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Home My WebLink About52640_DVIDSON, MARK_20081030CAMA / ❑ DREDGE & FILL 'ENER&L -PERMIT []New' ❑Modification ❑Complete Reissue []Partial Reissue 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 I City State ZIP Phone # O Fax # ( ) Authorized Agent } ❑ CW J EW ETA ❑ ES ❑ PTs Affected ElOEA ❑ HHF ❑ IH ElUBA ❑ N/A AEC(s): ❑ PWS: ❑FC ORW: yes / no PNA yes / ;no Crit.Hab. yes / no Type of Project/ Activity Pier (dock) length Platform(s) Finger pier(s) t 3 �.j' 7 - Groin length -- -- - — -- number - Bulkhead/ Riprap length avg distance offshore _ max distance offshore - Basin, channel cubic yards Boat ramp Boathouse/ Boatlift Beach Bulldozing Other Shoreline Length SAV: not sure yes no Sandbags: not sure yes -no Moratorium: n/a yes no Photos „yes no Waiver Attached: r;' yesno --�= A building permit may be required by: _ Notes/ Special Conditions Agent or Applicant Printed Name Signature ** Please read compliance statement on back of permit" 16/V Application Fee(s) �Check� # Previous permit # Date previous permit issued Rules attached. Project Location: County Street Address/ State Road/ Lot #(s) I Subdivision City ZIP Phone # River Basin } Adj. Wtr. Body_ ` (hat /man /unkn) Closest Maj. Wtr. Body (Scale: ) i ❑ See note on back regarding River Basin rules. i, Permit0fficer's Signature Issuing Date Expiration Date Local Plannin urisdicd n v -Fite Names . '% 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 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 ,91 ((75' 10/15/2006 10:56 9198787506 MEDICAL MUTUAL IN6U! PAGE 01/01 T0:19198767606 P.1 >� JCT-15-2008 09:59R FRAM: r Z��- Zit t NCDENR North Carolina Department of Environment and Natural Resources Division of Coastal Management Michael F. Easley, Oovemar James ti. Gregson, Director William G. Ross Jr., secretary Date Name of Property Owner Applying for Permit: r,,ArV'-, 11, C_ lid 4"a (—(-C- Mailing Address: Morehead city ocm I certify that I have authorized (agent) 5cek4 to act on my behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to install or construct (activity) b - at (my property located at) 5'ta 1 This certification is valid thru (date) Property owner Signature "ULU 400 Commerce Avenue, Morehead City, North Carolina 28557 Phone: 252-808-28081 FAX 252-247-33301 internet: www.nccoastaimanagement.net An Equal Opportunity 1 Affirmative Action Employer— 50% Recycled 110% Post Consumer Paper ADJACENT RIPARIAN PROPERTY OWNER STATE (FOR A PIER/MOORINGPILINGSBOATLIFTBOATHOU S I I hereby certify that I own property adjacent to I' 1 4 V- K � a v i.U50 ' (Name of Property Owner) 7 �008 property located at ,50( migloT,c g "CA (4,j 5' (Lot, Block, Road, etc.) City 0 M on Oo q to c .So u rj d , in % Lr9►y f r C 5 "cG -,N.C. (Waterbody) (Town and/or County) Applicant's phone #: Mailing Address: 3 d x + He has described to me, as shown below, the development he is proposing at that location, and, I have no objections to his proposal. I understand that a pier/mooring pilings / boatlift / boathouse must be set back a minimum distance of fifteen feet (15') from my area of riparian access unless waived by me. (If you wish to waive the setback, you must initial the appropriate blank below.) do not wish to waive I :do wish to waive that setback requirement. i` DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: (To be filled in by individual proposing development) ay I %S' a x J Je-+ 5K; ------------------------------------------------------------------------ (Information for Property Owner Applying for Permit) Mailing Address City/State/Zip Telephone Number Signature Date (Rip,aria Prope ty Information) x - <�o l Signature Print or Type Name Za Telephone Number Z // Date M • t ADJACENT RIPARIAN PROPERTY OWNER STATE ' FOR A PIER/MOORING PILINGSIBOATLIFTBOATHOU SE P %1ei) I 1 I hereby certify that I own property adjacent to M /I ir' k h A v i dSD,j0 G T 17 2008 (Name of Property Owner) located at 501 /��LA��T,c `cam, tjq� Morehead City c)GIV� property � �`:,� � � (Lot, Block, Road, etc.) on 3Oguy- .So�tA ,inlqIL,9,.lr,C &4c, N.C. (Waterbody) (Town and/or County) Applicant's phone #: ?(q' 9' QZ Mailing Address: ?- 1) • x 61 �62 '�' W . C 27762 4- He has described to me, as shown below, the development he is proposing at that location, and, I have no objections to his proposal. I understand that a pier/mooring pilings / boatlift / boathouse must be set back a minimum distance of fifteen feet (15') from my area of riparian access unless 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 AND/OR DRAWING OF PROPOSED DEVELOPMENT: (To be filled in by individual proposing development) G 1�crt Lies �p r a � � J I (Information for Property Owner Applying for Permit) Mailing Address City/State/Zip Telephone Number Signature Date (Riparian roperty Owner Information) Signature �Yl Imo,: C-L Print or Type Name �5=36(o3 Telephone Number Date CLARENCE E. DANIELS DBA DANIELS MARINE CONSTRUCTION PH 252- 26-7480 P O BOX 236 NEWPORT, NC 28570 DER OF Li A)Ko WACHOVIA Wachovia Bank, N.A. FOR(?Wachovia.com 4M4 M411�K p4✓id3Jl✓) lvn 3614 66-21/530 i BRANCH 77615 10 - 3 1 - 0p DATE -CL� -�� o'-"J� I.0530002191:1054671016562110 3614 :r A ILL GE MIT Previous permit # E114,ew ElModification El Complete Reissue El Partial Reissue Date pre\Cioo 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 U_6"res attached. ApplicantNameC k, Project Location: County_ Address -A Street Address/ State Road/ Lot #(s) Z City Stit" A Phone # fax Subdivision ut 4'. 4, k city ) ZIP Basin W El CW qfiW DYTA El ES 0 PTS r Phone River Affected 0 OEA [I HHF El lH 0 UBA El N/A AEC(s): Adj. Wtr. Bod LI)i il�4,i y ' -, man t'a /6- at I unkn 0 El PWS: El FC: ORW: yes / (,no PNA yes / lno Crit.Hab. yes It no / i Bod Closest Maj. Wtr. y Type of Project/ Activity i c i (Scale: Pier Pt f( FingE Groii Bulkl Basir Boat Boat Bme Gtl" Shor SAM Sanc Mor Phoi Wai, I length number ead/ Riprap length Sim MIN mi F-10 ME MM VE I MEN avg distance offshore E 0 E '■'... 0� �_ max distance offshore_ ,channel M M cubic yards ramp Pw ME M M jCT..� ......■■■.■.■. 51ine Length.., notsure yes no - M■I ■ M= �.■ ME ME sags: not sure yes■M -torium: n/a yes is: / . A -A-4-j4W. ■ ■■� A building permit may be required by: Notes/ Special Conditions 4 S; Agent or Applicant Printed Name Signature Please i reid compliance statement on back of permit Application Fe-e(s) Check ❑ See note on back regarding River Basin rules. Permit Officer's Signature Issuing Date Exprati6n Date Local Plani*quriscliction ..-A6ver File Name DCM COMPLIANCE INSPECTION RECORD