37981D - Fullerton

11 CAMA/ ❑DREDGE & FILL
GENERAL PERMIT Previous permit#
- New JModification 7-Complete Reissue liPartial Reissue Date previous permit issued
prized by the State of North Carolina,Department of Environment and Natural Resources
Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC '7,7 /.- - 0
❑Rules attached.
nt Name VP(n/ 1 rt, /ie r-1 Project Location: County 6i--.r r, ‘.4;(<_4._
s -2&(c I JC 55/C ci 44 vie Street Address/State Road/Lot#(s) /C)/2
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zed Agent City S / ZIP 22 '
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GENERAL PERMIT COMPUTER FORM
•
APPLICANT NAME: U,©,L r c ervt. riA11Q_,t. Jlt_
ADDITIONAL NAMES:
AEC DESIG: E) 'F DEVELOP AREA: _.. L PROJ DESC: P - 12
(Will only take 6) (Will only take 1)
WORK: 1 L I I t y
(Will only take 4)
6L 1 III /y
MAINT:
(Will only take 4)
IMP: OW 5 0'5
(will only take 6)
ACTION EXPIRATION
DREDGE & FILL REQUIRED: 0,1 /v - 7 ' 041
CAMA IvLAJOR DEVEL REQUIRED: 7' 7 ' 0 Y /0 . 7 • O

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OF WA T6 Michael F. Easley, Governor
0 William G. Ross Jr., Secretary
0 v North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E.,Director
O 1 l . Division of Water Quality
Coleen H. Sullins, Deputy Director
Division of Water Quality
July 6, 2004
Vernon Fullerton
2661 Jessica Lane
Supply, NC 28462
Subject: SionnwaterPerrnit o. SW8 031244
ullerton Residen
- Ingle Family Residences
Brunswick County
Dear Mr. Fullerton:
In accordance with your application to be covered under the State Stormwater General
Permit for Single Family Residences, received on June 14, 2004, we are forwarding
herewith the subject Certificate of Coverage Number SW8 031244 to construct, operate
and maintain impervious areas associated with a single family residence under the
subject General Permit. This permit is issued pursuant to the requirements of North
Carolina General Statute 143-215.1 and Title 15A NCAC 2H .1000, the stormwater
management rules.
Please take notice that this Certificate of Coverage is not transferable except after
notice to the Division of Water Quality (DWQ). The DWQ may require modification or
revocation and reissuance of the Certificate of Coverage.
This permit does not affect the legal requirement to obtain other permits which may be
required by the Division of Water Quality the Division of Land Resources, Coastal Area
Management Act, or any other Federal, State, or Local agency, law, rule, or ordinance.
If you need a copy of the General Permit, or have any questions concerning this permit,
or need additional information this matter, please contact either me or Gary Beecher at
[phone].
Sincerely,
Rick Shiver
Water Quality Regional Supervisor
RSS/ghb S:\WQS\STORM WAT\PERMIT\031244.Ju1y04
cc: Brunswick County Building Inspections
Division of Coastal Management
Gary Beecher (DWQ)
Wilminaton Reaional Office

•
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
STATE STORMWATER MANAGEMENT GENERAL PERMIT NO.
CERTIFICATE OF COVERAGE NO. SW8 031244
CONSTRUCT, OPERATE AND MAINTAIN
IMPERVIOUS AREAS ASSOCIATED WITH
A SINGLE FAMILY RESIDENCE
In compliance with the provisions of North Carolina General Statute 143-215.1 ,
as amended, other lawful standards and regulations promulgated and adopted by
the North Carolina Environmental Management Commission, and 15A NCAC
2H.1000, the Stormwater rules,
Mr. Vernon Fullerton
is hereby authorized to construct, operate and maintain impervious areas
associated with the construction of a single family residence and the associated
stormwater runoff located at
Fullerton Residence
1018 B-Var Road
Supply, NC
Brunswick County
to receiving waters designated as ICWW, class SA HQW waters in the Lumber
River Basin, in accordance with the provisions of the General Permit for Single
Family Residences, No. SW8 031244, and the approved stormwater
management plans and specifications, and other supporting data as attached
and on file with and approved by the Division of Water Quality and considered a
part of this permit for the subject project.
This Certificate of Coverage shall become effective July 6, 2004.
Signed this the 6th day of July 2004.

s-cue o 3 i 2 ¢¢
DIVISION OF WATER QUALITY/WATER QUALITY SECTION
STATE STORMWATER NOTICE OF INTENT
• SWG010000 -GENERAL PERMIT FOR SINGLE FAMILY RESIDENCES
•State Stormwater Management Application Notice of Intent for coverage under the
General Stormwater Management Permit for Single Family Residence Construction.
For the construction, operation and maintenance of impervious areas associated with
.the construction of a single family residence.
(Please print or type)
1. Mailing address of owner/developer:/ (The address to which all permit correspondence will be mailed)
Name _--VQCrlotl c--,1/4l\ecAr•
Street Address T Z l,,(0 .31 e S S,c ck L c;vI c'
City S�,p r1_I State N( ZIP 2 S1 L/6 ?
Telephone No. 7c 4i-c ciS- 3 3 30 FAX
•
.2. Location of proposed project:
Project Name F.,,\\er\-13'. Qes,cter,ce
Contact Person e r v10 A___SwA e ca.�_
Street Address 1 01 c' 13--L'c: N2(1 ,
City , .%'I _ State NC ZIP Z8'I6 Z _
County 1.r,n_ns„,_s 1C
Telephone No. Zoe qci S- 3.s'_30 FAX
3. Physical Location Information:
Please describe how to get to the project, using street names,state road numbers,and the distance
and direction from the nearest major intersection: 1=c-",, W,A,v1„Ati,n 11 s tv 21'
Lc -� 1=c..S 0•1 Z‘\ - 1i�1 n%.3le SkOAL C\:irhnsi tact 2,5,.-1- - Ilo.,.,)
� C ,v+�n�°. . -1 rn, C'S TC Ww l3 V�r,S o " Le..L
4. What isTangle ofie receking stream____ AD:RNAA j
i5. Receiving Stream Classification: L�FZ ICJ Lutn6s e
14.
6. This Certificate of Coverage is being submitted as a result of: 54 NQ
RNew or proposed project ❑ Modification to an existing project
Existing COC or Permit Number:
Date project is scheduled to begin construction: _.l.sr,- core&S
7. What is the total project area above mean high water? i; I VI ci(., ft2
8. What is the total amount of built-upon area proposed on this lot? d' 000 ft2

- __---
VERNON J. FULLERTON 1100079W83
CYNTHIA G. FULLERTON y ti ,
1505 TIN LANE 704-735-7565 DATE ( _v b_)
UNCOLNTON, NC 28092
1. S
PAY TO THE C
ORDER OF $ 14 Zd.av
.. J �� I 1 1 1I oiLARS el
NetValue
I L,NetBarik® Checking"
A 360312 "'ember FDIC '
MEMO � —
s r06 L09 L9771: L L00079646311' L39 2 i'

64-9197/610
• VERNON J. FULLERTON 1394
11000796463 CYNTHIA G. FULLERTON
1505 TIN LANE 704-735-7565
DALE 7 -7-og,
'I LINCOLNTON, NC 28092
• i PAY TO THE D. .F N R I $ /00.00
ORDER OF
0 V)e..- \t'lLt 1/\a,V*EkA CiG 1, .ci,l , Azio DOLLARS n ....._ „
Net Value
‘WS, et anlie3icii
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11
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1:06 LO 9 L9771: L L0007961,6311° L 3911 ,
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U.S. Postal ServiceTM . . „.
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CERTIFIED MAILTM RECEIPT
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For delivery information visit our website at www.uspe.comito U.S. Postal ServuceTM
43 CERTIFIED MAILTM RECEIPT
SUPPLY NC 28462 Ln
Postage In= c ra o (Domestic Mail Only;No Insurance Coverage Provid
For delivery information visit our website at www.usps.co
Certified Fee $2.30 0462 r-9
06 FU SUPPLY NC 28462
Return Reciept Fee $1.75 Postmark m
(Endorsement Required) Here 0
Postage $ 1,0.37
Restricted Delivery Fee S0.00 zE $2.30 0462
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(Endorsement Required) Certified Fee
U6 Postmark
Total Postage&Fees $ $4.42 06102/2004 =I Return Reciept Fee $1.75
(Endorsement Required) Here
Sent To D Restricted Delivery Fee $0.00
LEI (Endorsement Required)
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Street,Apt.No.; rn it $4.42 06/02/2004
or PO Box No. Total Postage&Fees .40
City,State,ZIP+4 11.1
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PS Form 3800,June 2002 See Reverse for Instructions N Street,Apt.No.; r _
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