HomeMy WebLinkAbout73876A_Martin, Elayne_20190925❑CAMA / ❑ DREDGE & FILL
r. GENERAL PERMIT
ENew ❑Modification El Complete Reissue El 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
Applicant Name 'MCL""Ae WCt r a in
Address <i j I C) 6(" b R " 9d
City State ZIP'r
Phone # C� E-Mail
Authorized Agent
Affected ❑ CW [T EW ❑ PTA ❑ ES ❑ PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
ORW: yes / no. PNA • yes / no
No. 73876
Previous permit #
Date previous permit issued
Rules attached.
Project Location: County
B C D
Street Address/ State Road/ Lot #(s)
IqI W &L✓ �)f (r t,
Subdivision
City 11i{i I iia'J zip ;2`1 17y?
Phone # ( ) River Basin
Adj. Wtr. Body (nat man unkn
Closest Maj. Wtr. Body
Type of Project/ Activity r Yc I c_. ,. t`('.l_ ' A r\a (
C c dr?) (Scale: I = SU )
Pier
Fixes
Flom
Fingi
Groi
Bulk
Base
Boat
Boat
Beat
Othi
Shor
SAV
Mor
Phoi
Wain
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■■■■i
r pier(s)
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length
number
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A building permit may be required by: '` t _> ❑ See note on back regarding River Basin rules.
( Note Local Planning jurisdiction)
Notes/ Special Conditions he n' aC P in iIn
r
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ARY^4 ; r
Agent or Ap licant Printed Name
Signature Ple'ase read compliance statement on back of permit
Application Fee(s) Check #
i �
Permit Of cefs Printed Name
G�
SignattWe
C+ 1 i
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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 - (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)
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
NC Division of Coastal Mgt. Habitat Impact Computer Sheet
Applicant: E I C'-� n Q fyko.r Permit #:
Date: '1/9> 11�
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
�Zttc0,
DredgeM Fill ❑ Both ❑ Other ❑
-7
-4
Dredge ❑ Fill El 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 ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
252-808-2808 :: 1.888-4RCOAST :: www.nccoastalmanaaement.not revised- 02/03/10
■ Complete Items 1, 2, and 3.
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X
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B. cReceived
V Q/J
1. Article Addressed to:
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1)
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❑ Addre:
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D. Is delivery address different fr9mi item 1? U Ye:
If YES, enter delivery addresf. below: ❑ No
3. Service e
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9590 9402 4940 9063 8453 56
>CCertified WHO
Delivery
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Merchandise
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u Insured Mail Restricted Delivery
Restricted Delivery
(over $500)
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United States
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If YES, enter delivery address below: ❑ No
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Merchandise
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nnmastin Ratiirn Ranaint
USPS TRACKNG #
9590 9402 4940 9063 8453 63
United States
Postal Service
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First -Class Mail
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USPS
Permit No. G-10
in this box*
0449
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Return Receipt Oardcopy) $ °"
F-1 Gertified Mall Restricted Delivery $ Hem
[]Adult Signature Required $ OCI
[:]Adult Signature Restricted Delivery $
0.9/27/2019
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A receipt (this portion of the Certified Mail label). for an electronic return receipt, see a retail
A unique identifier for your mailpiece.
associate for assistance. To receive a duplicate
Electronic verification of delivery or attempted
return receipt for no additional fee, present this
delivery.
USPS®-postmarked Certified Mail receipt to the
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retail associate.
signature) that is retained by the Postal Service'
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for a specified period.
delivery to the addressee specified by name, or
to the addressee's authorized agent.
vportant Reminders:
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You may purchase Certified Mail service with
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available at retail).
or Priority Mails service.
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International mail.
and provides delivery to the addressee specified
Insurance coverage is notavailable for purchase
with Certified Mail service. However, the purchase
of Certified Mail service does not change the
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certain Priority Mail items.
For an additional fee, and with a proper
endorsement on the mailpiece, you may request
the following services:
- Return receipt service, which provides a record
of delivery (including the recipient's signature).
You can request a hardcopy return receipt or an
electronic version. For a hardcopy return receipt,
complete PS Form 3811, Domestic Return
Receipt; attach PS Form 3811 to your mailpiece;
by name, or to the addressee's authorized agent
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Certified Mail receipt, detach the barcoded portion
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IMPORTANT: Save this receipt for your records.
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Agent's phone #:
RECEIPT REQUESTED
or Road, City & County)
Mailing Address:d—
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.
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. Contact information for DCM offices is
available at http://www.nccoastalmanagement.net/web/cm/staff-listing orby calling 1-888-4RCOAST.
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, boat ramp, breakwater, boathouse, or lift 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)
s�
Signa ur (r
61a�re K.
Print or Type Name
�\)b �A CQr%-%-A L
Mailing Address
,4, k-} 4 �, )14, � C-
City/State/Zip
L4s4) � r36 -S4 zS
Telephone Number/Email Address
Date
(Riparian Pro caner formation)
Signature
Print or Type--Na-me
9 I�-) C
Date
(Revised Aug. 2014)
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This map is prepared
from data used for the 4110 Bob Perry RD Owners: Martin, Elayne K Ttee - Tax District: Kitty Hawk "
inventory of the real Kitty Hawk NC, 27949 Primary Owner Subdivision: Subdivision - None
property for tax ' Parcel: 011312000 Lot BLK-Sec: Lot: Blk: Sec: „
purposes. Primary
information sources such Pin: 986508876501 Building Value: $427,600 Property Use: Disabled Veteran - Part
as recorded deeds, plats, Land Value: $92,400 Exempt
wills, and other primary jC.rot Ltig `.6A— Misc Value: $13,200 Building Type: Contemporary/modern r _ 'T, ..''_
_ _ _9
(� public records should be
~ `t,++L consulted for verification Total Value: $533,200 Year Built: 2011
t t
of the information
Untitled Map
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