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HomeMy WebLinkAbout55100_CADER, CAS M_20100201❑ CAMA / ❑ DREDGE & FILL GENERAL PERMIT Previous permit# ❑IVew3 ❑Modification ❑Complete Reissue ❑Partial a ssue -17 Date previous permit issued As authorized by the State of North Carolina, Department of Environment and atural Resources and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC Fil Wes ched. Applicant Name �.; l ? �..� ( k j tt Address City State ZIP -,, i Phone # ( '', 4 ()" � Fax # ( ) Authorized Agent f Affected ❑ CW ❑.EW Ei�P7A ❑ ES ❑ PTS AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A ❑ PWS: ❑ FC: ORW: yes / no PNA yes / no Crit.Hab. yes / no Project Location: County Street Address( State Road/ Lot #(s) i Subdivision 1 City OWN Phone # ( ) River Basin Adj. Wtr. Body ! 't. '� I 4 (nat /man /unkn) Closest Maj. Wtr. Body Type of Project/ Activity Pier (dock) length Platf (Scale: orm(s) pier(s) n length number head/ Riprap length channel ramp t h Bulldozing r not sure yes no bags: not sure yes no atorium: n/a yes no os: --- i av distance offshore max distance offshore I I I cubic yards � I i r n - ' � yes no _ � ~� I •- - Agent or Applicant Printed Name Signature ** Please read compliance statement on back of permit Application Fee(s) Check # �_- - 2010, pursuant to Senate Bill 831. The Permit Officer's Signature effective date of expiration for this �''I KC permit is f —� �/ Isswng Da Expiration Date Local Planning] u risd iction Rover File Name Agent or Applicant Printed Name Signature ** Please read compliance statement on back of permit Application Fee(s) Check # �_- - 2010, pursuant to Senate Bill 831. The Permit Officer's Signature effective date of expiration for this �''I KC permit is f —� �/ Isswng Da Expiration Date Local Planning] u risd iction 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, certifythatthis 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/ 1-888ARCOAST 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 ADJA,C',' NT IUPARI N PROPERTY OWNER STATEMENT (,FOR A .PIERIMOORING PILJIV VB0AT11F-1IBOATHOUST) T Hereby certify that 1 own property adjacent to 0.47-10-ICE amae, (Name of Properly Owner) prupct'ty located at zS Y ��E4,vFo.�: AJC (Lo(, Block, Road, etc.) MI - wit 14 7-.W .IV cge , iu ate .. N.C. (Wat:erbody) ('Town and/or County) Applicant's phone #i: Z,�Z - ZYJ- r4-- MailincT Address: l'Sy � .yFo,27-��1C . ZdrSl.6 Ele has described to mc:, as shown below, the: developmont lie is proposing at that location. and, I have no objections to his proposal. I understand that a pier/mooring pilings / boatlift / boathouse roust be set back a minimuin distance of fifteen feet (15') from my area of riparian access unless waived by roc:. (Ix you wisl) to waive the setback, you must initial the appropriate blank below.) 1 do not wish to waive J 1 do wish to waive that setback recp_iireino.nt. - - - - ------.. DESCRI1' PION AND/OR DRAWING OF PROPOSED Dirt V ls'LOP1V ENT: (To Le. fzlded in by individual Proposing develu t zent) l C; N u jg--/f Ne&)- LIP P i�' ----------------------- --..------ (Information for Property Owner Applying for Permit) 75-N-v w D jok uV Mailing kddress �- :Gk Is r, l 6-u F T e x l5 rin/G b0cle' -----------------------------=`---------- ----- (Riparian Property Owner Information) Al c z '/L City/stat�17 / Tcicphouo Number 5ignalurc l)atc g""-A-Ar-k— Signature r� rr VM . o Print or Type Name -715? 5z Telephone Number D*CEIVED JAI 2 12010 5D Morehead City D fi0'd ZZF9-Lb/Z �ZSZ) sawuE) w1i INd L9:0L 600Z `80 jagojop 'depsjn41 ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A k'LAR171100BJNr PLL.INGVBO.ATLI!{TIBOAT ROUST) I hereby certify that 1 own prol)erty adjacent to-S (Name of Property Owner) prupc.trty Icx zitcc] at ,�pc�/ �•¢..y !!� ..A/C (Lo(, Block, Road, etc_) on .._ �/1� � Tie/ w�.�—., iu �i. N.C. ('Waterbody) (Town and/or County) Applicant's pi.;one it, Z_fZ - 2Y�- �4 Mailing Address: Y He has described to mc, as ahown below, the: development lie is proposing at that location and, J have no objections to his proposal. I rmderstand that a pier/mooring pilings / boatlift / boathouse uwst beset back a minimeim distance; of fifteen feet (15') from my area of riparian access unless waived by me. (ix you wish to waive the setback, you must initial the appropriate blank helow.) l do not wish fo waive 1 do wish to waive that setback requirement- -----------...----------..._------- --- •----------- DESCRI PTION ANWOR DRAWING OF PROPOSED DEV LeLOPM 4,NT: (To Lc, fiUerd in by individual Proposing developinent) rl o JZ- i 14 R 1 Q t; 2 a O t_X tS ; "/V4, ' --- .------------------- (information for Property Owner Applying (Riparian for Permit) t 57 ocy /4 4 �.,,-Ivd Y Mailing Address ZSZ ?Z 8 3 Yo.� Vcicphono Number A�. signature l�atc i>o c IL Dperty Owner, Information) () Signature ,V i 24� Print or Type NJame �� ����.Cn / n V Telephone Number CEIVED Yt,✓ CAN 21 2010 Morehead City DCIVJ £0 d Z669-LbZ (Z96 sawuz) wil Wd L9:0( 600Z `90 jagoiop 'Aiapsjn41 N00-14-2000 15:20 Frow:UCM MHDCT'( To:921763.�E A- NCDIENR North Carolina Department of Environment and Natural Resources Division of Coastal Management Michael F. Easlcy, Govomor James H. Cregson, Director W(Ulam G. Rass Jr., Secretari Date Name of Property Owner Applying for Permit: Mailing Address: ..' � Z' 6 Y -/,- �0 W_ (_ � �&4 Y_ - I certify that I have authorized (agent) .-- to act on nay behaif, for the purpose of applying for and obtaining all CA,MA Permits Necessary to install or construct (activity) A- Nfw/ �0,4 �/�: -- sit (my property located lit) 4S `C 1'ePWc* ��-.7_ /G► Aelg�f-vFog i *G This eortiliicatioan is valid thru (date.) Property Owner Signature Date � r�urrrutErc;t twr;riuo; hSvrCireSd iy; Noiu`s Carolina 20557 RECEIVED Phone.-. 252-808-28081 FAX: 252••247.33301 Internet: www.nccoas(a1managF.94(.net j q j An F.qual Opportunity ) Aifirmatrve action Employer- 50% Recydeo I I(M Pnsl Consumer PaD9r BAN 2j l 010 Morehead City DCM ZC d G££9'LbZ izJz} saLuuC unl Ad 6_ 0 L 600<, 'ti30 jagoloo 'lEpsrnyl CaSM Bader, MD XCDC9852668 66-30/531 3081 Patrice JI Cader 1V=C 9855 905 137 A 252-728-5905 254-HowlaHd P1Wbl &,qufort, W 28576 DATE PAY TO THE C 1 ORDER OF !/G7 A42 Nc-" j � DOLLARS L'1 �,°��•° First Citizens Bank firstcitizens.co - f OR A6,4- - D�o -&k 1:0531,003001:00 L3 L7t,94779"' 0308 L 13