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Home My WebLink About56806_FULCHER, EDWARD & SYLVESTER, NAT_20100910❑ CAMA / ❑ DREDGE & FILL A �! GENERAL PERMIT `/ ` Previous permit# ❑New ❑Modification ❑Complete Reissue El Partial Reissue( Date previouspermitissued 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_ Address City Phone # ()_ Authorized Agent Affected ❑ CW AEC(s): ❑ OEA ❑ PWS: ORW: yes / no _ State ZIP Fax # (_— ) ❑ EW ❑ PTA ❑ HHF ❑ IH ❑ FC: PNA yes / no ❑ ES ❑ PTS ❑ UBA ❑ N/A Crit.Hab. yes / no 0 Project Location: County Street Address/ State Road/ Lot #(s) 4 Subdivision City ZIP 7 , i Phone # ( ) River Basin Adj. Wtr. Body (nat /man /unkn) Closest Maj. Wtr. Body ■■■■■■■■■■■■■■■■■M ME fin■ N�■■■■■■�■■� M. . C■■■■■■■■■■ CNEONii ■■�a ■■■■■■■iw`i H"M ■■■■s■■■■[■■e■■�t■n■■■■■■■■■■■■■■■■■■■■■ a lw�"on IMMMEMii�i��iii�■i■iiii■iiii■i■iii (/■■■■■■■1■■■■■■H11!■■■■■■■■■■■■■■■■■■■■ ■■Il■��N�■■■■11��1■■■��%11��■■■■■■■■■■■■■ ■��■■ ■■■■■ ■■■■d�� n11��■■ fi■■■■■■■■■■■■■■ v■In!■■1�1�■■■■■■■■�■■■■■ii■iii■i' ME ■■■■■■■■■■ ■■■■■■■■■■nail■s�■!�■■■■■■■ ■■■■■ ■ _ fL'a■■■■■■■ ■■■■■■11■■■■■�■EMOURIZUR[i11'HEN ■■■■■■■■■ilri�iuluu uriililr■■■■■■■■■■■■■■■ii■■■■■ N��■Ott®�N��■H�Nv��Ov�� Agent or Applicant Printed Name Signature "Please read compliance statement on back of permit" Application Fee(s) Check # Permit Officer's Signature Issuing Date Expiration' ate {y- Local PlanningJurisdiction 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 Mailing Address: 1638 Mail Service Center Raleigh, NC 27699-1638 Location: 2728 Capital Blvd. Raleigh, NC 27604 919-733-2293 Fax:919-733-1495 Morehead City Headquarters 400 Commerce Ave Morehead City, NC 28557 252-808-2808/ 1-888-4RCOAST Fax: 252-247-3330 (Serves: Carteret, Craven, Onslow -above New River Inlet- and Pamlico Counties) 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) Revised 08/09/06 A..cplicant: C Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement found in your Habitat code sheet. Habitat Name DISTURB TYPE Choose One TOTAL Sq. Ft. (Applied for. Disturbance total includes any anticipated restoration or temp impacts) FINAL Sq. Ft. (Anticipated final disturbance. Excludes any restoration and/or temp im act aammou�nt) TOTAL Feet (Applied for. Disturbance total includes any anticipated restoration or tem im acts) FINAL Feet (Anticipated final disturbance. Excludes any restoration and/or temp impact amount redge Fill ❑ Both ❑ Other ❑ ' jam( ,J ��jj��1� Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ ADJACENT RWARIAN PROPERTY ONVNER STATEMENT (FOR A PIERiMOORING PILINGSIBOATLIFT/BOATHOUSE) I hereby certify that I own property adjacent to (Name of Property Owner) property located at S Z �l �/_- P7P /✓n15/ (Lot, Block, Road, etc.) on rf f �/�� , in%��/ % T , N.C. (Waterbody) (Town and/or County) He has describer) 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/boatliftlboathouse 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. ----------------------------------------------------------------------------------------------------------------- DESCRIPTION AND/OR DRA WE'gG OF PROPOSED DEVELOPMENT: q (To be fulled in by individual proposing development) T L I /= i ------------ CAO V % L CL T `J (e n Q � 3 ----------- L------------------------------------------------------------------------------------------------------ Signature Print or Type Name zs-z --?"- 7 Telephone Number Date: — �D ADJACENT RIPARIAN PROPERTY ONVNTR STATEMENT (FOR A PIER4100RING PILINGS/BOATLIFT/BOATHOUSS'�av Zftx�'-) Cky,&A I hereby certify that I own property adjacent toT 3)1 's (Name of Property Owner) property located at (Lot, Block, Road, etc.) on��`�/��G� k , in C/'� ��/��l�C7 , 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/mooning 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 Flo not wish to waive the setback requirement. r I d-Q wish to waive that setback requirement. --------------------------------------------------------------------------------------------------------- DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: (To be filled in by individual proposing development) . l) --------------------------y�=- b /� N L,JV� � Ca ----------------------A/, -- ---------------------------- i Signature YL�fs � Print or Type Name 255- Z Telephone Number Date: ADJACENT RIPARIAN PROPERTY ONVNER STATEMENT (FOR A PIERIMOORING PILINGS/BOATLIFT/BOATHOUSE) V I hereby ertify that I own prop r y adjacent to a/;- 4117115 (Name of Property Owner) property located at I Sz 3 , /� P/ PA /)/f n )(Lot, Block, Road, etc.) p� a j on /✓� /. � 1� , in �� /�/ �r'/�1 , 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 " wish to waive that setback requirement. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: (To be filled in by individual proposing development) -r-- 0 4 a ---------------------------------------------------------- ------------ -- -------------------------------- Signature Print or Type Name Telephone Number Date: r- D ADJACENT RIPARIAN PROPERTY ONVNER STATEMENT (FOR A PIERAV100RING PILLVGSIBOATLIFTI OATHOUSE)0 t Qw I hereby certify that I own property adjacent to �- 's (Name of PropertyOwner) property located at Z (Lot, Block, Road, etc.) on 1� �` , in , 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. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: (To be filled in by individual proposing development) 0 ------------------------------------------------------ --------------------------------------------- Signature Print or Type Name Telephone Number Date: f ' 0<- — 2O/P LURA McLEAN FULCHER EDWARD D FULCHER 521 Neptune Dr Cape Carteret, NC 28584 2181 66-21/530 BRANCH 77614 < DATE DOLLARS t pan, e� WACHOvrA Wachovia Bank, N.A. wachovia.c4ID�* /./ f NP FOR— i:053000 2 191: L05463 2 L L8506il' 2 18 L W.