HomeMy WebLinkAbout57816_DUNNAVANT, WILLIAM_20110401❑CAMA / ❑ DREDGE & FILL
GENF�RAL PERMIT Previous permit#
❑New ❑Modification ❑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 I SA NCAC
❑ Rules attached.
Applicant Name_-
Address_
City
Phone # O_
Authorized Agent
Affected ❑ CW
AEC(s): ❑ OEA
❑ PWS:
ORW: yes / no
State
Fax # (
❑ EW ❑ PTA ❑ ES ❑ PTS
❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ FC:
PNA yes / no Crit.Hab. yes / no
Prolect Location. County
Street Address/ State Road/ Lot #(s)
ZIP -tl
Subdivision
City ZIP
Phone # () 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
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
—
-
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I
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1
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Shoreline Length
SAV: not sure yes no I-
Sandbags: not sure yes no j
i
Moratorium: n/a yes no
Photos: yes no
I
Waiver Attached: yes no
A building permit may be required by:
Notes/ Special Conditions
X
7 t4i
i
I'
i I
'_ ❑ See note on back regarding River Basin rules.
Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit **
Permit Officer's Signature
Issuing Date Expiration Date
Application Fee(s)
Check# Local Planningfurisdiction
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, certifythat this 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 complywith 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, NIC 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
"a
_--
Npplicant:
Date:
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
ternimpacts
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
tem im acts)
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount
6
redge ❑ Fill Both ❑ Other ❑
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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 ❑
''. 2G;�•? ? R d.COAST
From: John Smith To: Steve Silver Date: 3/1712011 Time: 11:03:48 AM Page 2 of 2
ADJACENT 7RIP" AN PROPERTY OWNER STATEMENT
(FOR A PIER&IOORB G PILLIVGS`IBOATLXFTIBOATHOUSE)
I hereby certify that I own property adjacent to 3 's
(Name of Property Owner)
property located at
(Lot, Block, Road, etc.)
on �,1fillQi , in Ate IseQ.ACi/1 , N.C.
(Wa-terbody) (Town and/or County)
Applicant's phone #: -Z,; 2 72 ta' 76 q4 wa3lfng Address: VVI ' cs Uyklb2 -
He has described to me, as shown below, the development he is proposing at that location, and,1
have no objections to his proposal. I understand that a pier/mooring pilings / boatlift / boathouse
must be set back a minunum distance of fifteen feet (151 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
zip , I do wish to waive that setback requirement
BESCRIPTI.ON AND/OR DRAWING OF PROPOSED DEVFLOI~'MNT:
(Tt? be fzlled in by individual proposing development)
(information for Property Owner Applying
for Permit)
Mailing Address
2..10-5y2 —
City/Statelzip
Tele bet
Signature Date
(Riparian Property Owner Information)
Signature
Print or Type, Name
82 4-- 77S-- rGgS
Telephone Number
bate
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT haf
ORINGPILINGSBOATLIFTBOATHOfTSEV ,_ J
(FOR A PIER�O
adjacent
u is I t �/ ►/ I,
I hereby certify that I own property ad3 to(Name of Property Owner)
property located at
(Lot, Block, Road, etc.)
on C.kR
in �Aul'��A�-h , N.C.
(Waterbody) (Town and/or County)
2-��4�1 Mailing Address- f2A S��'L
Applicant's phone #: 2�,2- ? ��,�-Z
He has described to me, as shown below, the development he is proposing at that location, and,1
have no objections to his proposal. I understand that a pier/mooring pilings / boa / boathouse
must be set back a minimum distance of fifteen feet (151 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)
(Information for Property Owner Applying
for Permit)
Mailing Address
2
City/State/Zip
2:� -Z— -7 2(e ---T 4 4 '�
Telep onber
Signature Date
Property Owner Information)
Signature
o
Print or Type Name
Telephone Number
Date
1287
W A DUNNAVANT
66-49/631 CC
VICKIE BOWLING DUNNAVANT
PH 919-528-4566
101 LIGHT FALLS DR oa
WAKE FOREST, NC 27567 $
Pay To The
t pecala on
d rnf (`l��U(� _Dollm.S
Or e �- iks .k cJ L-/L, .c(
Wachovia Bank, N.A.
Raleigh, NC 27609-5757
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