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Home My WebLink AboutCrumpler, Lealon & Christine*(:AMA / ElDREDGE & FILL �"' 62154 GENERAL PERMIT Previous permit # lew ❑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 15A NCAI Rules attache plicarit Namef ^� =`' ( �'' 1{„�oject Location: County�(j• �`, Address I i ,iq. { a 11'` ~:. r". Street Address/ State Road/ Lot #(s) ;City State ZIP.-,f Phone #3)ax # (_) Subdivision / Authorized Agent i tiVAV i k `k, JCitV i 1 i { (:'l G ZIP ❑ CW �IfW Affected TA 4S ❑ PTS Phone # --,;r AEC(s): ❑ OEA ElHHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body d .� ❑ PWS: ❑FC: � ORW: ('yes no PNA /(no Crit.Hab. Closest Maj. Wtr. Body / no yes yes Type of Project/ Activity 'l t ti Pier Platf Fing Groi Bulk Basir Boat Boat Beac Othr Shor SAV: Sand Mo 'Phot 'Wai lid (Scale: �- ) ■■■■�1:�!!!■!�!■■■■■■■■■■!! ■�rlr��!■■■■�uln max distance !■'i■■■■ll�q■■!■■■■■■■■■■!■!■■■■■filia�� ■■■�■■■■■■t ■■■■■■■■■■■■■!■!■■■`11i■■i�!■■ !■!■ ■■■■■■ NONE■■■■■■A!!■■■■■■■■!■■■■■ cubic yards ■■■■■■■■�■■■!i�■■E■■■■■■!!!■■■■■■!! 9. ■ramO•IC ■!■■■■�NLia ��■■■■■NONEENE ■■■■■■■■ W ■■�r..rirr�n...�1��iri�M� �rrr.�r_�■■■■ raw �I'.nrll amN■rfii��ii"ill■■►1■■►�■�1■!!.�l�■I■■■■■■■!!■ not sure. E no ON W.44111, i�■■�iii■ilii MENEii�Ei"D iMENNEN!'s: yes n NENENNOMNNMWN AM A building permit may be required by:_. -� ote on back regarr - -- � _�./,`�� t<'� ❑Seen Notes/ Special Conditio s, ` -.l i3 i : ' r \ i I T ( �- { (' � �/ � - �� t r + >" fit ''-_ t ;.td��.�r' ilk (,�?! ''7 ir`1(Ocl 0f4 River Basin rules. 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 consistent with the North Carolina Coastal Management Program. River Basin Rules Applicable To Your Project: 0 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/ 1-888-4RCOAST 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 �� J��zaa:�wa ��a -s`��C : _�.. ;?`]�'a�JII.�� S�S�:iu`�';�.]u•d. �.La.S.t.d -can 1 Applicant: Date: t ENO aJ 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 ❑ Dredge ❑ Fill ❑ Both ❑ Other Jq) I cl� - 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 ❑ d�`?-B��-��-� :. �-:�«3�-E36�i�,d��n .: mn�.�,��a,��c��;��3�9oaaG�i��a�ae�at.��t v�ya:��9; ��l�sl•3� Pat McCrory Governor Date /,7- /f A7" 1 j;A, HCD North Carolina Department of Environment and Natural Resources Division of Coastal Management Braxton C, Davis Director ' Applicant Name QQ/a4/ 7;�,.,,, Mailing Address .5- &. John. E. Rvarla, Ili Secretary I certify that I have authorized (agent) 4 to act on my behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to install or construct (activity) -ZE , at (location) This certification is valid thru (date) /• /�.. Signature L f aIa n ,- _ kRjf n .. _ 400 Commerce Ave., Morehead City, NC 28557 Phone: 252-a08-28081 FAX 252.247-3330 Internet: www,nccoastafmanagementnet An Equal Opporlurity 1 Affirmative Action Employer One N4 thCara ina Awnallj/ J l 'd L01 'ON - WdW� E t H '� l 'I EN ADJACENT RJEA—RIAN PROPERTY OWNER STA7 MENT I hereby certify that I own property adjacent to �� la.n-tnr;s-yie Cru property located at (i` rr]�Df Property owner) s �[� `� /LJe�'{k ,�,� I� �- � �a.,� re on -T�,-zr rem kt (Address, !o,,t Block,yoad,,etc,D -F- (Waterbody) ' in do a ►- ram N.c. (MY/Town an County) The applicant has described to me, as shown below, the development proposed at the above location. .�" I have no objection to this proposal. I have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (lncl"Iduai proposing development must fill in description below or attach a site drawing) pad 4vk- WAIVER SECTIQN I understand that a pier, dock, moorin back a minimum distance of 15, from myrlarea ofriparian traccess unless i boathouse, ftwaived by must be set wish to waive the setback, you must Initial the appropriate blank below.) ( You � - I do wish to waive the 15' setback requirement. _ I do not wish to .waive the 15' setback requirement.' Prope Ow r In (AdigFent Property caner Information) Si Lure /.� / /,�,� ,/ S1 afore f-�E�lOri f.-L Gr r CST/%�fr CaG�lO i� P not or Type Name Print ior - Name M n Vddres Q w� �.. 7-7 z � �� 5�� MailfngAddress CitylState/Zip 'Sa 5// 6A-23 City/state/zip 1r`,l Talsphone Number �7 � � � � _ �� telephone Number Dale ' ^ .2 Y Dale 311/� j3 (Revised 6/1 &2012) 6 'd CO I 'ON AdWti E106 ?A ADJAC NT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to Property located at /J (1`l� rf Property ��, C d� Cc''�ar rv_ 11 �s I (Address, Lo�Block,, oad,,etc,j on e r �r��`t , in - 1`c �c (Vtlaterbody) (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. I have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (Individual proposing development must flu in description below or attach a site drawing) 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 1 5' setback requirement. _ I do not wish to waive the 15' setback requirement. (Property Own r Informat on)--/ (Adjacent Property O er I ion) ,lo„>q�gnqtur. L' r > ,, -1,• Sign, tune Print or Type Name D% �r. Print or Type Name ,�t Mn�Address� CC�� z nr , �, 507 'S11"l. /,A.� Mailing Address — c clty/state/Zip _ - 0 'o `� �L i rG ¢ 1 r 1 a - asp/� Dia,3 city/state2lp 2. k.5' Lf Telephone Number Telephone Number 7-7 ra -- 72 Date Date (Revised 6/1812oi2) E 'd LOCI 'ON AdW� E06 '�l '1PA