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Home My WebLink AboutMoore, StephenJCAIVIA /'E1 DREDGE & FILL ENERAL PERMIT Previous permit # New ElModification ElComplete Reissue E]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 NCAC 'El Rules attached. plicant Name Project Location: County-,. Address StreetAodress/ State -Road/ Lot,#(s) - , City—, Statezip Phone # Fax # Subdivision V zip. 6Hthodzed Agent city— "i , KC,/ El CW [.YEW DP",TA DES 0 PTS Phone # River Basil Affected El OEA El HHF blH El UBA 0 N/A AEC(s): Adj. Wtr. Body (nat Iman /unkn 0 PWS: DFQ "I % Closest Maj. Wtr. Body s / rho P'NA yes rno -Gritliabi—ye- I n- ye %. Type of Project/ Activity V 111111MUMEMME MUM ■■■■■■■�■■■■■i111w1■�'i■■■®■!�■del EEO =NILA MEN !�■■■■v■Wlrii�Q�i M■■MM■W■■ ® ■■■ ■1■■ OW E=MMM5%MW==■M/ ENNUMEMEMENNIMMOMMINJIME MEMNON NIMUMMOMEMMENNOME ■■■■■■ ■i■�ME ■�NE mmomisi■■■■■■■■■■■■■■■■ E■MEMENNEM EM M. M. ONUMMERNINNI■ ■I ano MEWEEMINNIZE a■�I�■■■■■■■�I■�■��■■ MOOMMEME ■■■■■■■■■■ii■■■■;11■■�■ ME■ MENNEN m M ■■■■■■■■■■■.■■■■ JMEONN■■w■..■■■ M aM111011 Jqj;IM■NONIfflz A building permit may be required by: G. ❑ See note on back regarding River Basin rules. Notes/ Special Conditions I �A V Agent or Applicant Printed Name Permit Officer's Signature Signature "Please read compliance statement on bacl�of peqit*,* Issuing Date Expiration Date, A Ap plicationFee(s), 'Check#, Local PlanningJurisdiction Rover FileName m 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 ❑ 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/ 1-888-411COAST 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 N.G. DIVISION OF COASTAL MANAGEMENT AGENT AUTHORIZATION FORM Date 4 � Z-(. ( I Name of Property Owner Applying for Permit: �,�--y Mailing Address:! zr�14 c- Vd I certifythat I have authorized (agent) �� -1 -� � P\'"� 2 4 � Qtact (g ) on my behalf, for the purpose of applying for and obtaining all CAMA Permits necessary, to install or construct (activity) Z at (my property located at) �J� ,, Q This certification is valid thru (date) Property Owner Signature Date ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to S��(1'`�-`�� C; 2 's property located at of Property Owner)on — (A ess,1 Block, ad, e C (Waterbody) in (City/Town and/or, County) The appl' nt,has described to me, as shown below, the development proposed at the above locati I have no objection to this proposal. 1 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) WAIVER SECTION I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin must be t back a minimum distance of 15' from my area of riparian access unless waived by me7(lfu 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 Infonnation) signature Print or Type Name Mailing Address CiWstatemp Telephone Number/email address Date *Valid for one calendar year after signature* Print 1TNan6ro Mailing vnyiatci7(1 Telephone Number/email address Date � 2 (Revised Aug. 2014) ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that l own property adjacent to 's N?e fi of o Qwfier property located at (Address, Lot, BI Road, , ) on ✓' S C'�t— �y� in C �, `� \ c �, N.C. (Waterbody) (City/Town and/or County) The /2n licant has described to me, as shown below, the development proposed at the above loca I have no objection to this proposal. 1 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] WAIVER SECTION understand that a pier, dock, mooring pilings, boat ramp, 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. 1 do not wish to waive the 15' setback requirement. (Property Owner Information) Signature Print or Type Name Mailing Address CitylStatelZip Telephone Number/email address Date (AdY/cLIP pe O 9 {e llnformation) ' 111 S grtature * Print or Type Name t 5bl-i T Y1kci C - Q11 tr«tl � Address Ll Telephpneku berl-anmail address Date* (Revised Aug. 2014) *Valid for one calendar year after signature* 0 Styron, Heather M. From: Mason, Connie W Sent: Tuesday, April 28, 2015 12:35 PM To: Connell, Brad Cc: Styron, Heather M. Subject: RE: FYI Importance: High Brad: David Anderson of EZ Dock Solutions is working with Heather on a new permit. Please let her know of credit and how to handle it. I would place 100.00 with check number 1119 plus the new check number with the balance if it were me.....But not up to me and this could be a different EZ Docks??? Connie Receptionist NC Division of Coastal Management 400 Commerce Ave. Morehead City, NC 28557 Phone 252-808-2808 Fax 252-247-3330 connie.w. masonaamcdenn gov www.nccoastalmanagement.net. mail correspondence to and from this address. maybe subject to the North Carolina Public Records Law and may be disclosed to third parties From: Connell, Brad Sent: Friday, March 06, 2015 4:11 PM To: Styron, Heather M.; Davenport, Ryan Cc: Brownlow, Roy; Mason, Connie W Subject: FYI Importance: High EZ Dock Solutions has a $100 credit towards their next permit (check #1119). Let me know when it gets used so I can toss this note.... Brad Connell Field Representative _ NC Division of Coastal Management http://Portal.ncdenr.org/web/cm/dcm-home E-mail correspondence to and from this address may be subject to the North Carolina Public Records taw and may be disclosed to third parties.