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Home My WebLink About58135_DAVIDSON, MARK_20110629❑CAMA / Cl DREDGE & FILL r. GENERAL PERMIT Previous permit # ❑New 'EModification ❑Complete Reissue ❑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 ❑ Rules attached. Applicant Name Address City State ZIP Phone # O Fax # O Authorized Agent Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A ❑ PWS: ❑ FC: ORW: yes / no PNA yes / no Crit.Hab. yes / no Project Location: County Street Address/ State Road/ Lot #(s) Subdivision City ZIP Phone # ( ) River Basin Adj. Wtr. Body (nt /man /unkn) Closest Maj. Wtr. Body 1 ■■_ ■■■w�n■■■■!■■E! !■■■■��p■ ■■■■■■ - MOMMEEMM MNMMMM JIMMINIMENOMMMM !O!N 1■171 ■!MEN ■■■■!■■■■■■■■■■■■■■l\lit■L��JI��ll�l!■■■N■!■■!■ M. ■■■■■■■■■■■■■■■■■■■ice■.■!!■■■■■■■i■■M Lim ■■■■■■!�■■■■C!■■■■■■■ �■■Ili: ��\!\ ■■■■■■■i■■ ■■■■■■■■■i'i■!■■■■■■■■■Ili: ��■�ilili !■!■■■■!■ ■■■■■■■■■►�GSII�I■■■1�■nllll,lr�...li!■fir■+rl■■■■■■■■■ Agent or Applicant Printed Name i 'L PermitOfflcer'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, 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 C IV.. WI.... Ap.licant: % Date: Describe below the HABITAT disturbances for the application. All values should m h found in your Habitat code sheet. Habitat Name DISTURB TYPE Choose One TOTAL Sq. Ft. (Applied for. Disturbance total includes any anticipated restoration or t41p impacts) FINAL Sq. Ft. (Anticipated final disturbance. Excludes any restoration and/or temp im ct 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 I �&W�U Dredge Fill ❑ Both ❑ Other ❑ b �, �(Q O 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 ❑ 4024:08:23'? •, �.•' � .? ,..,. :: . _ _ � t, v r,� r.;,,.:t, r^�'rs�z;..in ,. •..��..�,.-l..�r3ay,ti�s3r-..r.:'rir_,^•:�,,.�.:n��s5.......r...„�a:r.Y_rxa:t _., aurwir- I[71 yrjw To:97EE5;'9 # NCDENR Nort Ceoi'na Department of En r,, onmet and Nate ai Re„our,,es Or CiVISIOrt of Coastal Management Pave:1,1 cvcry r.-vas PerQue, �cvtrr;r; James H. wr!$son, Director Dee Frearr, r, Se:rmary e i e ' 2 d Applicant Name Maftfag Rddros Lia ,.} 6-,_._..�...... - -- �--6 N i certify that Y have authQrired (agent) -()cad &�±nk T!"to act on my behalf, for the purpose o�upplY139 kr aX14 obtaining u11 CAMA Permits necessary to Install or cositjruct (activity) at (location) 5S g M i This �Crtjficstf n fs valid �hru (date) Signature Pho,w 400 Comun rce A enuf, Mc,e lead'iiy, NoAh Caroi'na 28557 i52- C� ;FAX, 2- 47- 33C'� intemet; ne6 Aqe SQ4 OwAu ly %Aff;,,rr,&h & A ;i(or Erpiayei 50% Recydod M% Poi W'�)nsvmv Paper ADJACENT RIPARIAN PROPER. T Y OWNER STATEMENT (FORA PIERIN10ORING.P'ILI.,VGSIBOAI'LIFTIBOA1'IIOIISE) !hereby certify that I own property adjacent to _ �i A ! k D I)p�o�! . _ __ _____ S .p�, (Name of ]Property Owner) ✓G� �� 2 d property located at S ®L It—+G �r (Lot, Block, Road, etc.) (Waterbody) (Town and/or County) Applicant's phone #: =t 1 � '� ,� Mailing Address, ._`1 l le has descl1be' i to ine, ns shown bolow, tlic development he is proposing at that location, and, I hi.vc nc olijections to his propcisal. I understand thata pierrii .'Joring pilings/ boatl:ft / boathouse ri i7lust be set back a m-.nilrllti i CI1St,311L' of fifteen feet (1J ) rl ill illy IrGa of riparian 'dGCn.SS llnl s5 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 lie filled in by individual proposing development') �►�,�13y2 � — -� 2 4 Sly 11c �05 1o� (Information for )Property owner Applying for Permit) Mailing Address -Clry/`tate/Zip cC i- t'i ---- Telephone Number Signature Date (Ri.paria�Prorrt -per information) I Signature IL Print or Type `dame ele hone Number p Date ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOP A PIERAY100RING PILINGSIBOA ILIFTIBOA T110USE) I hereby certify that] owri property adjacent to _� r e (Name of Property Owner) property located at `� A I �l-_ c, �k `•' t'' `"` l,. 9 „-,�,.—`_' (Lot, Block, Road, etc.) 2 �h U.C. 2�pII on (Water body) (Town and/or County)d C� Applicant's phone #: 11 ? `I-q Address-,_�1 1Ie has ciescriactl to .011ie, i15, SIIUSVII b'�10��', tlZc cievelopznent he is proposing at that location, and, 1 h.,vc flo otijecbons to his l�ropc�sel, I understand t11at. a pier/11)Ooring }pilings / boatlift / boathouse 1Til:st 1)e set back a iTi11111Tium list-jilcL of f fteerl feet (.15" fj7c rn illy arca of riparian a.CC�SS 11r1ICSs waived by me, (If you wish to waive the setback, you must initial the appropriate blazik below..) I do not wish to waive I do wish to waive that setback requirement. DESCRIPTION AND/OR DRAWING OF PROPOSED DI VIEI-.OPMENT: (To be filled in by individual propsing develor:nen "3 -3-4 i3 x z I Zc-YPS Z i 6 * M?k 3 -� c -� 0-5 ------------------------------ -- ------ ----------------- (Information for Property Owner Applying (Riparian Property Owner Information) for Permit)� Signature 11111aili Address Z� ,'ity/State/Zip Telephone Number Signature Date -,..-� �& � i(6 Print or Type :Name "15 - 2)°� - 30(a.3 Telephone Number Date yA 5108 w MUD BUCKET DREDGING INC 55-1121531 507 HEDRICK BLVD MOREHEAD CITY, NC 28557-3045 Date '? s fJ � T) Pay tO tfic ------ order Of -------------- BRANCH BANKING AND TRUST COMPANY I _800-BANK BST BB c0 jr FOR 1 2 Li:0005 293 21631' IIII —1120000sloal. 1:0S3IOL i