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Home My WebLink AboutBroome, ArthurjbAMA / ❑ DREDGE & FILL t.. a GENERAL 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 es attac Rules ed. Applicant Name t� s� §' �L k. �x ,d ;� Project Location: County �. Address h P j+i ! k 1A i",�aT/`i ` Street Address/ State Road/ Lot #(s)_ : t State i( IP t_x Phone # ( G ! t f;rfax # ()_ I Subdivision Authorized Agent City. ` I '� (:.3 ". ZIP [ ,CW EW PTA ❑ ES ❑ PTS Phone # '%t � '5 '°` 14 -( Affected -fiver Basin ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A AEC(s): Adj. Wtr. Body ❑ PWS: ❑FCC +� Closest Ma'. Wtr. Bod "� t-.I^r l t 1 • 1 ; t t) «"'" ORW: yes / o PNA yes / no Crit.Hab. yes / no i Type of Project/ Activity Pier (dock) length Finger pier(s) —WOMEN a ME 01 mar MMEN No Groin length _MMEMV mom �ii;ii number s Bulkhead/ Riprap length 1M:NI avg distance offshore � i��:.■mi■ II� :. distance �.max Basin, channel cubic yards Boat ramp Boathouse/ Boatlift III MEN MRSIME OPEN Is EMMEN Beach Bulldozing M NONE OtherO.!A� IN 11ELP4UNNgIMMEMEMEMOMMON 0 No MEMO ME No on NNW OMEN 001 .14 11NIVAIMME 19MAMEME MOMMMEMMEMEMEM ME ME roff"I I Is"Iffa SEMEN MOMEN ME MEMO iNEVINERIMMEN MMMIMIIMM MEMO Agent or Applicant Printed Name ,- r" Permit Officer's Signature Signa ure **Please read compliance statement on back of permit IssuingDate -• Expiration to Application Fee(s) Check # Local Plannllringf urisdiction Rover File Name f 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 0 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 howto 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/ 1-888-4RCOAST 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 Ii0 " IRA- -arn •47 Ga2v,} ii if`Y? 'a i!Iiam :.l:�:L� Applicant: 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. Dl turbance.total includes any - anticipated restoration or temp impacts) FINAL Sq. Ft. (Anticipated final disturbance. Excludes any restoration and/or temp im act'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 C1 Both ❑ Other Dredge ❑ Fill ❑ Both ❑ Otherfry) �^ LADredge ❑ Fill ❑ Both ❑ Other Dredge ❑ . Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both' ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ .Fill [I' Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ . Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both D Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ . Fill ❑ Both ❑ Other ❑ Dredge ❑. Fill ❑ Both ❑ Other ❑ '?�"?•��-m�� "��B�56�C�� T .; �v.roui,recs�;�s�: �taaae ��a��e�au,�=mac veva.��:d: ��,1��19B OCT-01-2013 11:25 From:DCM MHDCTY To;93936146 page;2/2 A WA IM 11111111111111101W RC I E I 14R North Carol na Department of vironmen, and Natural Resources Division of Co tal Manage i nent Pat McCrory Braxton C. Davis John E. Skvaaa, III i c Governor D tor Secretary Date Applicant Name Mailing Address 1/ 7 7-y1i c A Z"Ve U-) 'ge- /,I- . /-i i . r I certify that I have authorized (ag ent) purpose of applying for and obtab dng all CAMA This certification is valid thru Signature 400 Commerce Ave., Morehead City, NC 28557 Phone: 252MB-2808 I FAX: 252-247-33 10 Intemet to act on my behalf, for the &ssax y to install or onstruct (activity) 3Lt (location) P4Un -, 16-Carolvia ' ADJACENT RIPARIAN PROPERTY OWNER STATEMENT hereby certify that I own property adjacent to -Xy-� 's 1 �// (Name of Property Owner) property located at / �% A/1 ! 5 �� %�1 �OquL ��'�Y� (Address, Lot, Block, Road, etc.) on � _. , in , N.C. (Waterbody) (City/To n and/or County) The applicant has described to me, as shown below, the development proposed at the above I tion. I 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) k MAC 01, Z014 .°. {--� o DCM-MMCnY C V WAIVER SLCTION 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. do not wish to waive the 15' setback requirement. (Property Owner InfIII orm ion) _r S��i,,�ngqt��une ��rYZu,- �' l•q� lira orn� Print or Type Name Mailing Adli s ,-1aIN FA.JW«!� Telephone Number "O. (Adjac It Property Owner Information) Signature Cev y9e Print or Type Name ' lqpeS W, 1/1.4x-VV j)Y Mailing Addre /Vez,/ , w c, cry Zas� G 3 7 SFlI d Telephone Number / Date (Revised 611WO12) . • ADJACENT RIPARIAN PROPERTY OWNER STATEMENT hereby certify that I own property adjacent to Q4___�QP �'s (Name of Property Owner) property located at %9 %G (Address, Lot, Block, Road, etc.) on� !W:t — , in , N.C. (Waterbody) (City/Town and/or County) The applicant has described to me, as shown below, the development proposed at the above I�cati-- I � ��! have no objection to this proposal. I have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (Individual proposing development must rill in description below or attach a site drawing) Q/ ke 1 / WAIVER SECTION �. I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, lOr- g1pM 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. (Property Owner Information) ` C Sere ¢ ! ao. Print y e am Maili �l 2922,/ City/StatelZip "5a? Telephone Number Date (Adjacent Property Owner Information) S' ature o t Print or Type Name 970Frss ,�k <�P� Date z2e 3 7 o/ (Revised 611812012)