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Home My WebLink AboutHarrington, JulianApplicant Name / ----- Address I City: State ,. ZIP � (r Phone # (r )� ! E-Mail Authorized Agent CW Affected El OEA AEC(s): ❑ PWS: �SEW L TA ElES ElPTS ❑ HHF + ❑ H �BA ❑ N/A PNA vac / no -CAMA / DREDGE & FILL �. GENERAL PERMIT --,New ❑Modification Complete Reissue Partial Reissue 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. Project Location: County i No. 73423 A Previous permit # Date previous permit issued B C D Street Address/ State Road/ Lot #(s)_ Subdivision — 5 ZIP City Phone # ( ) __ River Basin 1 > _ t Adj. Wtr. Body (nat an /unkn) Closest Maj. Wtr. Body ■■■� ■ ■■■�■■■ ■■■ ■■�■■■■■ NONE EOEE ■�1�ENt.:E■ NENO�ONE1 ■NEEE■EME■HKI, Mann �OO�'\■liEtlt#�Ji',EEt#1■iiNYNE/ii�/■■tLl■i1=nNME iN■■■ ■■EOEONE■ NE NoO■O■O • . = O■OOE■®■E KINItUO aff, NEE �N■E■NOili� NONE NEEEE■NEN� . ■ENEN■ E■EEE■■E.EEEI��■%1�[iRliEtTl'iilltl�ii�/■t�tHM ■®EEE■S!/ No N E1�■ENE■ ■■ENN■N!�■■E■liiLe��N■ELI ■:lINENii :. M O■ENO■ONO�Oi■NONNl�O/O■EE■■�iONEEN■■ ■■Nl'�l■ ■� !� ■UFO �ONlEi _ EE■JE 'EONS■■ ■®E■ENN■ME ML1mENNEitlt� NOEOEOEEE 'NEE■', N E ir!i■ ■■ ■ 1, / ■■NEENt�I�■■IiENO■�iEIIE10I En 7EO■O■ .. .. Agent or Applicant Printed Name Signature Please read compliance statement on back of permit Application Fee(s) - 6r Che[k# Permit Officer's Printed Name 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 I) 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/ 1-888-4RCOAST 252-946-6481 Fax: 252-247-3330 Fax: 252-948-0478 (Serves: Carteret, Craven, Onslow - (Serves: Beaufort, Bertie, Hertford, Hyde, North of New River Inlet- and Pamlico Tyrrell and Washington Counties) 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 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 Hurricane Florence and TS Michael Replacembnt/Repair Request Form Date of Request: Property Owner Name: Address of Property: Telephone Number: Type of Work: 0f 6� OTE: • The Emergency CAMA General Permit 2500 is for repairs and replacement of water - dependent structures damaged because of Hurricane Florence and/or TS Michael. The replacement, reconstruction and maintenance excavation activities shall conform to current standards and rules. All work under the Emergency CAMA GP 2500 must be made in the same footprint of the previous structure with no additions, expansions, or enlargements. • If any portion of a structure being replaced is within the 15' setback of the riparian line or access area, signatures of the adjacent riparian property owner(s) must be obtained acknowledging the notification and waiver of the setback on the forms provided by DCM. • Any maintenance excavation or dredging requires signatures of the adjacent riparian property owner(s) on th,"otiQe�tion forms provided by DCM. Signature: RECEIVED N AN 3 0 Z019 DCM-MHD CITY