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Home My WebLink AboutRussell, TommyA- ❑CAMA / ---'DREDGE & FILL No 71654 -. GENERAL PERMIT Previous permit# A B !C D �New ❑Modification ❑Complete Reissue ❑Partialj�eissue 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 # E-Mail Authorized Agent f ecte Affected d ElCW D EW U PTA ❑ ES ElPTS A [IOEA ❑ HHF ❑ IH ElUBA El N/A ❑ PWS: ORW: yes / no PNA yes / no Type of Project/ Activity Pier (dock) length �--� Fixed Platform(s) Floating Platform(s) Finger pier(s) Groin length number •--�-- Bulkhead/ Riprap length's--- avg distance offshore --- max distance offshore - Basin, channel cubic yards,,, Boat ramp Boathouse/ Boatlift— Project Location: County Street Address/ State Road/ Lot #(s) Subdivision '----' City ZIP Phone # O River Basin Adj. Wtr. Body (nat /man /unkn) Closest Maj. Wtr. Body ■■NEE nNoWN HrNNEWHIMN Ma !■�' WON �L1�lr�!r.Vr�M111�1�■ Notes/ Special Conditions E ■ Agent or Applicant Printed Name Signature "Please read compliance statement on back of permit" Application Fee(s) Check # (Scale: ( - O c t ) ❑ See note on back regarding River Basin rules. Permit Officer's Printed Name s„ j 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 howto complywith 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 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) (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://portal.ncdenr.org/web/cm/dcm-home Revised 7/06/ 17 CERTIFIED MAIL • RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM Name of Property Owner: Address of Property: (Lot or Street #, Street or Road, City & County) Agent's Name #: Mailing Address: Agent's phone #: 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 dra iinq the development the are proposing. F have no objections to this proposal. I have objections to this proposal. you have objections to what is being proposed, you mustnotifythe 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 -Waive the setback, you must initial the appropriate blank bel `RtCEIVED I do wish to waive the 15' setback requirement I do not wish to waive the 15' setback requirement SEP 4 6 2018 (Property Owner Information) Signature Print or ype Name Mailing Address C►ty/State&ip Telephone Number Date ❑GM.MHD CITY Information) Print or Type Name ob aea& a. Mailing Address 9-V IVScS 7 CityVate ip Telephone Number ?-�,-« NOT. Revised 6/18/2012 i • I.i N a WAX I a FLOWUNE (TYP) �, b BACK OF CURS ACK OF CURB ti'• ..:. r 1 • . CH BASIN 0 �:. CONC. SIDJEWALK 1 _r = C. :CON,SIDEWALK• PS. 84°1 S'OO'E 200.00' : •2.3 3.4 CHAIN -LING, FENCE p j PF1Ct1'1 µG - GLASS SHOP FRAME -OWELU t W� OONDA SHOW .51KFBOOM 3.1 -t : .3.9 - . over POW tC1. e Poh • 4:5 Q a •3: w . . w 4. WOOD. AND T1N t1 ~'`-._. ocic o LDINGGU ON. CTO CRETE O. _ ♦.;,.c6�. SLAB ;,. 3.5• , AL AREA •4.2 4.0 :a CONCRETE AND ASPH. E%Sl jr Cot4CRM - ` ` BULKHEAD • ••• '��ry' ,'\ •R-�Y r: •��j _ ACRE - r .J�J CdMPu-sA�OrI ATE • T :;:,. _ AREQ To i p'otoo. •3.T • p O �1'�SCiSTINC�..tlCl�E`�.;f- -CONC .. �� 0 B HEAD c�+ 'CULD AB FQUIypA`('rOt1 •4. c T •3.4 ACM-M►� , .r � `:bXlS'•11KG°�HO�� .. • _ i3,3:. � �, � - ^� - M gSPH�-� AREA AND CONCRETE • '#- �• ,:•-:=` ' - ' . � � :.ems -�'Z�•W ... .-�r CERTIFIED MAIL • RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM Name of Property Owner: Address of Property: (Lot or Strebt #, Agent's Name #: Agent's phone #: or Road, City & County) 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 7 posing.4escfi Ftro adraw nr q .i`ert''`og rtfiep�fi' der. I have no objections to this proposal. I have objections to this proposal. If you have objections to what is being proposed, you mustnotifythe 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) ECEIVEC's (Adjacent Property Owner Information) Signature S E P 0 6 2 01 R, ur u-5�Z M-MHD CIT) � �Print or Typ Nam4 Print or a Na t r Mailing Address — � Mailing Address --2 City/State/Zip `i CitylStatelZip 26 Telephone Number Telephone Number 9 - 9---� (-)/5 1 - �-z�� Date Date Revised 611812012 CERTIFIED MAIL • RETURN RECEIPT REQUESTED DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM Name of Property Owner: Address of Property: (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,d�scnljtior "ar,,.drawrng "with�d merisions, rnust4.be,provided -, itta h. 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. 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