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HomeMy WebLinkAbout41322_VAN BEEK, LINDA_20050630L�CAMA / ' DREDGE & FILL GENE AL PERMIT 0]New L iModification ❑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_ Applicant Name L, Project Location: County /I Address Street Address/ State Road/ Lot #(s) CiState ZIP Phone # O // (,C . Fax # ( ) Subdivision Authorized Agent City _ < / ," , INN' T19-22- Previous permit # Date previous permit issued ,/ /-/ / / _ ZIP_ Affected ❑ CW ❑ EW ❑ PTA ❑ES ElPTS Phone # ( ) _ River Basin - ❑ OEA ❑ HHF 7 IH f_-1 UBA ❑ N/A AEC(s): Adj. Wtr. Body e,� ;�... _ (nat /man unkn) ❑ PWS: ❑ FC: ORW: yes / no PNA yes / no Crit. Hab. yes / no Closest Maj. Wtr. Body - Type of Project/ Activity Pier (dock) length Platform(s) Finger pier(s) Groin length number C Bulkhead/ Riprap length % avg distance offshore max distance offshore Basin, channel cubic yards Boat ramp Boathouse/ Boatlift _ Beach Bulldozing Other Shoreline Length P SAM not sure yes (no; r7 Sandbags: not sure yes �D Moratorium: n/a yes bio Photos: yes no Waiver Attached: yes no A building permit may be required by: Notes/ Special Conditions Agent or Applicant Printed Name Signature ** Please read compliance statement on back of permit t (Scale: . (i , i'. See note on back regarding River Basin rules. Permit Officer's Signature ` Issuing Datd Expiration Date Application Fee(s) Check # 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 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 consistentwith 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 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) 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 ADJACENT RIPARIAN R -AN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to L e- Is (Name of Property Owner) property located at (tot, Block, Road, etc.) orIA:N. C. eL (Waterbody) (Town and/or County) He has described to me as shown below, the development he is proposing at that location, 0 and, I have no objections to his proposal. f D LS C Ri 1 —110 IN A N—L) / 0 R D R AvVUG 0 F P R 0 P 0 S E D D E IVE LO PIN I EP--. (To be filled in by individual proposing development) IIbJ L) ------------- � ----------------------------------- -- ---------------------------------------- Sicynature a Print or Type Name �5 Q — � q :3 — C) S- Telephone Number Date: ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to property located at 11� vi�- 1111)D A (Name of Property Owner) (Lot, Block, Road, etc.) on �C> �� , in % / �� N. C. (Ivaterbody) (Town and/or County) He has described to me as shown below, the development he is proposing at that location, and, ve no objections to his proposal. _ -----------U------------------------------------------------------------------------- DESCRIPTION AN`D/OR DRAWING OF PROPOSED DEVELOPMENT (To be filled in by individual proposing development) ------------------------------------------------------------------------------------------------------------------ Signature C L [-4 /�J ') Print or Type Name "19. Telephone Number Date: V L. VAN SEEK 06-s2 2692 155 MEADOW LANE ' ' �c� ' ` , a / SWANSBORO, NC 28584 Date D 66-30/531 137 Pay to the Order of Dollars 6 FIRST CITIZENS 137 /, M.eh li d City Bank &2855 Company /._,,. ff j� I /( Mwphaed City, N.C. 28557 (__ JI VJ`L , For www. firstc itizens.com �/L-1 _ �' S 3 L00 300�.00 L 3 1 7408 L64ii' 0 269 2 o� GUARDIAWA SAFETY BLUE WBL 1