HomeMy WebLinkAbout54176_BRANCH, B. CLEVE_20090709❑CAMA / ❑ DREDGE & FILL fo
GEN EF1AL PERMIT ,� Previous permit #
❑New, ' ❑Modification El Complete Reissue Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
Applicant Name_
Address
City State ' ZIP
Phone # O Fax # O
Authorized Agent
❑ CW ❑ EW ❑ PTA
Affected
AEC(s):
ElOEA ❑ HHF ❑ IH
❑ PWS: ❑ FC:
ORW:
yes / no PNA yes / no
❑ ES ❑ PTS
❑ U BA ❑ N/A
Crit.Hab. yes / no
❑ Rules attached.
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision
,1
City ZIP � /
Phone # ( ) River Basin ? _ 6. 1. j
Adj. Wtr. Body (nat /man /unkn)
Closest Maj. Wtr. Body
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Agent or Applicant Printed Name
Signature ' **Please read compliance statement on back of permit"
Application Fee(s) Check #
Permit Officer's Signature
Issuing Date txpi
rati, n Date
Local Planninijurisdiction Rover File Name `
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, certifythat 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 Quality. Contact the Division of Water Quality 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
Raleigh Office
Mailing Address:
1638 Mail Service Center
Raleigh, NC 27699-1638
Location:
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
Fax:919-733-1495
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ 1-888-4RCOAST
Fax: 252-247-3330
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico Counties)
Elizabeth City District
1367 U.S. 17 South
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 -below New River Inlet- and
Pender Counties)
Revised 08/09/06
07/13/2009 09:42 2527527749 CONCOR INC PAGE 01
B. CLEVELAND BRANCH JR., CPA
P. O. BOX 1511
GREENVILLE, NC 27835
252-752-5245
FACSIMILE TRANSMITTAL SHEET
IO: FROM: ^ %� ,/
rCscif / ) - �L' lllm --
COMPANY: MPANY: DATE:
FAX NUMBER; TOTAL. NO. OF PAOPS INCLUDING COVF-X:
PUONS NUMBER; SPNDER'S REPRRENCC NUMBER:
R& YOUR RL.YFIRi NCE NUMBER:
❑ URGEN-T 0 FOP. RLVIPW ClPLEASE COIF MENT ❑ PLEASE REPLY ❑ PLF,ASS RECYCLJ
Na-c�.s�caMMENTs:
07/13/2009 09:42 2527527749 CONCOR INC PAGE 02
i
ADJACENT RIPARIAN PR(aPERTV OWNER STATEMENT
(FOR A PIE.RIVOORING PILINGS/BOA TLjFT/B()ATIIOUSE)
I hereby certify that I own property adjacent
(Name of Property Owner)
property located at
Road, etc.)
on in
--- +�<�f- eol - N , C
( a dy) (Town and/or C;ou n
Applicant's phone #: r 17 1193Mailing Address: J ox
He has described to rne, as shown below, the development h+: is proposing; at that location, aztId 1
have no objections to his proposal. I tnndcrswnd that a pier/mooring pilings / boatlift / boathouse
must be set back a minimum distance of fifteen feet (I Y) from my area of riparian access wihe ss
waived by me. (If ,you wish to waive the setback, you must initial the appropriate blank
I do not wish to waive
d`4 / "' �✓ _ I do wis1i to waive that setback requirenient.
--------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(Tv be filled in by individual proposing develgj2inent)
(Information for Property Owner Applying (Riparian Property Owner Information)
for Permit)
1\4.ailing Address Signaftim
City/State/Zip Print or Typc M.r -
'% �; (— -- — ---
lep one Numl
Signature D<<.te
Telephone Number
D ME.
07/13/2009 a9:42 2527527749 CONCOR INC PAGE 03 //
v
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIE RIMOO,RING .P,ILINGS/BOA TLI FT/BOATKOUSE)
�— I hereby certify that I own property adjacent to 3 <21ovt'
(Name of Property Owner)
property located at / I, oPAv l !. _
U (Cot, Block, Road, etc.)
( aterbodly (Town and/or C ntg )
Applicant's phone #JYY 717 Jt $ 3 Mailing ,Address:^ge O /�rs }! 4 // -. _ _,_
/I C A -? r 3.s
He has described to nee, as shown below, the developn?ent tic is proposingat that location, and, j
have no objectiolls Lo 11ils proposal. I understand that a pier/!Mooring pilings / boatlift / boatholase
must be set back a. minimum distance of fifteen feet (15') J.-rota my area of riparian access uai. -,ss
waived by me. (If you wish to waive the setback, you must initial the appropriate blank
below.)
I do not wish to waive
I do wish to waive that setback requirement.
DESCRIPTION ANDIOR DRAWING OF PROPOSED DEVELOPMENT:
(Try be filled in Ay individual proposing development)
------------------------------------------------------------------------------------- --------------------------
(lnforrnation for Property fawner ,applying (Riparian Property Owner Igo rm ation)
for Permit)
Mai litig Address
City/State/Zip
J Y .� ! — --- ------ -le n - u.n
O
Signature 1 )ate
S ignatu ,e
- Print or Type a.nle
J ��U
Telephone Numbs
-7-
_�Date
07/06/2009 10:50 2527527749 CONCOR INC PAGE 01
o A
...r.�.Mrj ewe■..,.
NDEK
North Carolina Department of Environment and Natural Resources
Division of Coastal management
Beverly haves Perdue, Governor James H. Gregson, Director Dee Freeman, Sea-etiry
Date
Name of Property OwnerApplying for permit:
Mailing Address;
���°�.,lr ►`rye �% C ,.2 7 8' .3.s � -
Ir certif, that l have au
thorized (agent) G -e.. to act on nr><y
behalf for the purpose of applying for and obtaining all CANIA Permits necessary to
install or construct (activity)
at (m,, property located at)
Th`i, cerlificatio►rI is valid thru (date) 2-
F Verty Owner Signature
oo� .
G e
Date
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: 252-808-28081 FAX 252-247-33301 Internet: www.nccoastalmarlagement,net
An Equal Opportunity 1 Affirmative Action Ernployar — 50% Recycled 1 10% Post consumer Paper
07/06/2009 10:50 2527527749 CONCOP INC PAGE 02
ADJACENT RIPARIAN PROPERTV OWNER STATEMENT
0"OR A P.ILWIMOORING PILfNGSIBOATLf t,T/BOATTIOUSL')
l hereby cez-t.ify that l owl, proE)erty adjacent t�l
(Name of Property Ow1ter)
pt-operty located at I
Po A
(Lot, 13IR
( MA
Road, etc.)
( /At-y-
terb(To�vrr acid/or Coup
Applicant's pbone #:� `r
s�a�� 7 l� �Mailing Address:_ 3o
He has described to nee, as shown below, the devel0l)DIC"t he is proposing at that location, Wid, I
have no objections to his proposal. 1 uMerstand that a l:.-iier/M00rin9 pilings / boatlift / boath6u&,,
must beset back a minimun) distance of flf-teen i=eef (IS') from IT) area 0Ftip<trian access unless
waived by me, (if you wish to waive the setback, you must initial the appropriate blank
below.)
—1 do not wish to waive
l do wish to waive that setback requirement.
-- ---------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(Tobe.Jilled in by individual proposing develol tnefzt)
%j
� f�lo*G� !.41r- x iS w. or
^---------------------------
(InfOrmiation for Property Owner Appiving (Riparian Property Owner Information)
for Permit)
7Wailing Address �-
City/State/Zap
le one Nurnt)
A
ll
Signature date
Signature
Print or Type Narae
Teleplhone Nurrll,,1
DCAf::
07/06/2009 10:50 2527527749 CONCOR INC PAGE 03
ADJACENT RIPARIAN PROPERTY OWNER. ST,/ATEMENT
(FOR A PIER/MOORING PILINGSIBOATLIFT/1?OATHOUSE)
I hereby certify that I owal property adiacent to /17 / . ` r?44,n lG
's
(Name of Property Owner)
property located at
Block, Road, etc.)
ofon► - ,
( aterboily —T` - ITI
(Town and/or C nty)
Applicant's phone #jY 7 /7
Mailing Address. do, O 1-36 A-/ _
IIe has described to [Ile, as shown below, the development he is proposing at that location, aiad, I
have no objections to his proposal. I understand that a pier/mooring pilings / boathlt / boatheust-.
must be set back a minimum dista0cc- of fifteen feet (15') from my area ofdpaz-ian. access utfles{
waived by m.e. (if you wis.b to waive the setback, you njust initial the appropriate blank
below.)
l do not wish to waive
I do wish to waive tbat setback a-equirc-metat.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(Tee befiiIled in ley individual prupr.►sing deiWopment)
Aoelor. l tee'114-c e- E)d
-------.,-----------------------------------------
(information f01- Property Owner Applying (Riparian Property Owner J�7ormation)- --
for Permit) n % II II A
Mailing Address
Ile PC A 433—
City/State/Zip -- —TM
Signature Date
St�gnati.ue`
1 / 54-1"
Print or Type Naive
Telephone Nurnt,er
Date
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