HomeMy WebLinkAboutGooden, Michael (2)%CAMA / ❑ DREDGE & FILL '`' 4 9
GENERAL PERMIT Previous permit#
[lew_ El Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources jam{ jj and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC ( i' •Q C)O D
_ r . E.4 Rules 4ttached.
Applicant Name 1 { t !! ` Project Location: County.
Address Street Add s/ State Road/ Lot #(s)
g ty C (1 State , � ZIP P_.�i 1-.'? S (. i ` !.
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Phone,! # �) ' i~; t"} `I IFax# (=) Subdivision I R i
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yes / lkiV� PNA yes /r
Crit.Hab. yes / no
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Signature Please read compliance statement on back of permit * Issuing Date ;
77�?/
Application Fee(s) Check Local Planning lurisd
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 officerwhen 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:
Q Tar- Pamlico River Basin Buffer Rules
Neuse River Basin Buffer Rules
❑ 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
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/ I-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
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' Applicant: E ° 11 �./�(1
Lpl I
Date.
�X r
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 ❑
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 ❑
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N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date 7— 2,7 r J RECEIVED
JUL 2 5 2013
Name of Property Owner Applying for Permit:
DCM•MHDCITY
G4 R /'� W C oo ele vl, /
Mailing Address:
Zo Z �. o y L ,eO 7-'- L c?,v-e_
o1ols
I certify that I have authorized (agent) a �h 04,4ve ( ,U�0,act on my
behalf, for the purpose of applying for and obtaining all CCAAMACPermits necessary to
install or construct (activity) `, �1' ��f"/S , T, Nyl� /'' �� �`t
at (my property located at) 7 Z f % �D � �� : �Z Ale,
This certification is valid thru (date)
Owner Signature
7— 23 - /Y .
13
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to /�r�G��u �op���✓ 's
property located at
4/2/2 �'oct (j, of Property Owner)
O G ,W Address, Lweo
ck, oad, tc. , ✓
(
on , inc C4 G
(Waterbody) (City/Town a r County)
The applicant has described to me, as shown below, the development proposed at the above
locati
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)
�c&- ' Gt�ao�e� J'oe-&? w
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RECEIVED
JUL 2 5 2013
DCM-MHD CITY
WAIVER SECTION
1 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.)
wish to waive the 15' setback requirement.
do not wish to waive the 15' setback requirement.
(Property.
,sigvature
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Telephone Number
7— 7--; - /3
Date
(Adjacent Property Owner nformation)
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Print or Type Name
70 & .d/r�n S r`
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MCI c K- i , iN •C • AgSV7
City/State/Zip
'?5;�? •22 & - /—A $� 6
Telephone Number
7,23-i3
Date
(Revised 611812012)
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INVESTORS TITLE Fax:9199682227 Jul 24 2013 15:46 P.02
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A04ACENT RIPARIAN PROPERTY OWNER STATEDENT
i hereby certify that I own property adjawritto �',1�44ef 6�0' 04N 's
property located at �Z ,�Q �,c a_er 10,.-(Name on Property Owner)
on 460qe— ;& K or (Address,
4.01 (Waterbody)
,0 'N.C.
The applicant has described to me, as shown below, the development proposed at the above
Io ,
1 have no abjection to this proposal.
I have objections to this proposal.
DESCRIPTION ANDIOR DRAWING OF PROPOSED DEVELOPMENT
Ondivlduai proposing development must 170 in description Wow or attach s site drawing)
RECEIVED
JUL 2 5 2013
1X'M-M—'-'D CITY
MMER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set
back a mirvmum distance of W 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 s' setback requirernenL
I do not wish to waive the 15' setback requirement.
(Prope 0� ,- anon) (Adjacent Property Own r Information)
SirQJr Pnht or Type Name P 'nr or T e Na e
/02- loam iew/o L-aae liz '�',��
rrrw G�atasrgrlGZ7fZ9
Gary to 5' A S CL* — 1?3 l
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(Revised t?✓ &2012)
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MCEIVED
25 2013
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JUL 25
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JUL 2 5 2013
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