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HomeMy WebLinkAbout40741_WHITE, LEON_20041222C.41VIA / i._ J DREDGE & FILL .9)""G1 GENERAL PERMIT P iouspermit# FINew El Modification F'Complete Reissue LlPartial 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 Project Location: County___________ Address U'"'' f ' ` Street Address/ State Road/ Lot # s City A 1 r - State --- ZIP -------- - -- ----- - ----- ---- Phone # O Fax # (`) Subdivision - Authorized Agent City ZIP ❑ CW OEW D PTA ES PTS Phone # () —__—_ River Basin Affected OEA ❑ HHF ElIH Fl USA - N/A AEC(s): Adj. Wtr. Body (nat /man,Junkn) ❑ PWS: ❑ FC: ORW: yes / no PNA yes / no Crit. Hab. yes / no Closest Maj. Wtr. Body --- Type of Project/ Activity (Scale: ) Pier (dock) length Platform(s)___ Finger pier(s) Groin length number Bulkhead/ Riprap length avg distance offshore _— max distance offshore Basin, channel 1* �4- cubic yards Boat ram - Boathouse/ Boatlift— li y. _ Beach Bulldozing --------- S - -� - — --^ Other Shoreline Length SAV: not sure yes no Sandbags: not sure yes no Moratorium: n/a yes no Photos: yes no Waiver Attached: yes no. A building permit may be required by: Notes/ Special Conditions Agent or `_rplicant Printed Nana} ' Signature Please read compliance statement on back of permit" Application Fee(s) Check # See note on back regarding River Basin rules. Permit Ofli sSignature Issuing Date Expiration 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 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 consistentwith the North Carolina Coastal Management Program. River Basin Rules Applicable To Your Project: j 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 Elizabeth City District Mailing Address: 1367 U.S. 17 South 1638 Mail Service Center Elizabeth City, NC 27909 Raleigh, NC 27699-1638 252-264-3901 Location: Fax: 252-264-3723 Parker -Lincoln Building 2728 Capital Blvd. Raleigh, NC 27604 919-733-2293 / 1-888ARCOAST Fax: 919-733-1495 (Serves: Camden, Chowan, Currituck, Dare, Gates, Pasquotank and Perquimans Counties) Morehead City District 151-B Hwy. 24 Hestron Plaza 11 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 // P057AL SERVICE® -r v ►71IA-L Al "INN Y M-11)E i .. . _ o00 SERIAL NUMBER ... .. r YEAR, MONTH; DAY POST OFFICE U `tl6 LLARS AND CENTS. 0705901669l 2004-12-21 85;�0n � AMOUNT: LINE HUNDRED DOLLARS 9: Ocil� PAY TO /� NEGOTIABLE ONLY IN THE U.S.'AND POSSESSIONS. EN ' SEE REVERSE WARNING ADDRESS FROM CLERK C.O.D. NO. OR� r 1 ! USED FOR 0�1 1:000001300 21: 073590 46691111 Ir«� ADJACENT PJPAJUA►N PROPERBYo 3.�.. � -"UMNT 4G PILIf5 d fF()RA P16)V'"00 f- �! G i hereby certify ttmt t own PrOPefty adjacent to _� (Nion+e of properly ()wntr) Eli propemy located at ock, Road, etc.)-- - on64�� , to (T n and/ar uo nty) (�,'a ecbodlrl He has described to ^°e. as shn b,,-low, the de%etopment he is prupU51ng at that 110cation, tand and, I have no pbjeCtiorls to b a msnpmjn. distdne f f►sfteer, fetta(l5) r` m my area ptisnts,'kxo.tl,Wboathoust must. be set of riparian a:cess unless waived by me. 6 dig no, wish to wave the SCqhhcK rcQuire,r,ent. 1 do wish to wave that setbAck regkJivnent. .............. T'E;,SCi(tP'i'dU, AND!OR�DRA`YING OF PROPOSED DEVE WP IENT: (To be f hell in by individual Proposing developrntrt() ' Pro ��c.�< 1---- ff,Kts Sign�tut� " print or Type Name Te)ephone Numbv Date 4� �� U Sk AW N ' RIPAWAN pRopERI, y OWNER � �� �` I' ,(FUR AADJ1i'IERi�6f+DOR11yG PI1.11�GSE8 3�(e ••��- K � l v v 'S i hereby certify that I own pmperty adjacent to (Nzante of Peon y (2wneri t� Vroperty located at ock, Road, ete.i in on (? n and/or County) (�Va4erbody) He has described to nee as shrµr, belo,v, the de%,etapmartt he ss proposing at that locA.00P, and. I have no objections to his proposal. C uncierstand that a pier,'mc►c'ring piling&Jb0atVL/boath'0uye rust be set back a min:msn, distance of `cfteer. feet (15') fram my a7sa Oil riparian a.:tess k)r31ess waived by me. ( wish to waive the setback requirement. 0 to wash to wive that setback req�.ire+nent. ..___-. Df:SC Fttr'j-10N AND OR. r)R.,4%VTNiG OF P opo EDVELOPMEVT* (To be filled in by ludavWual proposingdevelopment) e5 c print or Type Name 7 5 _ _ ---- - --- i-elephone Number Date: 12Z / � 7