HomeMy WebLinkAboutRose, Miriam6!cAmfiN, DREDGE & FILL
67810 No '
A B D.
ENERAL PERMIT
Previous permit #
ew ElModification ElComplete Reissue 0 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 I SA NCAC
Applicant Name i
F1,,] Rules attached.
Project Location: County_
Address,
i _V1
Street Address/ State Road/ Lot #(s)
Cityt' State rl I ZIP
Phone # O -Mail i
Subdivisio
Authorized Agent
city— zip )I
El CW &EW PTA ES 0 PTS
Phone # M/ River Basin
Affected
0 OEA El HHF El lH El UIBA 0 N/A
AEC(s): ❑Adj.
Wtr. Body x '(nat 6/mein /unLn).
El PWS:
ORW: yes / loo PNA des n?,,
Closest Maj. Win Body
Type of Project/ Activity
/5'
(Scale:
.e
Float
Fing
Groi
ro,
B&
Basir
Boat
Boat
Beac
Oth4
Shor
SAV:
Mo
Phot4
Waiv
lli
length
NEU
131
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EMINEMMUMEMEM1101
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ramp
-iouse/Boatlift—
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not sure
yes
a es rium: n/a yes
y
is: yes
r Attached: yes
Yes
A building permit may be required
Note Local Planning jurisdiction)
Notes/ Speciai,Conditions
L-J See note on back regarding River Basin
0
1, V,
Agent or f!pp.!i!;anr rrintea Name
Sig5or**Pl ease rea 6 d compliance statement on back of perrr
j
.Aipplicaticoh, Che
Permit Officer's,Printed Name
Signature 1.
I If:
Issuing Date;• ExpAt.
ion
0A
1,
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 [)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 Resources. Contact the Division of Water Resources 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
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ 1-888-4RCOAST
Fax: 252-247-3330
(Serves: Carteret, Craven, Onslow -
North of 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 - South of New River Inlet -
and Pender Counties)
http://www.nccoastaimanagement.nett
Revised 08/27/ 14
:::"" MA DREDGE & FILL
1
A BC
E111E L PERMIT
0
Previous permit#
ew El Modification ❑Complete Reissue El Partial Reissue Date previous permit i sued _._.-
uthorized by the State of North Carolina, Department of Environment and Natural Resources
'c)nvironmental
the Coastal Resources Commission in an area ofconcern pursuant to I SA NCAC
f�
t'
files attached.'
licant Name} t '
Project Location: County
Tess ? 1 t i
� j , ;
,.
Street Address/ Sate Road/ Lot #(s)"Y
;% `i. f State t t ZIP
ie # -Mail
Subdivisio
loried Agent f f.
City ZIP
CW
:ted PTAES ❑ PTS
Phone # Basin
❑ OEA ❑ HHF ❑ IH UBA ❑ N/A
(s)
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_WCAU
rtinte ame
Permit 'cef's rnte, Name
Pf re dcompliance statement onback of ermit
SigRat
tton Fee(s).Check
Issuing
Exp'
tion D a
&44
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Pat McCrory Braxton C, Davis
Governor Director .
Date O f � v) ' Aj
Applicant Layne L4j rl /f it
Mailing Address . a V') CS 4- Y—If � N r-ff r5�
John E. Skvarla, III
Secretary
RECEIVED
AUG 2 4 2016
«s�N IN►C. �s� DCM- MHD CITY
I certify that I have authorized (agent) — '--r � 4 /s to act on my behalf, for the
purpose of applying for and obtaining all CAMA Permits necessary to install or construct (activity)
'ev Z kF'f0/ , at (location)
This certification is valid thru (date) 1-7
Signature
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
AUG 2 9 2016
DCM- MHD CITY
One
North.Carohna
N�tli"�"
(individual proposing development
kfo
V r�
r
WAIVER SECTION .
I understand that.a pier, dock, mooring piings,.treakwater, 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
/" W I do wish .to waive the 15' setback requirement. AU G -. 2 9' 2016
it / ✓%. -{ ,
(Revised 611812012)
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
11
hereby certify that I own property adjacent to 1'i'T
(Name of Property Owner)
property located at l 6 7 ,c/ S-f
(Address, Lot, Blo Road, etc.
on _ � a� � y in _ / �; ,'� e r , N.C.
(Waterbody) (CityfTown and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
i have no objection to this proposal.
have. objections to this proposal.. .
w��:Nuvu�Vn.ut[HV_VJNU.Vr rrcvruStu uevCL.VrW1C1V F
(individual proposing deve%pi»ent must fill'in description below or attach a site drawing)
RECEIVE®.
AUG 2 4 2016
DCM- MHD CITY
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 -
3
wish to waive the setback, you must initled the. appropriate blank below.)
RECEIVED
�
I do wish to waive. the 15' setback requirement.
a
I do not wish to waive the 16' setback requirement. AUG 29 2016
(Property Owner Information) (Adjacent P operty OwnerP ;�t H D CITY
i
Sign�aAture p Sig re .
Print or Type Name Print.or Type Name
M t. g Address ,Mai%n Addr
Nsa,� lt1�C'_ 74 <5 IT S
City tatelzip City1State/Zip
r � 2ba� a
-
..
Te/ep�jon Tmber TblephVuffiber
Date Date
(Revised 611812012)