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HomeMy WebLinkAboutTester, Patricia & Golden, Philip�� Y Gt Ird� ia� � ���; ;j�; �, 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, certifythat this project is consistent with 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 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 Headauarters 400 Commerce Ave Morehead City, NC 28557 252-808-2808/ 1-888ARCOAST 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, Onsiow -below New River Inlet- and Pender Counties) VI"J`r 'Mu! !_ MM-m) *,1 '��`,�.���, -�f� r'1�i, � �.7.7 ����,��L: ;,1i;7�>>. L>�.} �n i3J[f'�il7ju_a! lF;t..mal _ 1 Applicant: j r L j Date: 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) 1 i � Dredge ❑ Fill[:], Both ❑ Other 1 • i r � Dredge ❑ Filf ❑ Both ❑ Other 1 Dredge ❑ Fill ❑ Both ❑ Other-Ij 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 ❑ !' ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to �fiu.� �: lct r ��� `� 68 w,"'i s A S Z n (Name of Property Owner) property located at (Adc7fe on /� �-U�`� , � Cnl' , , (Waterbody) ss, Lot, Block, Road, etc. , in Q , N.C. (City/Town an or County) The applicant has described to me, as shown below, the development proposed at the above loca ' n. 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) RECEWED JUL 0 5 Z013 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.) �--� I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. Owner Information Date (Adjacent Property Owner Information) ign,,ere S Print or T e Name I .)�-k © &IA42 L, S +- Mailing Ad ress WltatelZ':1� 6tj ►VC OW S5 7 Cify/State/Z�iv C5Z -7Z3 1Z Telephone Number z(,Sv--k-2.ok3 Date (Revised 611812012) I hereby certify that I own property adjacent to 712dj(4)ed /ep-r'P'0 t. 's property located at on ( J C�-- (�eP��_f(- , in SAL N.C. IWaterbodv) (CitviTown an or ounty) The applicant has described to me, as shown below, the development proposed at the above location. 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) REMMD DC9-MHDCrFY 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.) > wish to waive the 15' setback requirement. 1 do not wish to waive the 15' setback requirement. Owner Information) dace (Adjacent Property Owner Information) re II Print or Type Name (1 M il'ng A ress i�� a( N, & City/state2ip Telephone Number 7 3`)-3 Date (Revised 611812012) O v Y 1.►3 0 Q • U U 5 3.00mao H �- - - ­Z-, - —fir - 3A0."So FI I� i i i all Mw mend — M\a 09 q%-Lv 1- 133a1S s F119 At AM A i i all Mw mend — M\a 09 q%-Lv 1- 133a1S s F119 At AM A iii rr7 all 0 _may FILF r PY 0. � 0 0 M Q4 (d I•t REFERENCES DEEDBOOK 1404 PAGE 322 DEEDBOOK 1092 PAGE 166 PIN # 638614329957 = LOTS 6 & 10 AND EAST PART OF LOT 8 BLOCK "G" PIN # 638614329907 = LOT 7 & 9 AND WEST PART OF LOT 8 BLOCK "G" 9 0 0 0 0, t for Recording 0 CREEK C) � A"AI'�,�� r� l W 1 y W W W W W W S I 84-15'00" W W W W W W W EDGE OF WATER � W J IrW'00)! W W W LOW MARSH C.P. P, W W S 84} 1 - W W I SO.00� DER STAKE OF .NW STAKE W 50 00 W I4 �,��WQS• W W W W W W W W W 3 I D: � W W W W W W W W W� Ia• W W W STAKE, W W W W W W W W 1 W W W W W W W W Q• W O Q ID W W •• W W W W O j� Y W I I W .�j� . - • f , W j'.'♦ W W W STAKE LO W �% O, � O• � W W W W W I O LOT "'•E '.Z''� .' W I ;�, •r• EIR I O Q .•.:�. O O . �• ! �•-.• :t O Q I� U z . • LLE' • STAKE I I m EIR' � LEGEND: EIP - Existing Iron Pipe ECM - Existing Concrete M EIR - Existing Iron Pipe C EPKN - Existing P. K. Nail ERRS - Existing Railroad,9 EA - Existing Axle 0 SIP - Set Iron Pipe 0 SCM - Set Concrete Monw SPKN - Set P. K. Nail 0 CL - Centerline C.P. - Computed Point RNV - Right of Way R - Radius A - Arc MBSL - Minimum Building Sq. Ft.• - Square Feet