HomeMy WebLinkAbout56807_ENGLASSIA, ANTHONY_20100910❑CAMA / DREDGE & FILL
WGENEPIAL PERMIT �^
❑New [-]Modification❑Complete Reissue El Partial Reissue " L
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
Previous permit #
Date previous permit issued
Applicant Name �`''� 'Project Location: County
Address Street Address/ State Road/ Lot #(s)
City State ZIP 'r
Phone # O Fax # O Subdivision
Authorized Agent
Affected ❑ CW
AEC(s): ❑ OEA
❑ PWS:
ORW: yes / no
❑ EW ❑ PTA
❑ HHF ❑ IH
❑ FC:
PNA yes / no
❑ Rules attached.
City ZIP
❑ ES ❑ PTS Phone # River Basin r(
❑ UBA ❑ N/A Adj. Wtr. Body (nat /man /unkn)
Crit.Hab. yes / no Closest Maj. Wtr. Body
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Agent or Applicant Printed Name
Signature* Please read compliance statement on back of permit
J �
Application Fee(s) Check
PermitOfficer's Signature
( j
Issuing Date Expiration Date
?A ti/Rl V
Local Planning Jurisdiction 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, 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
Ao p l is a n t:
Cate:
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Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
I
ound in your Habitat code sheet.
Habitat Name
DISTURB 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
unt)
TOTAL Feet
(Applied for.
Disturbance
total includes
any anticipated
restoration or
ternimpacts)
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount
Dredge ❑ Fill ❑ Both ❑ Other [4-1--..
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 ❑
A�
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue, Governor James N. Gregson, Director Dee Freeman, Secretary
Date �/0
Applicant Name
Mailing Address
I certify that I have authorized (agent) �� /J,lL/�/� 7 to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity)
at (location) l�e -5
This certification is valid thru (
Signature
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: 252-808-2808 \ FAX: 252-247-3330 \ Internet: www.nccoastalmanagement.net
An Equal Opportunity \ Affirmative Action Employer — 50% Recycled \ 10% Post consumer Paper
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/'VIOORINO RI.LINOSiBOATLIF.TIBOAT.HO USE')
I hereby certify that! own property adjacent to Jd4�,9AI
(Name o Property Owner)
property located at-_w(/.. ..._...71/�i/,(7-
(Lot, Block, Road, etc.)
on �/V/j%.�� , in / ���� � 2Liz 'N.C.
(Waterbody) (Town and/or County)
AppIicant's phone # ��`'� ailing Address: 671a �/,,n ✓ li
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)
K-E&IC 6 �PI 6 LiFY
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W �kti'i A
W�
>v
(Information for Property Owner Applying
for Permit)
Mailing Address
City/State/Zip
4;2-� 9a/- Z--7oo,1-
Telephone Nu ber
-- e zev�_ /a
Signature Date
(RipariXTTrgperty Owner Information
Signature
( ,t'Iyl � e s L 61-
mint or Type Name
Telephone Number
9-(9-ln
Date
ADIACE'NT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER1711IDORING PILI1VGSiBOATLIFTII3OATFIOTTSE)
I_nereby certify that 1 own property adjacent to
-21;A �N
(Name of roperty Owner)
property located at ,Ir-
(Lot, Block, Road, etc.)
on C%�/�L , in /�T/r C l'����i , N.C.
(Waterbody)) (Town and/or County)
Applicant's phone #: �a�✓CCr y� �.�7.� Mailing Address: 6' l.�
ZZA::' 67 7�Of
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
4E 41 do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
(Information for Property Owner Applying
for Permit)
Mailing Address
City/State/Zip
� .T4 - � y-
Telephone Num r
Signature Date
o
e
---------------------------- -----------------------
(Riparian Property Owner Information)
e&4n- S
Signature
cCtiti/ � �OG✓�o/��
Print or Type Name
2-50
Telephone Number
Bate
MUD BUCKET DREDGING INC
507 HEDRICK BLVD
MOREHEAD CITY, NC 28557-3045
Date � - � � �j
Pay to the�-
_�s}1 ✓ i Deceilson
Ofl�eT of att/J� �7 Dollars
B—RANCH BANKING AND TRUST 14MO-BANK BBT BBT-00MMPANY
NP
FOR 1 L/
111000045531s i:053 LO L L 2 L1:0005 293 2 L834 LII'
4553
66-112/531