HomeMy WebLinkAbout55316_COOPER, AB_20100330❑ CAMA / ❑ DREDGE & FILL�1Ia
GENERAL PERMIT Previous permit#1
[]New t❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources j
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC i
1 ❑ Rules attached.
Applicant Name l�1 Project Location: County
,Yf t
Address i ":J, X `" �lx Street Address/_State Road/ Lot #(s)
City �"
State IV( ZIP
Phone # (1>�[.
ryry
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Fax #(_} )
Authorized Agent
• . '(_I,)
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❑ Cw
❑ EW
❑ P{A Q.ES ❑ PTS
Affected
AEC(s): ❑ OEA
❑ HHF
❑ IH ❑ UBA ❑ N/A
❑ PWS:
❑ FC:
ORW: yes / no
PNA
yes / no Crit.Hab. yes / no
Type of Project/ Activity
Pier
Platf
Fing
Groi
Bulk
Basir
Boat
Boat
Bea(
Othr
Shor
SAV,
Sane
Mor
Phot
Wai)
Subdivision
City I ZIP
Phone # (:' )t • x River Basin
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Adj. Wtr. Body (I%!: (;'{) P'Y� (nat man)/unkn)
Closest Maj. Wtr. Body
(Scale: I / I --�,' )
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A building permit may be required by: �1
Notes/ Special Conditions
Agent or Applicant Printed Name
Signature
a «Please read compliance statement on back of permit
Application Fee(s) Check #
❑ See note on back
regarding River Basin rules.
The time period requirement for this
development is suspended until 12-31-
- � 4-1 2010, pursuant to Senate Bill 831. The
Permit Officer's Signature effective date of expiration for this
P0 permit is W-1=1 I
Issuing Date Expiration Date l
Local P rngjurisdiction o ile Name j
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 Morehead City Headquarters
Mailing Address: 400 Commerce Ave
1638 Mail Service Center Morehead City, NC 28557
Raleigh, NC 27699-1638 252-808-2808/ 1-888-4RCOAST
Location: Fax: 252-247-3330
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
Fax:919-733-1495
(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: 9 10-395-3964
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)
Revised 08/09/06
Applicant:
Date:
Q5 I,
CnandDescribe below the HABITAT disturbances for the application. All v ues shou`u dd'fiatc a units of measurement
found in your Habitat code sheet.
Habitat Name
DISI UREA 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
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 ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Michael F. Easley, Governor James H. Gregson, Director William G. Ross Jr., Secretary
Date 5 " 9
Name of Property Owner Applying for Permit:
Mailing Address:
I certify that I have authorized (agent)
to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity)
at (my property located at)
This certification is valid thru (date)
Property Owner Signature
Date
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: 252-808-28081 FAX: 252-247-33301 Internet: www.nccoastalmanagement.net
An Equal Opportunity1 Affirmative Action Employer — 50% Recycled 110% Post consumer Paper
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PI LI NGS(BOATLI FT/BOATHOUSE)
I hereby certify that I own property adjacent to 6�_ I I is
(Name of Property Owner)
Property l ocated at - � -
(Lot, Block, Road, etc.)
on B�c,� Sow cAr,4—Q'c__ in N.C.
(Waterbody). (Town and/or County)
He has described tome, as shown below, the development he is proposing at that I ocati on,
and, I have no obj ecti ons to his proposal. I understand that a pi er/mooring pi I i ngs/boatl i ft/boathouse
must be set -back a minimum distance of fifteen feet-(15') from my area of riparian access unless
waived by me.
I do not wish to waive thesetback requirement.
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To befiilled in by individual proposing development)
�1E_
(Applicant Information)
Mal I i ng Address
0 13 L
City/state(zip
/IJ per_ j,-_ N C
Telephone Number
_j.6 14
Date
(Riparian Property ONner Information)
Signature
6L C/VA/
Print or Type Name
Telephone Number
%/O/
Ddte
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PI ER/M OORI NG PI LI NGS(BOATLI FT/BOATHOUSE)
I hereby certify that I own property adjacent totA -..7 G- t--- I
(Name of Property Owner)
property Iocated at I I ? Old h �' b d ►Z Q�� I ,
(Lot, Block, Road, etc.)
on j'�vE SovH n a�� ,in
(Waterbody). (Town and/or County)
He has described to me, as shown bel ow, the devel opment he i s proposi ng at that I ocati on,
aid, I have no cgecti onto his proposal. I understand that a pier/mooring pi I i ngstboad i ft/boathouse
must besiet.back a minimum distance of fifteen feet.(15) from my area of riparian access unless
waived by me:
- I do -not wi sh-to _waive _the setback _requirement.
1 do wish to waive that setback requi rennett.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To befilled in by individual proposing development) s�
z0 bZ' t�c q
01, 0 i ,
(Applicant Information)
P O Is of 256
Qty/9ateZp
Telephone Number
'36 �o
Date
Print 'or Y pe Name
Telephone Number
�c Z�
2S G v- `P )-5
Owner Information)
MUD BUCKET DREDGING INC
507 HEDRICK BLVD
MOREHEAD CITY, NC 28557-3045 4300
66-112/531
Date 4,2-6./o
Pay to the
Onfer of
RANCH BANKING AND TRUST COMPANY
1-800-BANK BBT BBT.com
FOR-14-0—lz+
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