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Home My WebLink AboutAylward, Lee Ann.16CA111GtiA / ❑ DREDGE & FILL GENERAL PERMIT Previous permit# ENew ❑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 t ' ,�— --- ; _- - __ r ___- i .. ___._ .__ . ._� (9 Rules attac hed. A�pplicant Name , L- s' / ; 7 / �r�' ! l ,. Project Location: County C� ,-r > (Address' % 't' C i` } it , Street Address/ State Road/ Lot #(s) + 'City, I i2 i . (J�/ / t {', r# l .' i i l` r State f ( ZIP c IPhone # ( ) P t �' Fax # Subdivision Authorized Agent E City ZIP Affected ❑ CW � ID EW ._p PTA ❑ ES ❑ PTS AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A ❑ PWS: ❑ FC: ORW: yes �' o' PNA yes /{nof Crit.Hab. yes /''no• Phone # ( ) River (Basin —)"I t'/fir Adj. Wtr. Body %� ' l!!i i1G; 1 (nat /man'/unkn) Closest Maj. Wtr. Body — Type of Projectt✓Activity (:} tt, I ` f ia� i. ,! I j r-'�. j,, I +ltl c' %yc-/� ;t F: i; .1_f Pier (o k Platf Fingi Groi Bulk Basic Boat Boat Beac Othi Shor SAV, Sand Mor Phot Wain !/ ✓/�� , (Scale: ir pier(s) i length number ■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■I avg distance offshore ■■■■■■■■■■■■■n' ®■■■�■■��..�.�. ■ •• • • ■■.EEO' • max distance offshore ■■■■■■■■■w��®�■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■ MEN ■■■■■■■E■■MEO■■■ ramiL ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■n ■■��■■■��® ■■■■■■■■■■ ■■■■■■■■■■■■■■ ■MM■M■� ■ �No EMEMOME■■ EO■EE■■■■■�E�1�:�dIC■�■■■��■■■/ate■■■■■■■■■■■■ ■�■EMEHM -line Length r ■■■■■ MEMO ■■ ■■■■■■■■■■not ■■ sure yes no ■■■■■■■■ ■s�nM■M■a■■■■■■■■■■■■■MM EM■■M■■M■■■■MMMEMEMMMEM wags: not sure yes • ME NONE ' MMM■■MM■ME■■■■■�MMM■M■■MM�■■MMM■OEM■■■E■■ yes no ■■■■M■OEM■■MM■ MEM■MM■MM MEMM■MMEMMUMMMM tr Attached: .Y • l A building permit may be required by It It & or 4 i� r •' Note s/ Spgcial Conditions ❑ See note on back regarding River Basin rules. I Agent or Applicant Printed Name Permit Officers Signature / r Si pature Please read compliance statement on back of permit" Issuing Date �.. , Expiration Date ApplicationFee(s) Check# Local PlanningJurisdiction 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/ 1-8884RCOAST 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 ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to �'2� QV7) to A) L property -located -at (Address ot, Blgck,'RRad etc.) y�.� on C�YIOI' , in tY>'0y' .OL ) V i�, N.C. (Waterbody) (City/Town and/or County) The applicant has described to me, as shown below, the development proposed at the above location. _ I have no objection to this proposal. have objections to this proposal. DESCRIPTION AND/ORbRAWING OF PROPOSED DEVELOPMENT (Individual proposing development must fill in description below or attach a site drawing) ?zvvoVe(; 0 0 x. V y w�1rf� S In6� �1ro er} WAIVER SECTION" 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.) do wish to waive the 15' setback requirement. do not wish to waive the 15' setback requirement. (Property Owner Information) (Adjacent Property Owner Information) ,.n n Sign tune _, , __:_ _ Sa ure n . Cr Lee #y1h Print or T pe am Print or T e N e a � q a c t. A ress Tilingn� 4� � SIB•—p. G a�Sta- Cit /State2i Telephone Number . 24 x4 ADJACENT RIPARIAN PROPERTY OWNER STATEMENT Lg e. AA A hereby certify that I own property ad' it to 's / nd me of Property Owner) ' propertylocated -at (Address, Lot, Block, Road, etc^� I on C(I�l , in �i i n ►� n i J %l O r (e , N.C. (Waterbody) (City/Town and/or County) The applicant has described to me, as shown below, the development proposed at the above location. have no objection to this proposal 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) t FT o � 0 �o 1P xotp- WAIVER SECTION" 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.)