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Home My WebLink AboutHill, Charles❑ DREDGE &FILL NTL) 70408 CAMA / A B C D GENERAL PERMIT Previous permit# ❑New ❑Modification El Complete Reissue El Partial Reissue Date previous permit issued As authorized by the State of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC ❑ Rules attached. Applicant Name Address City _ State ZIP Phone # ( )_ Authorized Agent El CW Affected El oEA AEC(s): ❑ PWS: f%RW voc / nn _ E-Mail ❑ EW ❑ PTA ❑ ES DPTS ❑ HHF ❑ IH ❑ UBA ❑ N/A PNA ves / no Project Location: County Street Address/ State Road/ Lot #(s) Subdivision — City ZIP Phone # ( ) River Basin Adj. Wtr. Body (nat /man /unkn Closest Maj. Wtr. Body -- r MEN n - � ■ M. ■ ■ 0 ON ME MN No 0 Agent or Applicant Printed Name Sign ture ** Please read compliance statement on back of permit" Application Fee(s) Check# t � 1 Permit Officer's Printed Name S gna! 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/ 1-888ARCOAST 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 401 S. Griffin St. Ste. 300 Elizabeth City, NC 27909 252-264-3901 Fax: 252-264-3723 (Serves: Camden, Chowan, Currituck, Dare, Gates, Pasquotank and Perquimans Counties) http://portal.ncdenr.org/web/cm/dcm-home (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 7/06/ 17 I hereby certify that I own property adjacent to (Name property located at MCI A,odress, Lot, ock, Rq owd and/or County) The applic pnt has described to me, as shown below, the development proposed at the above lgcation. 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) y 4t � � 0 9, *0640� 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. (Adjacent Property Owner Information) ,gnature Print or Type Name 4 f�..� M ng Address city /State/Z� ■ Complete items 1, 2, and 3. ■ Print your name and address on the reverse so that we can return the card to you. ■ Attach this card to the back of the mailpiece, nr nn the front if space permits. 1. Article Addressed to: 9590 9402 3854 8032 6638 68 2. Article Number (Transfer from service label) 7017 3380 0000 3638 PS Form 3$ , July 2015 PSN 7530-02-000-9053 ■ Complete items 1, 2, and 3. ■ Print your name and address on the reverse so that we can return the card to you. ■ Attach this card to the back of the mailpiece, or on the front if space permits. 1. Article Addressed to: J9 r) 1) dr'Q A. Signature ❑ A nt X Addressee B. Receiv by nn ed Name) C. Date of Deli erg D. Is delivery address different from item 1? ❑ Yes if YES, enter delivery address below: ❑ No L-- 3. Service Type ❑ Priority Mail Express® ❑ Adult Signature ❑ Adult Signature Restricted Delivery ❑ Registered Mail— ❑ RegisteredMail Restricted ❑ Certified Mail@ ❑ Certified Mail Restricted Delivery Delivery ❑ Return Receipt for ❑ Collect on Delivery Restricted Delivery Merchandise El Signature Confirmation"' ❑ Collect on Delivery ❑ Signature Confirmation 3 7 9 8 fcted Delivery Restricted Delivery Domestic ReturWReceipt A. Signature ❑ Agent ❑ Addressee B. Received by (Printed Name) I C. D. Is delivery address different from item 1? r U YO- If YES, enter delivery address below: ❑ No I I IIII� ill I'I I II I IIII II I I III I I I I I I I I I3. ❑ dullt Signature ice Type re Restricted Delivery ❑ Registered Mail Restricted Mail 9590 9402 3854 8032 6638 75 ❑ Certified Mail® Delivery ❑ Certified Mail Restricted Delivery ❑ Return Receipt for ❑ Collect on Delivery Merchandise ❑ Collect on Delivery Restricted Delivery ❑ Signature ConfirmationTM 2. Article Number (Transfer from service label) ❑ Insured Mail ❑ Signature Confirmation led Delivery Restrcted Delivery 7017 3380 0000 3638 3804 PS Form 3811, July 2015 PSN 7530-02-0004053 Domestic Return Receipt