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Home My WebLink AboutScott, MarkL [ ,C.4MA / ---'DREDGE & FILL A B C D GENERAL PERMIT Previous permit # JNew ❑Modification ❑Complete Reissue '—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 Rules attached. Applicant Name ` , Project Location: County Address.' Street Address/ State Road/ Lot #(s)_ City . __T State /t%%, - ZIP - Phone # Subdivision Mail -Mail bdi- - Authorized Agent City_._ ZIP_ ❑ CW ❑ ,kPTA S _.JPTS Phone # ( ) River Basin !' Affected ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A AEC(s): Adj. Wtr. Body +. ' X ' d I (nat /man /unknEl PWS: ) Closest Maj. Wtr. Body i! 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Agent or Applicant Printed Name Signature ** Please read compliance statement on back of permit ** Application Fee(s) Check # Permit Officer's Printed Name f� Signature Issuing Date Expiration Date 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 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 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 how to comply with these buffer rules. Division of Coastal Management Offices Morehead City Headquarters Washington District 400 Commerce Ave 943 Washington Square Mall Morehead City, NC 28557 Washington, NC 27889 252-808-2808/ I-888-4RCOAST 252-946-6481 Fax: 252-247-3330 Fax: 252-948-0478 (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) http://www.nccoastalmanagement.net/ (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) Revised 08/27/ 14 AWL a DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPONOTIFICATION[WAIVER FORM Name of Property Owner: k Address of Property: �Lf (Lot or Street #, Street or Road, City & County) Agent's Name #: Agent's phone #: Mailing Address: I hereby certify that I own property adjacent to the above referenced property. The individual applying for this permit has described to me as shown on the attached drawing the development they are proposing. A description or drawing with dimensions must be provided with this letter w✓ I have no objections to this proposal. I have objections to this proposal. If you have objections to what is being proposed, you must notify the Division of Coastal Management (DCM) in writing within 10 days of receipt of this notice. Correspondence should be mailed to 400 Commerce Ave., Morehead City, NC, 28557. DCM representatives can also be contacted at (252) 808- 2808 No response is considered the same as no objection if you have been notified by Certified Mail. 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. (Property Owner Information) A.'L JL- Le Signature Print or Type Name �1)6i Mtt4 5",_*4 Mailing Address Acw 1Jter.. AlC �8sl;G City/State/Zip .2 Lo Telephone Number Date (Adjacent Property Owner Information) Sign re Print 6r Type Name Mailing Address `ylec� n)G Z�SS� City/State/Zip Li 9 Telephone Number i4fck i i T mac^ i s Date Revised 611812012 V\ 1� I, give Mark Shawn Scott permission to install a boat ramp, as described per property drawing, on his property at 24 Mercer Dr., Merritt, NC. Agree to )� Disagree to Signature Dat