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Home My WebLink AboutPully, Bill"'�DREDGE & FILL M 62212C FINrE PERMIT Previous permit # Ic io GENERAL �od�i n ElComplete Reistsuart.ial Reissue Date previous permit issued As authorized by the State of North Carolina, Department ofEnvironment and Natural Resources and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC Zjules attached. Ap plicant tame 1e Project Location: County "1".) /7 ry !Address, Street Ad tntp_Re%� P ,City/ ij/p State At Phone # i Fax # Subdivision Authoriz 'e d A&nt city ZIP A I It Affected 0 CW YEW )r:ZTA El ES 0 PTS Phone # 1711 Rjver Basin WjA I 'k El OEA El HHF 0 lH 0 UBA 0 N/A man /unkr AEC(s): Adj. Wtr. Bod LtJ_�rJnnatJL_ El PWS: EIFQ Closest Maj. Wtr. Body— ORW: yes /(no_,,) PNA yes/ C, Crit.Hab. yes no MMM..,.,A.MM....,. .M. A ■■■ ■��■■■®■■■■MM■■■■■■N ! �■■■■■■■■■■■■■■■■■■ M ■■■= M■■M■■■:M 2.� I MMEMEMOMME cubic yards OF` "Im NE■ME =�N on ON OWN ON■No■No Boat ramp MEMEMMERNK"al M I WAI, - I VA NUM" W& Is I■Mml Boathouse/ Boatlift -MINMEN MEMO- , E M g Beach Bulldozing MM■►ai■ii■■ice■■�■■■■�■■■■Other 'ShorelineLenith ,,SAV.-- not sure yes jj Sandbags: not sure yes to Moratorium: n/a yes no Photos: yes, Waiver Attached: I yes no A building permit may be required by: ',f See note on back regarding River Basin rules: Notes/ Special Conditions Agent or Applicant Printed Name Permit Officer's Signature Signature Please read compliance statement on back o permit"" Issuing Date plication F - ee(s) Check# Local Planning- Jurisdiction 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 consistentwith the North Carolina Coastal Management Program. River Basin Rules Applicable To Your Project: ❑ 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 complywith 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 tl •:1 �1� ��-!1"�J�.��.�;� ;�� tv �:-�t}�•;�( �1?� c .:1�'!.<-.'7 r•`l �l--.'��`.� { i ll �" 1� "�'� Applicant: Date: ("p, -)-) oqc 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 LredgeXFill ❑ Both ❑ Other ❑ �'A 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 ❑ ��'��'t'd�-�w�� .. ��3�t;;•.�56��s�Sn��a .e �^rs��aA9,�cc4rh;�3.^�Oa�u�;��,�vmoa+3,a�� •erii��d�;+!);�1�'9�1�3; N.C. DIVISION OF COASTAL MANAGEMENT AGENT AUTHORIZATION FORM Date - 30 - !3 Dame of Property Owner Applying for Permit: 11 Mailing Address: 2 7 Z l� C,a m bR id�� A 276ag I certify that I have authorized (agent) 1'Yl �n g� cic ��cQq�•=-� to act on my behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to install or construct (activity) at (my property located at) K, This certification is valid thru (date) &A4 VAUA, Property Owner Signature _ Date �4TIV'� APR d 9 2013 ADJACENT RIPARIAN PROPERT'i OWNER STATEMENT I hereby certify that I own property adjacent to , 1) PLime 's (Na nr b of Property Oviner) property located at 'ZC:.So II 1j -J- (Address, Lot, Block, Road, etc.) on ^i� l� 1 �S �� t� 1� _—, in 'le.o,,4-nT , N.C. fflaterbody) (CitylTown andlor County) The applicant has described to mt, as shoimi balow, the devoloprne,rt proposed at the above location. c Z 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) I • � .pe a�..s,, Zoi -10 5 4 21 � q.4 I q,, Z cr `r o-5 RECEWED APR 0 8 2013 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.) � A- I do wish to waive the 15' setback requirement. 1-do not wish to waive the 15' setback requirement. (Property Owner Information) (Adjacent Property Owner Information) %,)I P,11 Signature %-0 � Print or Type Name Mailing Address -Z--7 � City/State/Zip I� 471 2�2� Telephone Number '3. 30 - ,g Date EL"'A b7= e Q, cts eSe- t or Ty e Name ',o, 2 ►� M ing Ad�ess p a Is5 - T� e-395L Telephone Number v:z- �?,6-/r? Date (Revised 611812012) ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that i own property adjacent to 9, ) I PL, 1'; (Marna of Properbj Oviner) property located at Z 6 50 Lc-:til Now - , C— If . (Address, Lox, Block, Road, etc.) OnZ _i�25 C�'C L _ , !n �eAe, -��r , N.C. (Waterbody) (Cityl`i'own and/or County) The applicant has described to mc, as sho-wn bolov,, the development proposed ai the above location. a� I have no objection to this proposal. I have objections to this proposal.&CCt3NNp DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (Individual proposing development must fill in description Abe/ow or attach a site i4ipgjolj I Lt$ y *Z9 dos DCU-WW Crrr a a ,Z it,414q y 2 ,T `t as 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.) eel I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Property Owner Information) yal� poj-'� Signatt e I�...- Print or Type Name T Z YL,I Mailing 2 — 7 � � '6- City/State/Zip ci (; f1-11 'z s ZG Telephone Number ►0 r(Ao'ent Property Owner Information) Signature Print or Type Name 610st.d %Le 'S Mailing Address Galat h.,r.o oe-, Z'753�f City/StatelZip Telephone Number Date (Revised 611812012)