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Home My WebLink About53610_General Permit_20090408err /S � ra i ❑ CAMA / F-1 DREDGE & FILL y GE" JERAL PERMIT � Previous permit # [-]Nevi* ❑h%dification ❑Complete Reissue ❑Partial Reissue Date previous permit issued i As authorized by the State of North Carolina, Department of Environment and Natural Resources j and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC ❑ Rules attached. Applicant Name_ Pro'ect Location: County Address - City --- Phone # ( ) _ Authorized Agent 11 CW Affected AEC(s): ❑ OEA ❑ PWS: ORW: yes / no State ,%' ZIP Fax # ( ) ❑ EW ❑PTA ❑ HHF ❑ IH ❑ FC: PNA yes / no Type of Project/ Activity Pier (d 'Ztfo Finger Groin Bulkh Basin, Boat i Boath Beach Othei Shore SAV: Sandi Mora Photc Waiv( ❑ ES ❑ PTS ❑ UBA ❑ N/A Crit.Hab. yes / no Street Address/ State Road/ Lot #(s) Subdivision 1 i ��` } City ZIP x Phone # ( ) \ River Basin Adj. Wtr. Body-------------- _ (at/man /unkn) Closest Maj. Wtr. Body — (Scale: ) Milo ■ ®■■iSol ce■■■■■■■■■■■■■■■ ■■ ■■�' i�i all ■�ii ■■■■■■■■■■■■■■■G■■■■■■■■■■■WWI ME M M M 0 MEN f, ■■■■■■ ■■■■■w■■ : ■■i■IN0ON mp �: - : ■ Bulldozing__oil ■ E:1■�■Kill � %M■■■■V S■■ Imew XKONL".� MINN ine Length irg I 9 URI='! M MMIVEWMW 911MIN, not sure yes no IrTNIUMI zgs: not sure yes no trium: n/a yes no yes no A building permit may be required by: Notes/ Special Conditions r jaT Agent or Applicant Printed Name Signature Please .ad compliance statement on back of rmit** Application Fee(s) Check # See note on back regarding River Basin rules. s l rerlllll WJJ1L l Jlb+1IGWI C / Issui g ate rr.• Expiration at _c(��--- Local PlanningJurisdiction RoverFWNamm f V. 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/ 1-888-4RCOAST 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:910-395-3964 (Serves: Brunswick, New Hanover, Onslow -below New River Inlet- and Pender Counties) Revised 08/09/06 ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIER/MOORING PILINGSBOATLIFTBOATHOUSE) I hereby certify that I own property adjacent to —/GAG 97 &/� '&"'s (Name of Property Owner) property located at /-/y(f9 A , (Lot, Block, Road, etc.) on &J"K� in �� Z'- i, , 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) APR 009 ----------------------------- (Applicant Information) -1 �-' 96) �/ /Z), VY Mailing Address ity/State/Zip c� - 7a- Telephone Number /-/ -e-D (Riparian Property Ow er Information) Signature c d 1/ Print or Type Name Telephone Number q- - Y -- o6j Date Date ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIER/MOORING PILINGSBOATLIFTBOATHOUSE) I hereby certify that I own property adjacent to �'�AZI,d Ae0,W�s property located at 0/ (Name of Property Owner) /j (Lot, Block, Road, etc.) on �'�,��e, =� �� 2 , in / ! (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. tZ 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) APR 2009 Morw -------------------------------------------------- (Applicant Information) ?',J2 le oy /� ��- Mailing Address I-ej- V 7 City/State/Zip ,;;2. S-2 -- 7.2 4r�' �// Telephone Number —O —� Date (Riparian P oper Owner nformation) iKl_ Signature Print or Type Name -2-Q-7-6-C��7 Telephone Number Mg. .02 lv\-R� �� I �a e Q' r tl THE HARBOR MASTER, INC PH.(252) 726-2541 P.O. BOX 1048 MOREHEAD CITY, NC 28557 PAY TO THE ORDER OF 44061 66-30/531 DATE D 137 �— ®First Citizens Bank firstcitizens.com :053 1003001:0013 12 L03396u■