HomeMy WebLinkAboutMangum, Barry 80051CMCAkIA / ❑ DREDGE & FILL N9 80051 A B C D
GENERAL PERMIT Previous permit#
ENew ❑Modification ❑Complete Reissue ❑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 /J" _ � N • /
((,, ❑ Rules attached.
Applicant Name L-a� �f I0a (y VW Project Location: County I }.
Affected ❑CW ❑EW ❑PTA '141 €S ❑PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA Cl N/A
❑I, WS:
ORW: yes -/ no PNA yes �/ �/
Type of Project/ Activity
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Fixer
Float
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A building permit may be required by:
( Note Local Planning Jurisdiction)
Notes/ Special Cond!tions
A/1, -I , I,
Neat or Applicant Printed Name
t�
v —"
Signaure-"Please read compliance statement on back of permit"
IF rt /
Application Fee(s) Check #
I' \/ ❑ See note on back regarding River Basin rules.
( J -
-� tl'4 fff
PermitOffcers'P'�rir ted Natt7,e
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
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ 1-888-411COAST
Fax: 252-247-3330
(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)
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax: 252-948-0478
(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
®^] CAMA / ❑ DREDGE & FILL N9 80051 A B C D
GENERAL PERMIT Previous permit#
MNew ❑Modification El Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality ; 1 ,,
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC
El Rules attached.
Applicant Name \ \� i [' ('l1 Project Location: County i
Address Street Address/ State Road/ Lot #(s)
City
1 StateR zip�c
�)y
Phone # (�)
�.
(`� - �� � � IE-Mail
Authorized Agent
❑ CW
❑ EW ❑ PTA 7 Es ❑ PTS
Affected
AEC(s): ❑ OEA
❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
ORW: Yes / no
PNA Yes/ no.�
Agentor Applic tPrintedpame
Signature ** Please read compliance statement on back of permit'"*
v
Application Fee(s) Check #
Subdivision
YI 11 zip
City ` \ i" i` _
Phone # O _ _ River Basin _
Adj. Wtr. Body I ' (; / _ nat /man unkn
Closest Maj. Wtr.
Permit Officers Printed Name
i
Signatu�
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 andvoid.
This permit must be on the project site and accessible to the permit officerwhen 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, certifythatthis project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
❑Tar -Pamlico River Basin Buffer Rules ❑
❑ 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
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ 1-888ARCOAST
Fax: 252-247-3330
(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)
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax: 252-948-0478
(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
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: _ &y✓a—
Mailing Address: I .'�. (> n' 2c7j4F
Phone Number:
Email Address: _J Gl�l*nr ;.1 Ci'ri ;�`'. Pervt
I certify that I have authorized I r // l%? d 4!j ,
/i Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: I gD P) Sn r
at my property located at
in 6 - County.
I furthermore certify that I am authorized to grant, and do in fact grant permission to
Division of Coastal Management staff, the Local Permit Officer and their agents to enter
on the aforementioned lands in connection with evaluating information related to this
permit application.
Property Owner Information:
Title
C'v I /,) 4 I _;'�2-1
Date
This certification is valid through
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(252)424-8850
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