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Home My WebLink About56831_HIGGINS, FRANK_20100917r� y-/7 l0 t� �� •:.• �a :ram s ❑CAMA / ❑ DREDGE & FILLS GENERAL PERMIT � Previous 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 i 5A NCAC ❑ Rules attached. Applicant Name Project Location: County City State ZIP Phone # O Fax # (� } Authorized Agent 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 Street Address/ State Road/ Lot #(s) Subdivision City. ZIP p fir. Phone # ( } _ /:' River Basin Adj. Wtr. Body (nat /man /unkn) Closest Maj. Wtr. Body .■■■■.■■■ NEW C■■■■■■■■■■■■■■■■■■■■■■■ ....CC■■■■■C■■■..■■■■■■■■■■■■■..■■■■■■ACC■ M.: ®CCCCCCCCCCCCCCCCCCCCCCCONE CMEN CC■C■C ■■■.■■■■..■■■■..■■■■■■■■■■■C mom ■■■■ ■■■■■■■■■■■■■■■■■■■■■■r�■■■■■■c�a■■■ Will M■iCCCCoCECCW®®CNEEM191 n■ii■EiCCC i■■■■■■■■■■■■C■■■■i�i■�9ii■■■S�MWENIC e■■■■ EN CCCCCCCENCCC®.CCCC :::W: VEMMMCMCCCC ■ ■ ■ ■■■ s■■■►�■■■■r,��■�n�■■■■■■ ■..C■■.■■■■■■.■■�.■■..■■■■■■■■■■■■■■ Agent or Applicant Printed Name Signature ** Please read compliance statement on back of permit Permit Officer's Signature Issuing Date J (+ Expiration Date ApplicationFee(s) Check# 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 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 V Date: 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 impact amount) TOTAL Feet (Applied for. Disturbance total includes any anticipated restoration or -temp impacts) FINAL Feet (Anticipated final disturbance. Excludes any restoration and/or temp impact amount 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 ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ 1i--'$38-4rC0A 2 r,!r�i��* t_ � z err _rri of rev a�: +3ZC3101 Appendix A Adjacent Riparian Property Owners Statement (for a bulkhead, dock/mooring pilings) I hereby certify that I own property adjacent to—. �,.7/' I (Name of property owner) property located at , 31-57 (Lot, Block, Road, etc.) on _, 2i6z"e , in 'i'r NC (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 dock/mooring pilings 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 drawing of proposed development: (To be filled in by individual proposing development) A r 1-14 Print name l L�s� S' �- Address A-2 ate Telephone number t, Appendix A Adjacent Riparian Property Owners Statement (for a bulkhead, dock/mooring pilings) I hereby certify that I own property adjacent to_ z ; ° s (Name of property owner) property located at (Lot, Block, Road, etc.) onOr�'G�' , in / `�P�� , NC (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 dock/mooring pilings 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 drawing of proposed development: (To be filled in by individual proposing development) A Signature Print name Date Address Telephone number A-2 0 • 0 f .Cc MICHAEL D FOLEY, JR. 66-7704/2531 568 LIC. 26016819 / �j(Z� 08631897316 PH.252-229-7147 `0 * ♦� 235 CARTER LANE �(G �:3 ] DATE /TRRENTTON, NC 28585 ` )� PAY TO THE ORDER OF p DOLLARS L'J EEL= g . i State Employees' Credit Union® x Trenton, North Carolina 240 nr a MEMO i�/7/!/f—' 1:2531?70L+91:0663 L89?3 L611' 0-56183 ^ -_--_' '-__�_---___-_ _-�_' // _--_____-' v _ -----__--_--___-__-'_'-__'-_' __- �____---'_-____-___ _ --__--_-_--_'-- _-__-__ __ - -__-------_-_---___� _ ___--- '__�-__'___-_-_ -__---_-_ _- �--��'---__-___� '_-__'--_-_-__� -__ _---'___' ��---___--__---'-� '_-_-' _-- _--_---_-_____--__--__-___--______-_--�---'__�--- --_-____ __-__-__-_--_--_� _-�_'_--'-_--_---_'-�-_�--_ - --_--___�_--__-----___'--_�-'---____-- _ -__----_-___- ______ ___ ________-� __-__-__--__-___�.__ ____---_-_-__--__'--_-______--'_'__---_----_--�_ _ ---__ ' �-_'--___�___-_-_'_-_-_____'___--- _� __'-__ -____ '_-______'-_---�-__-_--____'--___- ��-_' _____ -' - - ��`��`��`��'��`�� . _ _ _-'-_ -_ - _-______ -____-_______- _'_________ °