HomeMy WebLinkAbout59680_ANANDA, LLC_20111213❑CAMA / ❑ DREDGE & FILL
r. GENERAL PERMIT
❑New ❑Modification ❑Complete Reissue El 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 I SA NCAC
Applicant Name
Address
City
State ZIP
Phone # O
Fax # (}
Authorized Agent
❑ CW
❑ EW ❑ PTA ❑ ES ❑ PTS
Affected
AEC(s): ❑ OEA
❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
❑ FC:
ORW: yes / no PNA yes / no Crit.Hab. yes / no
i� Rom' .... .. • : � �a
;_',�CPO
Previous permit #
Date previous permit issued
❑ Rules attached.
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision
City ZIP
Phone # ( ) River Basin
Adj. Wtr. Body (nat /man /unkn)
Closest Maj. Wtr. Body
ME ..
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MEMO No■:
Agent or Applicant Printed Name
Permit Officer's Signature
Signature ** Please read compliance statement on back of permit Issuing Date
Application Fee(s)
Check # Local Planning jurisdiction
Expiration Date
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:
❑ 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
Mailing Address:
1638 Mail Service Center
Raleigh, NC 27699-1638
Location:
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
Fax:919-733-1495
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ 1-888ARCOAST
Fax: 252-247-3330
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico Counties)
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
0097
66-30/531
471
Date
Pay to
the L- I V i+\ 7 C
Order
O of � �
CIIPC-1 _ Dollars
First Citizens ---
Bank
I:0 5 3 L00 3001:00 L, 7 1 7 5 9 5 26 Sm, 000 9 7
MIN MR
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N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date ././// 7&
Name of Property Owner Applying for Permit:
Mailing Address:
� 0, 146t g �
I certify that I have authorized (agent) &es6O to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) bc—)c L q
at (my property located at)
This certification is valid thru (date)
Property Owner,Srg"ture
RIPARIAIN'ii PROPERTY OWNER STAX1'ET'1,1ENA`
I hereby certify that I own property adjacent to �)JI t.41(AL (' C ,S
(Name of Property Owner)
property located at `
(Lot, Block, Road, etc.)YY tt--
on f ¢ , in �f rt A+ , N.C.
(Waterbody) (Town and/or County)
Applicant's phone #: � ` Mailing Address: Q, CO3 °> C) i
cy t _Af 4 N C � V3 71
He has described to me, as shown below, the development he is proposing at that location, and, I
have no objections to his proposal.
LL` Dl.1Clr 11V1\ t>1\L/Vri L14t111711� V T1r0;0S
(To befilled in byrerty owning development)
i
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it' -14 to. 1?I AT - D & 11
-------------------------------------------------------------------------------------------------------------------
(Information for Property Owner Applying (Riparian Property Owner Information)
for Permit)
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Mailing Address
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City/State/Zip
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Telephone Nutiiber,
,).tee //// '
Signature
Print or Type Name
Telephone Number
Signature' / Date Date
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?y
12/8/11
English
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5:^.ob Bi:Sn83s Sal::i6t33
SERVICE STATUS OF YOUR ITEM DATE & TIME LOCATION FEATURES
First -Class Maim Delivered November 28, 2011, 3:49 pm IVARLBORO, NY 12542 Expected Delivery By:
November 25, 2011
Certified Mail'
Return Receipt
ON USPS.COM
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Notice Left November 25, 2011. 1:29 pm MARLBORO. NY 12542
Arrival at Unit November 25, 2011, 9:22 am HIGHLAND, NY 12528
Dispatched to Sort November 22, 2011, 4:51 pm BAYBORO, NC 28515
Facility
Acceptance November 22, 2011, 11:03 am BAYBORO, NC 28515
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'ShIp a Package Sand Uai Sus ness So LA nsWa/
SERVICE STATUS OF YOUR ITEM
DATE & TIME
LOCATION
FEATURES
First -Class Maid Delivered
November 29, 2011, 4:13 pm
ISLIP TERRACE, NY 11752
Expected Delivery By:
November 25, 2011
Certified Mail'
Return Receipt
Notice Left
November 26, 2011, 12:26 pm
ISLIP TEPRACE NY 11752
Arrival at Unit
November 25, 2011, 8:01 am
ISLIPTERRACE NY 11752
Processed through
November 24, 2011, 10:45 pm
FARMNGDALI; NY 11737
USPS Sort Facility
Dispatched to Sort
November 22, 2011, 4:51 pm
BAY BORO, NC 28515
Facility
Acceptance
November 22, 2011. 11:03 am
BAYBORO, NC 28515
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1
I
p
■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
y 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.
`i 1. Article Addressed to:
LU.DW 1&- T. 5 , VVN ME✓`
1 S 1i �,L E � -1
c�aRL S0 ,2,o1 r') y 1 a s 4 Z-
A. Signature
X ❑ Agent
❑ Addressee
B. Received by (Printed Name) C. Date of Delivery
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
3.
Se ' e Type
Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number 7008 0150 0003 6074 3727
(Transfer from service label)
PS Form 3811, February 2004 Domestic Return Receipt 102595.02•M-1540
UNITED STATE,
• Sender: Please print your name, address, and ZIP+4 In this box •
Nywk24 N i�—
L P r2 D
ME 4A QC-
UNITED STATES POSTAL SERVICE
First -Class Mail
Postage & Fees Paid
USPS
Permit No. G-10
• Sender: Please print your name, address, and ZIP+4 in this box •
T �i t+v�rJ ags S
11.,11*11J., 1".).J..J.1,.1L,I I-J]!;jj,"..tv,,J,;1.l,1�,.1.Jf
■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ 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, Article Addressed to;
ED1'JA-"2-0 T- T9 1 12 O T► S
350 MA1Pt✓E111)0OzS
F—SL, �' T�✓ZRa4c� f N y t t - 5
2. Article Number
(Transfer from service label)
PS Form 3811, February 2004
A. Signature
X fx/ ❑Agent
❑ Addressee
B. �teceiv% bey (Prinj�darn,) - C. Date of Delivery 4
OD
D. deliveryD. Is delivery as rent from item 1? ❑ Yes
If ❑ Yes
If YES, r delivej Ie ss below, ❑ No
a
m
oti �
3. Servibd" type
❑ Certie� ILlaiyK N cpress Mail
❑ Registered Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
7008 0150 0003 L074 3710
Domestic Return Receipt 102595-02-M-1540