HomeMy WebLinkAboutEthridge, Bruce W.I�ACAMA / ❑ DREDGE & FILL
GENERAL PERMIT Previous permit#
P,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 concer pursuant to I SA NCAC �Tr,
Rules attached.
'Applicant NameA4�1 Project Location: County
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Address Street Address/ State Road/ Lot #(s)
[City :�•� z..} f„ State ,ZIP ��
;Phone # ( �'.,j_, �1(14 ,"Fax # O Subdivision _
A uth nt1�. ri..( t'L City. �'i: i + i ti., ZIP ,,(..._�
��yy (. ?) River Basinl
Affected ❑ CW / \ PTA ❑ ES ❑ Prs Phone # '? }� �
❑O H ❑UBA ❑N/A �" �,1�•Zr1C�s1c ,
AEC(s): __ Adj. tr. Body �' ! �- !'1i 1. t • f at /man /unkn)
-❑ PWS ❑FC: ° E -
- —�- Closest Maj. Wtr. Body
RW: yes o PNA yes / o Crit.Hab. yes / no
Type -of -Project/ Activity %-) (J"I
j
(Scale:
Pier dock len th
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Fing
Groi
Bulk'
Basir
Boat
Boat
Beac
Othf
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ilaing er a required by:
Notes/ Special Conditions
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❑ See note on back regarding River Basin rules.
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'{gent or Applicant Pr ted Name Permi r °
Signature . Please read compliance sta ement on back of permit* Isswrj e
i
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, 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
❑ Neuse River Basin Buffer Rules
El Other:
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,
Mailing Address: 400 Commerce Ave
1638 Mail Service Center Morehead City, NC 28557
Raleigh, NC 27699-1638 252-808-2808/ 1-888ARCOAST
Location: Fax: 252-247-3330
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
Fax:919-733-1495
(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
--u) y-Zilzmt'n Eiji�e:a �� air 3L �liaa 3—}—+nf':. irr)fl:��;'r: � 0r-_ 01
Applicant:
3
Date:
-IH9 n
f
cv
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
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 ❑ Both ❑ Other
9?0
—�
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 ❑
'������-�wT.� .. a ��B�!•6R�®SST .: �v�r s�Ao�,h��-�to�a���4>aenne5at.r�:dk re�r9a��: ��,l���l�B
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to gfuoA ri Jpe, '
c f-s
(Name of Property Owner)
property located at 'Iht 3,euu'for4- (hn - Jai An,, St .
(Address, Lot, Block, Road, etc.)
on Gclavo 5 dann-it( , in aeawr r+ , N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
A_ 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)
Replace a 31x2a,
' a vckl nt, J- C A end
4e. 'P Y'154 %" �dcl
Yt x+e� Plt�rh.{ w�riG a t �cy�
/ un)wo�r . III v,t�k �o
be
aon�
wa , et
-�aa-v Pf A+- QAJ Atee
yv,1%
be
A o
1A li�e. iium 6r- of beaari 111, pS .
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.
_IX —I do not wish to waive the 15' setback requirement.
(Propert Owner In rm ion) (Adjacent Propert Owner Information)
-4 . /�U"'(A /Aa
s ffsFur-c-t 7'�-R Lfl Gv5 ;tur `.`
Pri t or Type Name Print or Type Name
Cb i Ai.ttl lot Ann 51-
Ma!'l' g Address Q I Mailing Address
ISLS 14L' ?iCJ✓ \ b $ratW'a(+ lV L zgyl t
City/Sta ip City/State/Zip
tjooa 336 - 7a8 —a sv7
Telephone Numper Telephone Number
3�b �� _ 3 G /Y
a, • ,,
Date
N
(Revised 611812012)
MAR 12 7.14
»CM MHn CfTY
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r
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/ \ �
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
hereby certify that I own property adjacent to gfuce. t4r,Jle 's
(Name of Property Owner)
property located at 1k1 geaufor� (hh - loI Ann 54
(Address, Lot, Block, Road, etc.)
on %a(1art4 s (Aan►+e I , in BraU'Far}— , N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
X 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)
RepIare, q 3'x20 %x-el PI ear -,►je—C wi o, Gt xYs
-��0AVk) a%Ck aYk1 gW01
-4 -P Q�s���j dock
)io r1nPfyox-,
Atk wo(1- +0 k (�neL
-�M t PA,At a rid -hl�(e. WN b, e
n%Am 61K 0-� 6001-+ 61') p
W,11TWIZZ 101ne
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.) RECEIVED
do wish to waive the 15' setback requirement. '04
MAR 12 2014
4 1 do not wish to waive the 15' setback requirement.
(Property Owner Inform ion) (Adjacpht Property Owfib,'e S�drri ation)
<�: L
Stnature
nguce C.
Print or Typ Name Print or Type Name
in Address M ding Address
RT t�G Z8 ^� & e � l�
City/Sta e/Zip City/State2ip
22-�z-728-26oa �Fa_ 72-9 - 7t t17
Telephone Number Telephone Number
3 —16—1
Date Da e
(Revised 611W2012)
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Beaufort Inn floating Docks
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Bruce Ethridge
101 Ann Street • Beaufort, INC. C 28516
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