HomeMy WebLinkAboutMaxwell, Scott,�1CAMA / ❑ DREDGE & FILL
GEN RAL PERMIT Previous permit #
IANew dific tioRn❑C plete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the S o o?!fi, C�ardllna, Department of Environment and Natural Resources i"��,
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC' (? GOD
t Rules attached.
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Authorized Agent l' ,', ! E (' 1 e l i' t r .� r 1; t 0
Affected ❑ CW W PTA ❑ ES ❑ PTS
AEC s : ❑ OEA �HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS: ❑ FQ
PNA yes / p� Crit.Hab. yes / no
ORW: yes / (� o
Street Address/ State Road/ Lot #(s)
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Phone # ( ),,_
Adj. Wtr. Body -% _?,�:
Closest Maj. Wtr. Body
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regarding River in u s.
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Agent or Applicant Printed Name
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PermitMer Signature
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.Signature "Please read compliance statement on back of permit
Issuing Date j
Expiration Date � !
IF'
tip,
'Application Fee(s) Check # .:
Local Planninj u' risdiction- .
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 andvoid.
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 howto 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 Mail
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
Applicant:
Date:
O
Describe below the HABITAT distur ances for the application. All values should match the name,
found in your Habitat code sheet.
nent
Habitat Name
.68
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
AA�
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 [I' 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 ❑
' ^':_ itECETVED
JUN 24 2014
DCM-MHD CITY
eevized: MOM 0
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to fC07q &A, rt c// 's
(Name of Property Owner)
property located at Z<>13 SAGO" .".'-p
(Aaaress, Lol, Block, Road, etc.)
on )SW , in /rF�i� C: N.C.
(Waterbody) (CityIT 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.
I 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)
em
o� of M
,4. K RECF
JUN 2 4 2014
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or toaiW.n=tTl a 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.
:Dw— I do not wish to waive the 15' setback requirement.
(Property Owner Information) (Adjacent Property Owner Information)
ltzd
Signature
,Sc_a-tf
Print or Type Name 14�-
u 0"It"
Ming Address N G }Gc�.(_9_-� a T
City/State/Zip
Ctl9 030
Telephone Number
np
ure
Print or Type ame
uWe
(Revised 611812012)
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to S Z-4 k NX.1". ( ) 's
(Name of Property Owner)
property located at f+kaz (- . k tkikQa d ,;+6 . N G .
(Address, Lot, Block, Roatl, etc.)
on 3�1G L---L Sd 0A , in hnornl•t,a.cl. G!4,1 , N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
I ation.
I have no objection to this proposal.
I 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)
IEGBTVED
APR 0 8 2014
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. RECEIf you
wish to waive the setback, you must initial the appropriate blank below.) u
do wish to waive the 15' setback requirement. JUN 2 4 2014
I do not wish to waive the 15' setback requirement.
nrMMFfi rrry
(Property Owner Information) (Adjacent Property Owner Information)
�nLNKWA
Signor re
LO 4-f kCxV.t,,AJ
Print or T�yppe Name
16Dto W� 1(0.r A PJQ,C9
Mailing Addresw s ,
27VCO
City/State/Zi
aL .�2( �So3 C-)
Telephone Number
Date
Mailing Address
City/State/Zip ,70 "t
Telephone Number
Date
J-
(Revised 611812012)
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NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Pat McCrory Braxton C. Davis
Governor Director
Date 4 — ,; " 14
Applicant Name
Mailing Address _ G�Co LZ 1110. r
John E. Skvarla, III
Secretary
I certify that I have authorized (agent) Sk'- Lou ti to act on my behalf, for the
purpose of applying for and obtaining all CAMA Permits necessary to install or construct (activity)
at (location)
20t3 (4pho,r KkQd C ,J v NC XSE-7 .
This certification is valid thru (date) JZ -3) "' % 1
Signature t
400 Commerce Ave., Morehead City, NC 28557
Phone: 252-808-28081 FAX: 252-247-3330 Internet: www.nccoastalmanagement.net
An Equal Opportunity 1 Affirmative Action Employer
APR 0 8 2014
II)CH-MM Uff
;itECEIV�D
JUN 2 4 2014
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otthCarolina
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