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Home My WebLink About33118_LA BRIE_20030114❑,CAMA / ❑ DREDGE & FILL GENERAL PERMIT ❑New ❑Modification ❑Complete Reissue ❑Partial Reissue 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 Previous permit # Date previous permit issued attached. Applicant Name,�Ii, !%i, S !; rx by-, C Project Location: County A Address `7 Ll 3fe i a D010e", -C)s- Street Address/ State Road/ Lot #(s) City State" Y ZIP Phone # Fax # (J) Subdivision Authorized Agent City ZIP Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Phone # (,) River Basin AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body (nat /man /un n ❑ PWS: ❑ FC: ORW: yes / no PNA yes / no Crit. Hab. yes / no Closest Maj. Win Body Type of Project/ Activity (Scale: Pier (dock) length Platform(s) Finger pier(s) I Groin length number Bulkhead/ Ripraplength avg distance offshore max distance offshore Basin, channel i I ` Y I I. cubic yards Boat ramp Boathouse/ Boatlift + j - Beach Bulldozing Other 1 I C 14 Shoreline Length SAM not sure yes no Sandbags: not sure yes no Moratorium: n/a yes no Photos: yes no _ ..' Waiver Attached: yes no -- f A building permit may be required by: Notes/ Special Conditions iv _. - — ! _. ❑ See note on back regarding River Basin rules. Agent or Applicant Printed Name Signature a Please read compliance statement on back of permite Application Fee(s) Check # Permit Officer's Signature Issuing Date Expiration Date Local Planning Jurisdiction Rover File Name ..�..�-�. �.. _ a"�:_9:ww,...ii�-�vr.}`-- ..:vs.;�i.��1'c..fy�o•LL �..i&.::':�.eai,�a_. -, sa::g .k—�.�.:. i3:�,-d �.sLs-. 1,.: :.:.ter. _.+ , ;.:::i:�.. 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 (910-395-3900) for more information on how to complywith 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 / 1-888ARCOAST 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) Morehead City District 151-B Hwy. 24 Hestron Plaza II Morehead City, NC 28557 202-808-2808 Fax: 252-247-3330 (Serves: Carteret, Craven, Onslow -above New River Inlet- and Pamlico 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 910-395-3900 Fax: 910-350-2004 (Serves: Brunswick, New Hanover, Onslow -below New River Inlet- and Pender Counties) www.nccoastalmanagement.net Revised 10/05/01 LAWRENCE J. LA BRIE NC 28512 �TACHOVIA Wachovia Bank of North Carolina, N.A. "Morehead City, NC 28S:i" 0264 66-152/531 $RC V:IId IeRluRn DOLLARS Q n.i.u. �. w'r FOR 3 I I _- - ----- - -- :1:053LOL5291: 5462 L9491,5110 0264 .: t _ DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVERL�FOR/M {� Name of Individual applying for Permit: L Address of Property: ^p f1 ( �^ 1 "rl !"ln RCI 7'1oY'es fV� er"�1 Ccic✓t�Y (Lot or Street #. Strut or Road, City & County) I hereby certify that I own property adjacent to the above referenced property. The individual applying for this permit has described to me as shown on the attached drawing the development they are proposing. A description or drawing, with dimensions, should be provided with this letter. '� I have no objections to this proposal. If you have objections to what is being proposed, please write the Division of Coastal Management, Hestron Plaza A 151-B, Hwy. 24, Morehead City, NC, 28557 or call (252) 808- 2808 within 10 days of receipt of this notice. No response is considered the same as no objection if you have been notified by Certified Mail. WAIVER SECTION I understand that a pier, dock, mooring pilings, breakwater, boat house, lift or sandbags must be set back a minimum distance of 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.) JZ" I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. OS o i Sig((��ature Date �10�41'3 tu_4r-tom — Print Name ZS Z- _22.U-41 96 Telephone Number With Area Code . sx, j, WX :fM^ s �,, r-i dx,i r g 6QLJ CD os • Sender: Please nt our n fne, address;°Fi'P+4 fntf"�,•' Fir n, koo/( Shores 1 r ■ Complete iten item 4 if Restr._.__ ■ Print your name and address on the reverse so that we can return the card to you. ■ Attach this card to the back of the mailpiece, or on the front if space permits. 1. A ticle Addressed to: S6 -SIT 9 �o ��-��r-� ee-ni 6l e- aad3� - � fl u rAyem ❑ Addressee B. Received by (Printed Name) Datep Delivery D. Is delivery address different from item 1? ❑ Yes If YES, enter delivery address below: ❑ No 3. Service Type Certified Mail ❑ Express Mail ❑ Registered ❑ Return Receipt for Merchandise ❑ Insured Mail ❑ C.O.D. 4. Restricted Delivery? (Extra Fee) ❑ Yes 2. Article Number (transfer from service label) 7002 0860 0003 9498 1900 OPS Form 3811, August 2001 Domestic Return Receipt 102595-02-M-0835 N Y