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Home My WebLink About34039_GRAY, DON_20030529.. 7CAMA / ❑ DREDGE & FILL{ GENERAL PERMIT Predis'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 15A NCAC ❑ Rules attached. Applicant Name Address City 1, , ;v, iie State Ji ZIP :, 6) _ Phone # Fax # ( ) Authorized Agent - 6b S a / l ti G r, t.-C ❑ EW El ❑ ES ❑ PTS Affected CW AEC(s): Ci OEA 1:1 HHF ❑ IH ❑ USA ❑ N/A PWS: ❑FC: ORW: yes / no PNA yes / no Crit. Hab. yes / no Type of Project/ Activity Project Location: County Street Address/ State Road/ Lot #(s) Subdivision City ZIP Phone # ( ) _ River Basin Adj. Wtr. Body__ ,_ (nat /man /unkJn Closest Maj. Wtr. Body �� ,,,� z ✓ �r,cr-; : J; j, I in (Scale: N,-, Pier (dock) length i Platfo Finge Groin Bulkh Basin, Boat Boath Beac Othe Shore SAV: Sandi Mora Phot< Waive h r —t I r pier(s)77T- J length number ead/ Ripraplength J I J avg distance offshore �_ J max distance offshore channel cubic yards L {^ J I - ramp......_._............... .....---t t ..... ouse/ Boatlift J J _ I Bulldozing - - J I .... ........ ._ line Length �� i"` � _ i i p I Ii not sure yes no ags: not sure yes no— :orium: n/a yes no `! i i s: yes no :r Attached: Yes no A building permit may be required by: Notes/ Special Conditions ❑ See note on back regarding River Basin rules. Agent or Applicant Printed Name Permit Signaturd r�14tt)a)3 CNI A-t2a Signature Please read compliance statement on back of permit* Issuing Date f/ Expirati ate ApplicationFee(s) Check# Local Planninglurisdiction Rover File Name A building permit may be required by: Notes/ Special Conditions ❑ See note on back regarding River Basin rules. Agent or Applicant Printed Name Permit Signaturd r�14tt)a)3 CNI A-t2a Signature Please read compliance statement on back of permit* Issuing Date f/ Expirati ate ApplicationFee(s) Check# Local Planninglurisdiction Rover File Name lk 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, certifythat this project is consistent with the North Carolina Coastal Management Program. River Basin Rules Applicable To Your Project: ❑ Tar - Pamlico River Basin Buffer Rules ❑ Neuse River Basin Buffer Rules ❑ Other: 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 (910-395-3900) for more information on howto comply with thesebuffer rules. Division of Coastal Management Offices Central Office Mailing Address: 1638 Mail Service Center Raleigh, NC 27699-1638 Location: Parker -Lincoln Building 2728 Capital Blvd. Raleigh, NC 27604 919-733-2293 / 1-888-4RCOAST 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) Morehead City District Wilmington District 151-B Hwy. 24 127 Cardinal Drive Ext. Hestron Plaza II Wilmington, NC 28405-3845 Morehead City, NC 28557 910-395-3900 202-808-2808 Fax:910-350-2004 Fax: 252-247-3330 (Serves: Brunswick, New Hanover, (Serves: Carteret, Craven, Onslow -above Onslow -below New River Inlet- and New River Inlet- and Pamlico Counties) Pender Counties) www.nccoastaimanagement.net Revised 10/05/01 it PAY TO THE ORDER OF FOR rnhnnreA Aaca mrnf._ 5rr- bn_rk for AtlalIs- uy�� r �] 5 r . a__ — COASTAL MARINE CONTRACTORS INC PH. 252-638-6407 PO BOX 12729 Q NEW BERN, NC 28561-2729 DATE A), gm • oo 66-112/531 01901 s leo 0 1,) DOLLARS 8 �^ BMT BRANCH BANKING AND TRUST COMPANY NEW :B7E�NORTH CAROLINA u■ 1:05310112L11:5L�IO6Is2C398ii' u 0068 38 emu,. uiR6+TW,.31]AWQ -i...:iiimill,lf�++i:1l iYS.'NItl..11{�.RIY(�1 :. 1-1 :IPRG'..iS:llRri!r5':a'�� — 9 ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIERIMOORING PILINGS/BOATLIFT/BOATHO USE) I hereby certify that I own property adjacent to C) N is (Name of tProperty Owner) property located at �� VC AI O LcWgt nr (Lot, Block, Roaft, etc.) on _ -7rAi° N l , in C o , N.C. (Waterbody) (Town an 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 piling s/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) 157 e � aD �ol-D 1 _Yz s��2z9,� �Y 1 e' I C., ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIERIU00RING PILINGSIBOATLIFT/BOATHOUSE) I hereby certify that I own property adjacent to vo N Gg A 's (Name of operty Owner) property located at b) ve l D of k avd,v (Lot, Block, Roa , etc.) on O C N t C1.KU-AL , in 1 t C a , N. C. (Waterbody) (Town an 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/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 DRAWING OF PROPOSED DEVELOPMENT: (To be filled in by individual proposing development) G � Ox`�a EL 1 57 fie � da � C L,k5TO /r^ �� LL --- ------ - --- ----- - ----- �-1-------- ----- Signature Print or Type Name Telephone Number Date: 10 - 04 - 0�)