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Home My WebLink About57095_DIXON, DAVID_20110322❑CAMA / ❑ DREDGE & FILL GENERAL PERMIT Previous permit# ❑New ❑Modification El 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 i ❑ Rules attached. Applicant Name Address City State ZIP Phone # (} Fax # (__}----- 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 Prolect Location. County Street Address/ State Road/ Lot #(s) Subdivision" ram` .. I City ZIP Phone # O River Basin Adj. Wtr. Body (nat /man /unkn) Closest Maj. Wtr. Body Type of Project/ Activity Pier (dock) length Platform(s) Finger pier(s) (Scale: ) Groin length number Bulkhead/ Riprap length avg distance offshore I i max distance offshore Basin, channel cubic yards Boat ramp Boathouse/ Boatlift Beach Bulldozing Other Shoreline Length SAV: not sure yes no Sandbags: not sure yes no Moratorium: n/a yes no Photos: yes no I Waiver Attached: yes no A building permit may be required by: Notes/ Special Conditions i I i it � 4 ❑. See note on back regarding River Basin rules. Agent or Applicant Printed Name Permit Officer's Signature Signature ** Please read compliance statement on back of permit ** Issuing Date Expiration Date Application Fee(s) Check # Local Planning] uriscliction 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, certifythatthis 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/ 1-888-41RCOAST 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 of Coastal Mgt. Habitat Impact Computer Sheet Applicant: David Dixon Date: March 22, 2011 General Permit #: 57095C 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 ® 120 120 OW Dredge ❑ Fill ❑ Both ❑ Other ® 120 120 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.nccoastaimanagement.net revised:02/03/10 ADJACENT RIPARJAN PROPERTY OWNER STATEMENT (FOR A PIERIMOORIXG PILINGS/BOATLIFTIBOATHOUSL) 1 hereby certify that I own property adjacent to s d } yr D&oA3 's (Name of Property Owner) property located at _ (Lot, Block, Road, etc.) on � OLoW-f- Cpr"AL. _, in C. (2, (2.RQ-T ) N.C. (Waterbody) (Town and/or County) Applicant's phone #: a 52 -G 5a -13 c S Mailing Address: 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 / boadift / 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) �Ro4ek*-1 L W I LS a-IJ QRoeepn-Y COO ---------- - ------------------ -------------- ------______ __-------------------- --------------------- - (Information for Property Owner Applying (Riparian Property Owner Infortnation) for Permit) �4L AL1 Fa RR, 77� Mailing Address Signature NeW.Pola, A-) t AS S t� City/State/Zip 959 -to5A- ?3�5 Telephone Number - — Signature Date bliz� L � 7U (7SeI( Print or Type Name Telephone Number Date ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIERI-ffOORIVG PILLVGSIBOATTLIFTIBOATHOUSE) I hereby certifij that I own property adjacent to DAU I D r xa� s (Name of Property Owner) property located at 7 ��L t. �� K , I� (Lot, Block, Road, etc.) on �"/M'IGt�a� �AyyIK— inN.C. (Waterbody) (Town and/or County) Applicant's phone #: ZS�.-�yb'3�b7LMailing Address: OP'o-04XoN P6x�A, aS;.-(.52- 73c,5 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 o not wish to waive I coo wish to waive that setback requirement. ---------------------------------------------------------------------- DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT - (To be filled in by individual proposing development) 011 L" ej-e � a' LSaAJ QRoPe21-1 L Pve f ------------------1 �--------------------------------------- -- (Information for Property Owner Applying for Permit) 34i ` ()UL FA Pay-) R� Mailing Address t�ew P0P, k) 'S City;t4te/Zip dSA —toS�— 7.3� Telephone Number �a,1,4 Signature Date (Riparian Property Owner Information) Signature /"I/IRK t.Jtc.ho.) Pr.nt or Type Name 251.-6q1�- 3S7Z 3-7- 2011 Telephone Number Date 57-776-532 2146 DAVID J DIXON PH 252-652-7365 20 341 BALL FARM RD NEWPORT, NC 28570 PAY to-Q- ille ordel Of �e WACHOVIA BANK, N.A. WACHOVIA.COM 1:05320?7661:100751345463711' 2L46