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Home My WebLink About57876_BAILEY, MATT_20110429❑CAMA / ❑ DREDGE & FILL GENERAL PERMIT Previous permit # ❑New ElModification ❑Complete Reissue El 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 El Rules attached. 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 y& / no Crit.Hab. yes / no Project Location: County Street Address/ State Road/ Lot #(s) Subdivision City ZIP Phone # O River Basin Adj. Wtr. Body (nat /man /unkn) Closest Maj. Wtr. Body Type of Project/ Activity Pier (dock) length :.. NINO 1111101000000 ro-m-mamiammm moommomm MINES ■■■■®lalA�O■■�■MO■i/1■lMOilil�■■■■■.■■■■■■■ ■■®■r!�■■ ME■■■■■ ENS!■■■ ■■ ®■■■®�,'iL3 ■■■l■M�iE■■■E■■'I/■■■M!■a■■■■■ NONE■■_ �■ ■■■■■■■■■■■■ MwffEEOM■!■■N■■■■■■■■■■■■■■ ■■■■■■■■■i((isi■ii■■�i�■■■■■��■i■■■■■■■■■■■■ ■�■■■ MEN ■■Mf�si®1��lEon"MEOO■E■E■■EOMEEEE ■.�IAMAN1l1O■M MIMOM MEMO ■■■■■■■■■■■ONE • �Ja EEME=EEE■E■EMEUEEEEEEE■EE■■■EEEEE■ ■OE■ ■OOE■■EOEEOEEME■ME■■■■■OEO■■■■EEO EOO■EME■E►�Z■O■■EO■EMEMEMEE■EEE EEME■MEE EEO■■M■■E■■■■■■O■■■■EEO■■■■■■ ■EEE■E OO■MM■■■■■■E ■EMM!■■■■O■M■■■ ONE MEN • o EEEEE■r�EEE■EEEEEME®ate■EEEE■■MrXNMUw■EEE OEO■EM■OE�#EE ■■EE■!� ■■EEO!■ME■rsE �E■!E■wO=EEE O■■!■Em■®a■■E MEN ONE M■OOE■■■Ol�rOOO�OOO■MOO■OOOOO■!!O■OOOOOO ■■■E■■■■■■■■■■EOEE!■■EO ■■■■E■■■■�■!■E Agent or Applicant Printed Name Signature Please read compliance statement on back of permit ** t Permit Officer's Signature Issuing Date 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 landowners). 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 (910-796-7215) 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 NC Division pack Computer Sheet 'Applicant: Matt Bailey Date: April 29, 2011 General Permit #: 57376C Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement found in your Habitat code sheet. Habitat Name DISTURB TYPE Choose One TOTAL Sq. Ft. (Applied for. Disturbance total includes any anticipated restoration or temp impacts) FINAL Sq. Ft. (Anticipated final disturbance. Excludes any restoration and/or temp impact amount) TOTAL Feet (Applied for. Disturbance total includes any anticipated restoration or temp impacts) FINAL Feet (Anticipated final disturbance. Excludes any restoration and/or temp impact amount HG Dredge ❑ Fill ❑ Both ❑ Other ® 90 90 OW Dredge ❑ Fill El Both El Other 1,001 1,001 Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ ADACE-N Y RIPARL4, PROPERTY ONNINER STAT'E214TxENT I hereby certify that I own property adjacent to t' A I1 Y ;eLi i1xE l-. (� (Name of Property Owner}-1 property located at "I `.�_ .�' s •'s' ... -, o c' �- ,Lot, $lock, Road, etc.) �j e on t `I eo t. f- -. r* t" , in faVP.} .i�C.' . J . g am , N.C. (Waterbody) (Town and/or County) Applicant's phone #910 65+C>Z�Gcz Mailing Address: -" SLYZI 1 F uej , F He has described to me, as shown below, the development he is proposing at that location, and, I have no objections to his proposal. DEScRfpT10,N A:INDIOR DRAWING OF PROPOSED DEVELOPMENT: (F (To be Wed in by property owner proposing development) k < j eta �v .. Q -,--� �-2, C(ZJ t �a O %t}a (information for Property Owner Applying (Ripa P perty Owner Information for Permit) % Mailing Address Aignature Citylstatelzip Print or Type Name yDL-oz Tel e Number � Telephone Number 2 (P �\ Signature Date Date A-DJACEN'T RIPAR:WNIPROPERTY OWNER STAMED-MIN—il I herrebl, certify that I ()w-,tprrperry adi-,,cent to [A,, (Name 6f Properq, Owaer)^ property located at (IL-3t, !Binct�' Road, etc.'' on N.C. (Waterbody) (Town and/or County) ApplicanVs phone #PWO -ODisc,, 'Mailing Address: ":NV ;O Ke) as described to rne., as shown belo%,.,,tliede.velo-niner.tire ;s proposinz-az !N!" loce-Tion.and. 1 have no objections to his proposal. ----------- ------------------------- -- -- — ---- ------ 11 ESCR WF! 0 N -410V-40 R 01�t-k IVY! N G OF FROPOS ED DE V E L01!1V"E' NT: (To he fitted in bv property mvner proposing developmen!) L. D C> ............ A 2- iz ...... — -------------------- --------- (Information for Property Owner Applying (Riparian Pro erty Owner Information) fo r Permit) Mailing Address Signature Citv"Sla-C"Yip Print or ype \N ame eleDhoine N"urnber Telephone Number z LJ Signavui'e pare Date -y/►- /� -� % 1 t , t• c> 4 1 i ttiT'41t`�� `?� 3a3p o.R'.L F> 4077A i LIA4V7,^^ herchv CCTV'R, that 1 Uwn property adiacCrit to (-gyp !a.y�P:.�..3 zl� lztE `�— .. ✓% 'g (Name of Property Owner)^ property located at (Lot. ?toad, etc.) in 'ft��3''_i� .=� i.`� ^ jam_. V.C. (Waterbody) (Town and/or County) Applicant's phoneMailing Address: He has described to me. as shown 6eiow, the development he is prn- sm- at that location. and. 1 have no objections to his proposal. 71)FSf_'RtP'I!0N A.NDPEW, DRAWING (,k PROPOSED (T'o be filled its by property owner proposing development)to v a 1 ----------------------------- (Information for Property Owner Applying (Riparian Pro erty Owner Information) for Permit) `v��C t `6i�i:� (/lam �i l✓� Mailing Address ___ Sitrnature '��`yp..--t�' �,. `•� � �G � - _ ��. G;% _�.___ � c. �• •tom. Ci.r State/Zip Print oriype tiame TeleDhurw Number Signatu?e Late Telcphone Number Date rrofteN RBCEIVED APR-2 9 2011 I)CM-MHD CITY ADJACEN- 7 RIPARLAN PROPERTY OWNER STATEMENT I hereby certify that I oNvn property adjacent to hA (Name of Property Owner)' r. c• property located at 55 �-� F'' �� 1,3 (2- Z'RCC--?7>— tLet, Block, Load, etc.) on NCOt)n �'1`1C-r- in '11pypw7 � (��' �-� ��'� ,N-C. (Waterbody) (Town and/or County) Applicant's phone # 13 -��r` E" -�a Mailing Address: :-')C'7�xill/ !1 P OPT le , He has described to me, as shown below, the development he is proposing at that location, and, I have no objections to his proposal. - -DESCRIPTION A:NIDIOR DR:kWfNG OF PROPOSED DEVELOPMENT: t�e o be lied in b ro er o owner proposing development) (T � YP P t1 P P o •1 � i �B s viP ; G ('Information for Property Owner Applying (Rips ' P perry Owner Information for Permit) % lvlailing Address ignature J'A "Cka T �✓ —_ City%State: Zip Print or Type Name 10- iLI01-535!] a-tC>� Tel e Number Telephone Number Signature Date Date ib Q -Z RECEIVER APR 2 9 2011 DCM MHD CIrV MATTHEW J BAILEY L� 177 1 INEZ L BAILEY PH. 910-849-5357 66-1 t 2/531 956 BECTON RD HAVELOCK, NC 28532-8655 v Date Pay to the ^ r Order of , �1 O' 1 BRANCH BANKING AND TRUST COMPANY 1-800-BANK BBT BBT.com For L' -<<— 1:0 5 3 10 L L 2 11: 1 0000 6 L ?0 2 31,'00