HomeMy WebLinkAbout55347_JACOBELLIS, THOMAS_20100525❑CAMA / ❑ DREDGE & FILL
GENERAL PERMIT Previous permit#
❑New [--]Modification El Complete Reissue El Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources ' t 1-,)
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC r
_ ❑ Rules attached.
Applicant Name ' ^ t: �'�;{ �' j Project Location: County
Address r, ,'>J. J art' t l f Street Address/ State Road/ Lot #(s) ; ,-79
City �" if�J J ; i t Y` Stag Zl ~�
Phone # ( Fax_# ( -') Subdivision i+:_`y 5
Authorized Agent y E' C' City 'I i ZIP^
❑CW &fW >FPTA ❑ES ❑PTS Phone # River Basin
Affected ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
AEC(s): El PWS: ❑ FC: Adj. Wtr. Body : f ' {-- n man unkn
L ; _
ORW: yes / no PNA yes / no Crit.Hab. R
yes / "no
Closest Maj. WrrBody
Type of Project/ Activity Lox; � � )-on ,' 6
Pier (dock) length_ X _5
Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
h v,
,A+�r✓r�
Beach Bulldozing .
Other
I
Shoreline Length ~� `
SAV: not sure yes no
Sandbags: not sure yes no
Moratorium: n/a yes no
i — I --
Photos: yes no �'
Waiver Attached: yes �n
A building permit may be required by: _
Notes/ Special Conditions
Agent or Applicant Printed Name
i
Signature ** Please read compliance statement on back of permit
Application Fee(s) Check #
-1�
(Scale:' )
See note on back regarding River Basin rules.
Permit Officer's Signature
Issuing Date n ' Ex
pi rafion 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
landowners).
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/ 1-888ARCOAST
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/MOORhVG PILINGSIBOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to 7;; /,A 9s _i olog_ /%/.S 's
(Name of Property Owner)
property located at
,mil (Lot, Block, Road, etc.)
on .�2F.tJ % t �K�.c �- , in 1 11 C-o , N.C.
(Waterbody) (Town and/or County)
Applicant's phone #:
Mailing Address: 37 5oc.• E,0_ L,'I)
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 (IY) from my area of riparian access unless
waived by me. (If you wish to waive the setback, you must initial the appropriate blank
below.)
I do not wish to waive
`,_) G�
I do wish to waive that setback requirement.
--------------------------------------------------------------------�u------- -----------------------------------
p D �� ( o N o P DESCRIPTION AND/OR DRAWING OF P SED DEVELOPMENT:
(To be filled in b individual oposing development)
F� L) .J To EXlsT//V
-?I EiZ LJ/3D1' 1 zt {flG(S E
(Information for Property
for Permit)
7 S4zc)V E2 /V G ��
Mailing Address
kpptyilng
arian Property Owner Information)
w. >
/ Signature
,!✓ /i91LFo2D C-7 626 7710 j4j + M k CL _&�_A/ TAN
City/State/Zip Print or Type Name
,2sa - 70--
Telep Number Telephone Number
V .04� C1148A
Signature Date Date
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOOR 1VG PILINGSIBOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to �;;bA1,6S ,1 p /%/ S is
(Name of Property Owner)
property located at g3ai ,E�km '2c�
(Lot, Block, Road, etc.)
on / �F.�J % �dL� �� , in / k") /t c 0 � . , N.C.
(Waterbody) (Town and/or County)
Applicant's phone #: Mailing Address:3Z�vExl— PJ- .
,A)�c� /j'l i %vela CT- O17�
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. (If you wish to waive the setback, you must initial the appropriate blank
below.)
I do not wish to waive
I do wish to waive that setback requirement. �0-
- - ------------------------------------------ --------- -----------------------------------
b CT i o tJ o f- DESCRIPTION AND/OR DRAWING OF P SED DEVELOPMENT:
(To be filled in b indi>>idual oposing development)
�F-k —IE11,47-l6I,J To-XIsT/N4
S E
S
(Information for Property
for Permit)
Mailing Address
A&&,) /I'M1LF02d) C 2& %l4
City/State/Zip
arian Property Owner Information)
Signature
AAt M 'r y
Prin r Type Name
TelNumber I Telephone Number
Signature Date Date
AG..r.,....
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue, Governor James H. Gregson, Director Dee Freeman, Secretary
Date - = /f/ ` jd
Name of Property Owner Applying for Permit:
7x4'', "¢ S i e- l// Sr
Mailing Address:
37 �sp�t�cr2 141 %1
Alg,r,J /yliLc-a410> �!-r Cc/., 7 7
I certify that I have authorized (agent) .G4S Gd to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) Pil` fe ,V125AIt� ''a^j ,
at (my property located at) 0/3 a ---5X 4' CC A-'
This certification is valid thru (date)
Property Owner Signatfire
Date
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: 252-808-2808 \ FAX: 252-247-3330 \ Internet: www.nccoastalmanagement.net
An Equal Opportunity \ Affirmative Action Employer — 50% Recycled \ 10% Post Consumer Paper
NC Division of Coastal Mgt. Habitat Impact Computer SI
Applicant: Thomas Jacobellis
Date: May 25, 2010
General Permit #: 55347C
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
found in your Habitat code sheet.
TOTAL Sq. Ft.
FINAL Sq. Ft.
TOTAL Feet
FINAL Feet
(Applied for.
(Anticipated final
(Applied for.
(Anticipated final
DISTURB TYPE
Disturbance total
disturbance.
Disturbance
disturbance.
Habitat Name
Choose One
includes any
Excludes any
total includes
Excludes any
anticipated
restoration
any anticipated
restoration and/or
restoration or
and/or temp
restoration or
temp impact
temp impacts)
impact amount)
temp impacts)
amount
OW
Dredge ❑ Fill ❑ Both ❑ Other ®
150
150
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
252-808-2808 :: 1-888-4RCOAST :: www.nccoastaimanagement.net revised:02/03/10
TR PRESCOTT MARINE CONSTRUCTION LLC
545 ALLIGATOR LOOP RD 252-745-7135
MERRITT, NC 28556
Pay to the
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