- max distance offshore ,channel f � I cubic yards ! ramp louse/ Boatlift i Bulldozing i � r _ - i eline Length not sure yes no bags: not sure yes no � atorium: n/a yes no I - t os: yes no erAttachedi es no • Y A building permit may be required by: Notes/ Special Conditions Agent or Applicant Printed Narfie Signature "Please read compliance statement on back of pe Application Fee(s) Check # ❑ See note on back regarding River Basin rules. 2006 Permit Officer's Signature " r- j `y Expiration Date Local Planning Jurisdiction Rover File Name • Y A building permit may be required by: Notes/ Special Conditions Agent or Applicant Printed Narfie Signature "Please read compliance statement on back of pe Application Fee(s) Check # ❑ See note on back regarding River Basin rules. 2006 Permit Officer's Signature " r- j `y 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 that this project is consistent with the North Carolina Coastal Management Program. River Basin Rules Applicable To Your Project: ❑ Tar - Pamlico River Basin Buffer Rules ' 1 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 FROM ' SHIRLEY'S CANVAS FAXjNO. : 19103261710 Jun. 23 2006 07:38AM Pl I 711Z.- 15 J(ia a3, 24 6 � /6 ccz-A�) L) e-,P-cr'e-4 1n ADJACENT RIP-A�'AN PROPERTY OWNER STATEMENT (FOR A PIER/MOOBLVigpILINGS/,BOATLYFTIBOATH'OUSE) ! hereby certify that Z awn property adjacent to 's (Name of Property Owner) Property located at (Lot, Block, Road, etc.) onv 01 Gt�Jci�L'Uc�,�rC %�ll}2 lt�� Yt<�i�� N.C. (Waterbody) (Town and/or County) He has described to me, as shown below, the development he is proposing at that location, an,d,1 have no objections to his proposal. I understand that a pier/mooring pilings/boatlift/boath,ouse must be set back a minimum distance of fifteen feet (15') from my area of riparian access unless waived by me. I do not wish to waive the setback requirement. t// 1 do wish to waive that setback requirement. — --- ------- —------ -------- ------------- ----------- --- ----- DESCRIPTION AND/OR AND/OR DRAWING OF PROPOSED DEVELOP NT .� (To be filled in by individual proposing development) o 0 t / 1 / 73117 Si,(;iiature �Typ:�Narne Print or Telephone Number Date: / O Td WdEtb:LO 900E EE -unr 0U-T9E20TGT : ON Xdd SUnNd9 S�J.31�lIHS WOHA M c0, �6 �1 _�: �� _ `. ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIERIMOORING PILINGSBOATLIFTBOIA 1THOUSE) j I hereby certify that I own property adjacent to ei � t h i a U� I k Yt e y's (Name of Property Owner) properly located at f y j h�14 m u � cy (Lot, Block, Road, etc.) in Habert 11 i Ow" N.C. (Waterbody) (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. I do not wish to waive the setback requirement. +/ I do wish to waive that setback requirement. 0 f'.C) 0 DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: (To be filled in by individual proposing development) s. il,4RL L , Ro sa A/ Print or Type Name 916 _ S Flo � Telephone Number Date: �o� �U�/ oC% 6 (p f � fS 1 ,,v ` j fif2 1►�\f�`l�,`\�l�ll'`'1;�� f`f�i��1., 66-30/531 ., .fir. r ; •, �, �� , , Dollars.. 8 w FA \ <7r\ f\ rr✓� \� �'>\f� !, ill �rf\l ` ?: g u sea 3,T, tic ,/�✓>t, : j�� ; !` �\• �g�NY 5qa °ly l* ,\l �\,� �''�. : `'.r Il" i t •� .`,r) InS.0",<��/��>I�c\'I�ti 1j�l \. `� > 11 ! � l� •/ �\�� 1 \' `; jt �, •, , k�ra�k d �' . � � . - QUAAbIAN®5AFELY.BLUE WBL .