HomeMy WebLinkAbout57860_COOPER, A B_201104260 CAMA / ❑ DREDGE & FILL
GENERAL PERMIT 4 Previous permit #
E]New ❑Modification []Complete Reissue OPartial 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
City State ZIP
Phone # () Fax # ( )
Authorized Agent
CW EJ EW ❑ PTA
Affected
OEA ❑ HHF ❑ IH
AEC(s):
o PWS: 0FQ
ORW:
yes / no PNA yes / no
❑ ES ❑ PTS
❑ UBA ❑ N/A
Crit.Hab. yes / no
Street Address/ State Road/ Lot #(s)
Subdivision
City ZIP
Phone # O River Basin
Adj. Wtr. Body (nat /man /unkn)
Closest Maj. Wtr. Body
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Agent or Applicant Printed Name
PermitOfficer's Signature
Signature ** Please read compliance statement on back of permit **
Issuing Date Expiration Date
Application Fee(s) Check # Local Planning Jurisdiction RoverFile 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 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 Morehead City Headquarters
Mailing Address: 400 Commerce Ave
1638 Mail Service Center Morehead City, NC 28557
Raleigh, NC 27699-1638 252-808-2808/ 1-888-4RCOAST
Location: Fax: 252-247-3330
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
Fax:919-733-1495
(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
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
to impacts).
FINAL Sq. Ft.
(Anticipated final
disturbance.
Excludes any
restoration
and/or temp
impact ount)
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
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 ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
232• G:-210.3 .. 'J s COAs7 '-A-A-.a-I, IJ"
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TURNER bBR
DOCKS - DECKS - SEAWALLS - BOARDWALKS and BOAT LIFTS
R.O. BOX 1885 • Morehead Ci/, NO 2?5577
Phone 726-1253 Ca %aj 70?s - a v /6" (C
C%
North Caroiir,a Depar`rnent of En-vironment and R,iatural Resources �
d
D3'j;si�t1 (o Coastal Manag?-ent <all
Michael F. Easley: Governor Charles S. Jon es, �iractor William G. Ross Jr., Secret,r�
Date - - I b- I I
Applicaxit ,value ey«N6 ga B ►1T
mailing Acidness � C.cF1 ci'
l certify that l have auti[10rized (agent) �Dl��l� to aci On M'.-
behalf, for t1le purpose oa applying for and obtaining all CA14�iA Permits necessary to
install or construct (acti'Oty)at (location) _ _�_� � i 1 +3 -
PrT1, Prt4TI c- t3 c-+4
This ce'-fication is La}sCl t1iru (date) lam•
Signature
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to E-UG lL 6a�18 �s qo � z
4
(Name of Property Owner) j4%;,
,� V
property located at Q bS Nb�A S f4arz TA1;L j4.fn all
(Lot, Block, Road, etc.)
on MAP MA"6 C-.(\"L-- in �T[�1l�(G —&-i4, C.Ale (2Vr , N.C.
(Waterbody) (Town and/or County)
Applicant's phone 9 �`�� 6�?" �D� Mailing Address: 57 05116fAXS7 Cpvf2t
1>6-94fAm W— a?-2a5-1R2'4f
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 AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by property owner proposing development)
0 Q $
8 '
-----------------------------------
(Information for Property Owner Applying (RipanProtyner In rmation)
for Permit)
Mailing Address Signature
ts- r
City/State/Zip Print or Type Name
Telephone Number Telephone Number
Signature Date Date
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT c
I hereby certify that I own property adjacent to 606E*� DW lei 's r j
(Name of Property Owner) �;
property located at "L AAm PfAc
(Lot, Block, Road, etc.)
on V'(YAT4 M41fDZI GAt-- A - , in A-T'LW11C kc-4 ,_QA4(2 N.C.
(Waterbody) (Town and/or ounty)
Applicant's phone(:1O966-1-$b51- Mailing Address: t--1C�F-N7TtTa C
fiq�sm N c, --?`z 7 bS
He has described to me, as shown below, the development he is proposing at that Iocation, and, I
have no objections to his proposal.
---------------------------------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by property owner proposing development)
g tj'i i tv.
VMCK:
------------------------------------------------f----•----
(Information for Property Owner Applying
for Permit)
(Riparian Property Owner Information)
Mailing Address -- Signature
City/State/Zip
I - fu r- 3tr `1 �,
Telephone Number
Signature
Date
Print or Type Name
Telephone Number
Date
ADJACENT RIPARIAN PROPERTY O10 R STATEiIVIENT
� C,%oPE� qA
I hereby certify that I own property adjacent to E urcspy 0*$r is I j
(Name of Property Owner) �l14,,�
property located at vP D5 rog L, iirn C-2PAC , c�
(Lot, Block, Road, etc.)
on M-AO MPff— C+b-)AL, in 49 —(LPif-C- '13G44 C 3 KC.
(Waterbody) (Town and/or County)
Applicant's phone 19�64?- &� Mailing Address: S CZJ T ST
'psl*rn iJ(- '?-1-7bS
He has described to me, as shown below, the development he is proposing at that location, and, 1
have no objections to his proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by property owner proposing development)
S-r)
i
(Information for Property Owner Applying
for Permit)
Mailing Address
City/State/Zip
Telephone Number
Signature
Date
LA
(Riparian Property Owner Information)
Signature
Print or Type Name
Telephone Number
Date
Boll
SAMMIE E. TURNER
MARINE CONSTRUCTION ACCT
252-725-3415
P.O. BOX 1885
MOREHEAD CITY, NC 28557
DATE �( ' XC- —L
5090
66-112/531
TOTHF_
ORDER OF ..���—.���_bb���_�. E_.E __—_—___.--���_ •.�. .-- 1 $ CQ
-- -- i DOLLARS
• BRANCH BANKING AND TRUST COMPANY
1-800-BANK BBT BBT.com
FORIMP
053 10 L 1 2 &110 2 LOS8406Gum
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SAMMIE E. TURNER
MARINE CONSTRUCT40N ACCT
252-725-3415
P.O. BOX 1885
MOREHEAD C)TY, NC 28557
PAY
TO THE
ORDER OF
0
DATE
$
5090
66-112/531
DOLoa�aBa»
BRANCH BANKING AND TRUST COMPANY
(, ,� p�1.800-BANK BBT BBT.ccm r�
FOR `�v �` ►' 1 -1-tv '
NIP
1100 5090111 a,053 l0 L l 2 L+ 0005 2 L0584066ii'
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