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Home My WebLink About57041_DANIELS, MELISSA_20110127❑CAMA / ❑ DREDGE & FILM, GENERAL GENERAL PERMIT Previous permit# ❑New ❑Modification ❑Complete Reissue ❑Partial Reissue44 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 I SA NCAC Applicant Name Address City State ZIP Phone # ( ) Fax # ( ) Authorized Agent CW ❑ EW ❑ PTA Affected ❑ OEA ❑ HHF ❑ IH AEC(s): ❑ PWS: 0 FC: ORW: yes / no PNA yes / no ❑ ES EJ PTS USA ❑ N/A Crit.Hab. yes / no ❑ Rules attached. Project Location: County Street Address/ State Road/ Lot #(s) Subdivision CityZIP Phone # O River Basin Adj. Wtr. Body (nat /man /unkn) Closest Maj. Wtr. Body i BE M11111 'Ewa MENEM' iiiiiiiiiiiii2i . • NINo■■■■■■■■■.■■OEM■.■■■■■OEM MOM■■■■■■ ■..•...■■MN■MEE■■E■ME■■■■■E■■E■OMM■M■ ■■■.■■■■■■■..■■�I.�'i.i�7....[!■■■r�■■■■■■■■ ■.■■■ ■ ■■■ MEMO ■C■OMMO■K■EMEM■■■■■■ mom ■ ■■■■■■■■NMEME■■�1■■■■■■■■■NONE ■■■■■ ■■■■■■■■EEO■■OMOS!■MEME9V1LrE■ :. ■lfi�lY11[�iLttM.Ii�®t' No MEMO ME ■■■l�l■■■■.i�■■N MM■■EMMEN Agent or Applicant Printed Name Signature ** Please read compliance statement on back of permit Application Fee(s) Check # Permit Officer's Signature Issuing Date Expiration Date Local Planningf urisdiction 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 consistent with the North Carolina Coastal Management Program. River Basin Rules Applicable To Your Project: ❑ Tar - Pamlico River Basin Buffer Rules ❑ Neuse River Basin Buffer Rules ❑ Other: 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 252-946-648 l 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 of Coastal M91. Habitat Impact Computer Sheet Applicant: Melissa Daniels Date: January 27, 2011 General Permit #: 57041C 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 OW Dredge ❑ Fill ❑ Both ❑ Other ® 686 686 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 ❑ 252-808-2808 :: 1-888-4RCOAST :: www.necoastalmanagement.net revised: 02103/10 Jan 14 11 08;09a Melissa 550-802-8215 p.2 NCDENR Varth Carollna Department of Ervirvnrnen,[ and Natural Kescurees t)j,As+on of COW0 Management Beurl3y Eaves Pa�lue, Governor ,Samos H. Gmpgn, Dirvctef Erperrtan, Eestca^y date i' // Mailing Address r %� i �r certify Mat F hnve autbay)zed (agent) to aeton my bebair, !'ar the purpose zf applying for and obtaining all CAMA Pern;its necessaq 0 • ,y install or construct (sciivity) Tbia certit;cabon is solid tbru (date) S igu ato refl` ' 400 Cumn:erce Avenue, orithead City, Nod Carolina 28557 Phone: 252-808-=81FAX. 252-247-333011ntemet: Yrkw.r,ecoastalmamgernent.�iet AnegiJdppnrfunkyIAYirrrsrrveAdonE-nopyer- SOY. 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(Waterbody) (Town and/or County) AppIicant's phone #: LSL J9!S 4 Mailing Address: I GOD �P 09S60 He has described to me, as shown below, the development he is proposing at that location, and, I have no objections to his proposal. I understand that a pier/mooring pilings / boatlift / boathouse must be set back a minimum distance of fifteen feet (15') from my area of riparian access unless waived by me. (If you wish to waive the setback, you must initial the appropriate blank below.) 1 do not wish to waive I do wish to waive that setback requirement. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: (To be filled in by individual proposing development) (Information for Property Owner Applying for Permit) -r Mailing Addres City/State/Zip �Soy ("I(�n Telepho e Numb f Signature Date (Riparian Property Owner Information) Signature Print or Type Name ,2sa) 6 34; --0 75 Telephone Number Date Jo 2f T 61L z .9 q, of� T-Imcl ty'7�-Qp w ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIER/MOORING PILINGS/BOATLIFTIBOATHOUSE) I hereby certify that 1 own property adjacent to (Name of Property Owner) property located at Z�,-'�57,� // ' (Lot, Block, Road, etc.) on �vS e !i , in ,c wYr��/ �4�ie� N.C. (Waterbody) (Town and/or County) Applicant's phone #: �,��— ailing Address: ZG He has described to me, as shown below, the development he is proposing at that location, and, I have no objections to his prOposal. I usderstoad that a pier/mooring pilings / boatlift / boathouse must be set back a minimum distance of fifteen feet (15') from my area of riparian access unless waived by me. (If you wish to waive the setback, you must initial the appropriate blank below.) I do not wish to waive i do wish to waive that setback requirement. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: (To be filled in by individual proposing development) , i %L V VLev ------------------------------------------------------------------------------------------------------------------- (Information for Property Owner Appi ing (Riparian Property Owner Information) for Pe i5 71 � 1z Maili g Address Signature Print of Type Name Telep4wierJNiimber17 Telephone Number oignature Date Date o (DomesticOnly,.•, M r m .0 Postage $ M $2.80 01 Certified Fee M r-I Return Receipt Fee $2.30 Postmark Here p (Endorsement Required) Restricted Delivery Fee $Q`� (Endorsement Required) O ° R.I Total Postage &Fees d5.S4 01/13/2411 O i Sent Ti ---------- ----�C � Street, Apt. No.; or PO Box N-- - -- / 1.r�� f --- - i(f GG// f !! PS Form 3800, ALIgust ... See Reverse for InstrLIC601= Certified Mail Provides: ■ A mailing receipt ■ A unique identifier for your mailpiece ■ A record of delivery kept by the Postal Service for two years Important Reminders: ■ Certified Mail may ONLY be combined with First -Class Mail® or Priority Maile. ■ Certified Mail is notevailable for any class of international mail. ■ NO INSURANCE COVERAGE ;IS PROVIDED with Certified Mail. For valuables, please consider Insured or Registered Mail. ■ For an additional fee, a Return Receipt may be requested to provide proof of delivery. To obtain Return Reos)pt sorvice, please complete and attach a Return Receipt (PS Form 31111) to the article and add applicable postage to cover the fee. Endorse mailpiece "Return Receipt Requested'. To receive a fee waiver for a duplicate return receipt, a U$PSd postmark on your Certified Mail receipt is required. ■ For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent. Advise the clerk or mark the mailpiece with the endorsement "Restricted Delivery". ■ If a postmark on the Certified Mail receipt is desired, please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed, detach and affix label with postage and mail. IMPORTANT. Save this receipt and present it when making an inquiry. PS Form 3800, August 2006 (Reverse) PSN 7530-02-000-9047 1 L�. Postage. Cert'rfied Fee Ol Postmark Return Receipt Fee $2. (Endorsement Required) Here Restricted Delivery Fee sl] • �Q (Endorsement Required) Total Postage & Fees $ 15.54 nlf13f2411 PS Form 3800, August 2006 See Reverse for Instructions Certified Mail Provides: ■ A mailing receipt ■ A unique identifier for your mailpiece ■ A record of delivery kept by the Postal Service for two years Important Reminders: ■ Certified Mail may ONLY be combined with First -Class Mail® or Priority Maile. ■ Certified Mail is not available for any class of international mail. ■ NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables, please consider Insured or Registered Mail. ■ For an additional fee, a Return Receipt may be requested to provide proof of delivery. To obtain Return Receipt $ervice, please complete and attach a Return Receipt (PS Form 3811) to the article and add applicable postage to cover the fee. Endorse mailpiece "Return Receipt Requested". To receive a fee waiver for a duplicate return receipt, a USPS4 postmark on your Certified Mail receipt is required. ■ For an additional. fee, delivery 'may be restricted to the addressee or addressee's authorized agent. Advise the clerk or mark the mailpiece with the endorsement "Restricted Delivery". ■ If a postmark on the Certified Mail receipt is desired, please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed, detach and affix label with postage and mail. IMPORTANT: Save this receipt and present it when making an inquiry. PS Form 3800, August 2006 (Reverse) PSN 7530-02-000-9047 ■ 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: W LiLojno Lob q- �gs�v A. Signature I, c��I� (� �` ❑Agent X & ❑ Addressee B. Received b Pn ted Name) 7/-/ Date of Delivery ^., D. Is delivery address different from item 1? ❑Yes If YES, enter delivery address below: ❑ No 3. Service Type ,ktertified Mail ❑ Express Mail ❑ Registered ❑ Return Receipt for Merchandise ❑ Insured Mail ❑ C.O.D. 4. Restricted Delivery? (Extra Fee) ❑ Yes 2. Article Number (transfer from service labe 7010 0290 0000 3608 6730 f PS Form 3811, August 2001 Domestic Return Receipt 102595-02-M-103c . UNITED STATES First-Class'Mail . aiq..tj?� -- i" Postage & Fees Paid qA. A USPS frATAG;1 ZrL CAROtT.WA. A r"PWO it N.20 - ..f - 0 Sender: Please print your name, address, and ZIP+4 in this box • a�5q� I JIM REGISTER 66-66/531 1492 NCDL 1703005 P.O. BOX 4846 PH. 252-504-0707 j � ell EMERALD ISLE, NC 28594 DATE _ L�- I � PAY TO THE � � - ORDER OF / r ,q �!/71 , I G �� DOLLARS LJF RBC Bank'" -�' RBC Bank(USA) MEMO 1:053100850l:028020429311' L492 �J I I iFfw:lPell+JtWpyg�gyyya.-...+r�L'o:F; f EMERALD ISLE MAIN PO EMERALD TSLE, North Carolina 285941905 36i3950584 -0099 %i11 (252)354-6677 03:22::- �t - Sales Receipt --Fir', Dduot Sale Unit uec:; iptlon Oty Price F , f; ".61NIA BEACH VA 23453 7,u. 14 'ie-2 First -Class -ter 70 oz. •'pected Delivery: Sat 01/15/11 2.turn Rcpt (Green Card) . stifled 6�.7t1 -,:)el #: 701002900000360865K aue PVI: $5.r., bERN NC 28560 $0.44 - -1 First -Class :rer 10 oz . acted Del i ver'y: Fr-i 01/14/11 R. ,rn Rcpt (Green Card) $2 rifled $'i 61 701002900000360867,15 e PVT: Tr,t�l - �d;u by: Lash _,r e Due: $2:` :ii; 49 ,.lr) stamps at USPS.com/shop or call Starrrp24. Go to USPS.com/clicknsr�!r- int shipping labels with postage j `ier information call 1-800-ASK-!,sP •••K***Xxx**XX%Xx*xxX**xX**xxxxXxxxr. •t,•:XxrcxxxxX*Xx%*xXXX**x*X**XXXX**m+'x .•.ir mail when and where you want a secure Post Office Box. Sign uli 'or rnline at Usps.com/poboxes. tit xXA)k X*%***x***7:XXXX x*X*'X**%nt %: r, ,, ,t%xx*xxx*xx*xxxx****x*Xx***xxx*%t♦ It' '.000102731048 01 y1es final on stamps and postage 'is 'for, guaranteed servicas on], ank you for your business nxx%X%*XXx%'*x*X%%+Xxxxxxx*X*Xx %XX%xxXxX%x*xXxxxxXx*xXx*x�, +ELP US SERVE YOU BETTER ns : /,"postal exper 1 ence. com/p:,,, `60Ur YOUR RECENT r. T,;L EXPERIENCE "i. r:P. ' O!JNrS t �.h •. tXr tAX MxXXX'K*x'1XX• 1`, XITX ,rA7! tx7txX'Xx:K'X%'. .f R AW-ACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIER/MOORINGPILINGSBOATLIFTBOATHOUSE) I hereby certify that I own property adjacent to",L (Name of Property Owner) property located at 1 l,, C_ 4(--�i, a \ (Lot, Block, Road, etc.) on i 4l �D 11l i 1.1i , in u (� C , N.C. (Waterbody) (Town an/or County) phone #: 1-n-(�- Q'JI S W-5 Mailing Address: (\4 k . MC �S�Nvb He has described to me, as shown below, the development he is proposing at that location, and, I have no objections to his proposal. I understand that a pier/mooring pilings / boatlift / boathouse must be set back a minimum distance of fifteen feet (15') from my area of riparian access unless waived by me. (If you wish to waive the setback, you must initial the appropriate blank below.) I do not wish to waive VI do wish to waive that setback requirement. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: (To be filled in by individual proposing development) 2a 0-V 0, 0 -------------------------------------------------------- (Information for Property Owner Applying for Permit) MaiKg Address (Riparian Property Owner Information) Signature City/State/Zip Dg 5Q 4 Print or Tlype Name Teleph e NLi SignatL�re Date Fi S-9 - q W 3 r?a 9 Telephone Number I I`?,1> > Date l A- �f 4�� Lbs� L�o �t �'`� dot 5 3�Lr ,f/iuse ��eY -- ?,o � g 12 1