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Home My WebLink About54394_FORREST, CHUCK_20090922❑ CAMA / ❑ DREDGE & FILL Fa A 19 4r ` GENERAL PERMIT Previous permit # ❑New ❑Modification ❑Complete Reissue ElPartial ReissueT 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 i" Project Location: County Address Street Address/ State Road/ Lot #(s) .. City T ! Stat ) ZIP, Phone # O ` +' Fax # ( '^j-�—�--- Subdivision Authorized Agent City ZIP Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A ❑ PWS: ❑ FC: ORW: yes / no PNA yes / no Crit.Hab. yes / no Type of Project/ Activity Pier e Platf Fing Groi Bulk Basin Boat Boat Beac Othe Shor SAV: Sand Mo Phot Waiv, Phone # O River Basin ` Adj. Wtr. Body IY,P (nat /man /unkn) Closest Maj. Wtr. Body (Scale: -� p /' ) CCCCCCCC�C=CC -��•_+�� r� . �� io'�'■CCCC 11011111NMIC ; length C:CCCCCC'rC ..■...........■....®....aC..CCC number ■CCCCC■CCCCCCCNCC� C■CCCC ead/Riprap length_ ■CC avg distance offshore■■■■■■■ ■■■■■■■■■■ ■■■�■■ ■■■■■ max distance offshore ■■■■■■■C■■■■�!■■■■■■ ■■■ ■■■■■ ��!�...E!■A■■■ ■■■ ■■■C■■ iii■MEN r■CCCmin .' CiCC CCC CCC■■i�■C cubic yards■■8■■■■■C■CMII ■■■■■■■■■C■ ramp- imilmmmmmmmiip, ■CC■�2E �Iouse( oatli M'o NIi ■■C■■■■■■■■■■mmmm.m.■■■■LENUM EN ■■■■■■■■■■■■■�ICIN■ ■I■■■■■■■C■■Bulldozing MIME IMMEWWWWWs CCCCCCCCCCCCCiiCiiCC�� ii1riff? i1102mmil ■■■■■�■I!�■■■■■�iil■'2I 1.1II1III�I.■1\��7filMr J■ ismx.JLW—rA.M [line Lengtl�l .■■■■■■■■■■■■■fl��J■■�■■�■■ not sure yes ■■■■■■■■■■■■■�I I■■■�■■■■C■■■�■■■ ■■■■■.N 001=11101 ME ME -s: not sure yes C i!iEmmmNCCCINN Cs: yes•■1�■■■■■■ INIZ■■ ■■■ ■■■■■■■mr�. .lL'iC■■■■■CC■■■C■►ilE�.:�1■■■■B■C■W■�■i�.7r e A building permit may be required by: ;N 4 , !`' l ❑ See note on back regarding River Basin rules. r his The time period requirement for t Notes/ Special Conditions �� n,�� "� Authorized development is suspender � , "in- until December 31, 2010, pursuant to the "Permit Extension Act of 2009. Agent or Applicant Printed Name r � i J t lv Signature Please read compliance statement on back of permit ApplicationFee(s) ,,�(.LM Check# Permit Officer's Signature //0 Issuing Date ! Expira • n 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 ❑ 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 Morehead City Headquarters Mailing Address: 400 Commerce Ave 1638 Mail Service Center Morehead City, NC 28557 Raleigh, NC 27699-1638 252-808-2808/ 1-888-411COAST 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: 9 10-395-3964 (Serves: Brunswick, New Hanover, Onslow -below New River Inlet- and Pender Counties) Revised 08/09/06 North CarolinaDepartmentof Environment and Natural Resources Division -of -Coastal Management - Michael F. Easley, Governor Charles S. Sones, Director William G. Ross Jr., Secretary -Bate <�OA-a-7 'zA Applicant Name � 3Kailing Address _�z�C�7.✓�i_ I certify that I have authorized (agent) to act on my behalf, for the purpose of applying for and obtaining as CAMA Permits necessary to install or construct (activity) at (location),, This certification is valid torn (date) Signature - 7,�� 400 Commerce Avenue, Morehead City, north Carolina 28557 Phone: 252-808-2808 ! 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