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HomeMy WebLinkAbout38825_ELLIS, HOWARD_20040601F� CAMA / D DREDGE & FILL GENE_ _ GENERAL PERMIT Previous permit # CNew `!Modification F.-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 —1 Rules attached. Applicant Name ` Proi1ect Location: County Address City State Phone # Fax # Authorized Agent Affected ElCW ❑ EW ❑ PTA ❑f5 ElPTS AEC(s): ElOEA ElHHF ❑ IH ElUBA El N/A ❑ PWS: ElFC: ORW: yes / no PNA yes / no Crit. Hab. yes / no ZIP Street Address/ State Road/ Lot #(s) Subdivision City _ ZIP_ Phone # ( ) _ _ River Basin Adj. Wtr. Body Closest Maj. Wtr. Body (nat /man /unkn) Type of Project/ Activity (Scale: ) Pier (dock) length Platform(s) i Finger pier(s) Groin length number Bulkhead/ Riprap length _.... avg distance offshore max distance offshore —) Basin, channel cubic yards_I Boat ramp ..........__._�...... ---_...--- - Boathouse/ Boatlift Beach Bulldozing 1 ' Other_ 11-1 -- Shoreline Length" -- — — -- ` - I i ` � I N SAM not sure yes I,P. y Sandbags: not sure yes fio , - I Moratorium: n/a yes �no _ Photos: yes no Waiver Attached: yes no A building permit may be required by: ; UN"Y �' See note on back regarding River Basin rules. Notes/ Special Conditions Agent or Applicant Printed Name i/ Signature ** Please read compliance statement on back of permit Permit Officer's Signature Issuing Date Expiration Date Application Fee(s) Check# Local Planningjurisdiction 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 consistentwith the North Carolina Coastal Management Program. River Basin Rules Applicable To Your Project: ❑ Tar- Pamlico River Basin Buffer Rules ❑ Other: �euse 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 (910-395-3900) for more information on how to comply with thesebuffer rules. Division of Coastal Management Offices Central Office Mailing Address: 1638 Mail Service Center Raleigh, NC 27699-1638 Location: Parker -Lincoln Building 2728 Capital Blvd. Raleigh, NC 27604 919-733-2293 / I-888-4RCOAST Fax:919-733-1495 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) Morehead City District 151-B Hwy. 24 Hestron Plaza II Morehead City, NC 28557 202-808-2808 Fax: 252-247-3330 (Serves: Carteret, Craven, Onslow -above New River Inlet- and Pamlico 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 910-395-3900 Fax: 910-350-2004 (Serves: Brunswick, New Hanover, Onslow -below New River Inlet- and Pender Counties) www.nccoastalmanagement.net Revised 10/05/01 HOWARD AND CAROLYN ELLIS NCDL 615889 NCDL 1774438 918 MURPHY FARM RD MERRITT, NC 28556 252-745-3359 8935 it / 66-7704/2531 ale a-dder o 119 State Employees' Credit Union 34 Neui Bern, North Carolina n Jz11( 1:253 L77049i:086047978 81i' 8935 ADJAC ENT RWAKLAN YKUYEK' A U'VVINEK N'I'A' LMI N Y I hereby certify that I own property adjacent topoWar44- Ck}� n EI III 's (Name of Property Owner) property located at �(� O k r'o � •/ V , /% e P-7 ,W Al C sZ g S5-6 L t, Mock, Road, etc / on /� l ✓fir'' , in Pci I'�I 1 C O 6o , N.C. (N'aterbody) (Town and/or County) He has described to me as shown below, the development he is proposing at that location, and, I have no objections to his proposal. ------------------------------------------------------------------------------------------------------------------ DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPNIENT (To be filled in by individual proposing development) prD�",-)y (' Sys 5 ✓I, H c.ee S6C)- GL rr'evi�ly Pro,dto-4y 54or•-'e-'4-Z)b /-r t° - r-a/),0 SJ A e-AAA Cf a TAXI yS -q 1-6 /y h %-4- Hv'-I'0t 4 r, l/ r S Sicynature Print or Type Name (7�'6 � - Z/ S� rc- c�trt-er.� fllesi pro")e/--7`y d /itG44 e I 1,70 0 *--o t Telephone Number Date: _4- - -2,,0 - _ G7 �� ADJAC ENI' IUVAKIAN YKUFERI' Y U VViNEK I hereby certify that I own property adjacent topOW'A'14Y Ce4h!V11y E- 1l tS 's (Name of Property Owner) property located at inn ./ f' Rol; 9 i Parr,` 14 A%C 2, 8.7S'4 /n (Lot, lock, Road, et .) on /� , in ,pQ jv4 { I C Q CEO , N.C. l ✓fir (ti'aterbody) (Town and/or County) He has described to me as shown below, the development he is proposing at that location, and, I have no objections to his proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPNIENT (To be filled in by individual proposing development) ptlz) P er y a 5P� H Ce` s GJ t- G l� t, e vi�/y ProP4,04Y GA A A eC' a �4�r V "S Ga r-d ly h 4-- HC> L✓q," r— l f i S Signature Print or Type Name 5" re. c " rrC$)gY Prcy)e"I'y W /LitC,44 e l /`70 0 't—o r. Z-� Telephone Number Date: .<1 / L�