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Home My WebLink AboutAinsley, CharlesCAMA / DREDGE & FILL -r GENERAL PERMIT Previous permit # New - -Modification Complete Reissue _ artial 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___ _ _ Street Address/ State Road/ Lot #(s) City State ZIP Phone # O Fax # (_ _) Subdivision Authorized Agent _ City _ _ ZIP Affected ❑CW ❑EW DPTA ❑ES ❑PTS Phone # ( ) _ _ _ _ _ _ _ River Basin AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body (nat /man /unkn) 111 PWS: ❑ FC: ORW: yes / no PNA yes / no Crit.Hab. yes / no Closest Mal. Wtr. Body NONE UnnWOMMURMINMENE MEN MEN SOMEONE MEN 0%1ISI9 MENEM MOMMENEWHEM01=111M EMOMMEMEMEMOM 111111111.�Nlllmirlmml MENEM MENEM MEMEME N�■�ns NR il SOMMEMEMMINEMESISSIN.VA.M.E.E.E. MMININ EMIMM 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 Planning Jurisdiction 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 comply with these buffer rules. Division of Coastal Management Offices Raleigh Office Morehead City Headquarters Washington District Mailing Address: 400 Commerce Ave 943 Washington Square Mall 1638 Mail Service Center Morehead City, NC 28557 Washington, NC 27889 Raleigh, NC 27699-1638 252-808-2808/ 1-888-4RCOAST 252-946-6481 Location: Fax: 252-247-3330 Fax: 252-948-0478 2728 Capital Blvd. (Serves: Carteret, Craven, Onslow -above (Serves: Beaufort, Bertie, Hertford, Hyde, Raleigh, NC 27604 New River Inlet- and Pamlico Counties) Tyrrell and Washington Counties) 919-733-2293 Fax: 919-733-1495 Elizabeth City District Wilmington District 1367 U.S. 17 South 127 Cardinal Drive Ext. Elizabeth City, NC 27909 Wilmington, NC 28405-3845 252-264-3901 910-796-7215 Fax:252-264-3723 Fax:910-395-3964 (Serves: Camden, Chowan, Currituck, (Serves: Brunswick, New Hanover, Dare, Gates, Pasquotank and Perquimans Onslow -below New River Inlet- and Counties) Pender Counties) Revised 08/09/06 iiTG aVY1",73aMrf�G-lc .7� RJ12s . J:nbl-N li? 56adpf9 —,v, s9��i�],ry��i ` • Applicant: L Date: / III LIU�1 l 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 Dredge ❑ Fill ❑ Both ❑ Other 1�1 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 ❑ 3a� v �- ��-2av 8o u�,�a QhveS�t, `s re�vas �9: 0.11� 1 A jFA �- NCDENR North Carolina Department of Environment and Natural Resources Division of Coastal Management Pat McCrory Braxton C. Davis Governor Director Date /0—/cf—/3 Applicant Name 0,AV IXS R/N5L9U Mailing Address 00-0 fit . S!- Vg fs John E. Skvarla, III Secretary 719A&,en N e- 7d'84 I certify that I have authorized (agent) 131(Ac- W°fe''' Ar%14,e 60A's f. to act on my behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to install or construct (activity) fy"M EgcftiAldpdc, 20?cib i c, 4;44s , at (location) This certifi Signature 400 Commerce Ave., Morehead City, NC 28557 Phone: 252-808-28081 FAX: 252-247-3330 Internet: www.nccoastalmanagement.net An Equal Opportunity l Affirrna6ve Action Employer RECEIVED OCT 29 2013 ._ is'k 1l" � j'i NorthCarohna Naturally ADJACENT RIPARIAN PROPERTY OWNER STATEMENT -- I hereby certify that l own property adjacent to /i%2C I- Akg—AF.G� -- --- - - _ . __-s---- -- ---- (Name of Prop rty Owner) property located at �4 7 /Jl"�'� S'f ' (Address, Lot, Block, Road, etc.) on 3s4tir— SD4r.f10 , in /19ftd;i(P' 0 C/Ty , N.C. (Waterbody) (City/Town and/or County) The applicant has described to me, as shown below, the development proposed at the above locati 1 have no objection to this proposal. I have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (individual proposing development must fill in description below or attach a site drawing) N i I AAA_ I I _ _. 0 b �d �o d I fo��ls ou GCtf C`J A#%*X — WAC"O. ^ F/ST"I3 f�'�'�• WAIVER SECTION jN51ty t�h� �41kHce�Q I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set back a minimum distance of 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 wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Pr y ner I ation) (Adjacent Property Owner Information) ignature 7�=Nam Print or Type Name / -3cdw s c�.►a�f� S�. �7oL'2 .� Mailing Address ling A dres 7c Pe City/State/Zip City/Stafe2ip Telephone Number Telephone Number Date Date DCMMOCITY (Revised 611812012) ' "j., PAGE 01/01 ADJACENT RIPARIAN PROPERTY QWNER STATF. MIENT I hereby certify that.I own property -adjacent to_ 4f1/¢�t & Sri 's (Name of Pro orty Owner) piopeity located at ��Q'l /d '� s� (Address, Lot, Block, Road, etc.) on._,,,. o !� s' , in01�1 _ /0 4li�_ N.C. (Waterbody) 0—AF1(City/Town andlor County) The applicant has, described to me, as shown below, the, development proposed at the above location, have no objection to this proposal. I have objections to this proposal, (Individual proposing ION AND/OR DRAWING OF PROP08ED DEVELOPMENT development must fill inadescription be it site drawing) POOP WAIVER SECTION '�• '°h ` i understand that a pier, dock, mooring pilings, breakwater; boathousei lift, or!Toin must be set back a minimum distance of 15' from my area of riparian access unless waived by me.. (If you wish to waive the. setback, you must Initiat the appropriate bank, below:) 9-�t- I do wish to nraive the IS' sciback requirement. _ I do not wish to wave the 15' setback requirement. (Property ner In lion) (Adjacent Property Owner Information) -"'- S.rgnature S5 gnurure ef Print or Type Name �� Print or r pe Name Mailing Address Mailing Ass / Crty/statelzip cilylSlate/Zip 2013 nrM mid Mr Telephone Numb r -Date O� (Revised 6118R012) tr, �,- A n,QA 5U5 li?� � �C��]'J7r��'�rsa .�� `�i'�,,..��5•u3� ��'��< �=3��,�a`;':sir �Itaa,'9< .�,� �:s�:id`),try.?7 r`a�' >ii;a;"�4} Applicarit: 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 temp impacts) FINAL Sq. Ft. (Anticipated final disturbance. Excludes any restoration , and/or temp impact amount) I 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 ❑ ��'?-B��=� �tz� ;. a �� B � .: a,n �a.�cca» ��k�6o3a�;��a�nvice5a•t,�=era y�vila�d; t@�.(��19