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Home My WebLink About38851_ELLIS, HOWARD_20040622-:`�?.-''�?`j`S�q•=:•+?�'.`',r'..��,f;4c,e,+,nRS.RRFx'7:">�:.;s%si�:;'-'�'Io;�l¢I,'�g+. � ,,d"3�� -CAMA / DREDGE & FILL GENERAL PERMIT -New -Modification ❑Complete Reissue CPartial 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 I SA NCAC Previous permit # Date previous permit issued Rules attached. Applicant Name 11c '.; c_ ' !a Project Location: County Address 1 / rtli"' r'�' `; �� "" 'K� Street Address/ State Road/ Lot #(s) City / i,.... , State ZIP Phone # ( ) % /� Fax # O Subdivision Authorized Agent ' 'f t City s i -f' r l ZIP ❑ CW Affected ❑ OEA AEC(s): ❑ PWS: ORW: yes / no ❑ EW ❑ PTA ❑ ES ❑ PTS Phone # ( ) River Basin HHF ❑ IH ❑ UBA ❑ N/A .� Adj. Wtr. Body " -(hat /man /unkn) ❑ FC: - PNA yes / no : Crit. Hab. yes / no Closest Maj. Wtr. Body ■■EMIE■■M■■WM■i�■(�■fi■■■■ ■■■■■■ ■■■®M■E■ ■■■■■■■■■■■■■■■■■■■■ p ■■■■■■NUM ■■■�■■�■■■■■■ ... ``■�®� ME ■ No M.J�2�■ MIE ®�M■■■■■■ll■O■ NNE mom 11011 ME ■■■ !!■■■■1T,r■■■■■■■■N■■■a■■■N■■■ME ili® ■■■■■V ■■ ■■�■��ri■ ►1/ �O■�■■■■ni■■■■■■■■ mom 0 mom IS .. � ■ M■�IONO■■ 0 R.7��i► ■Il.MEE■�IME■�■■■■■EERIE IS locoklwi ■■EE■!!!f!■■■■INIri/ilt■ tfril�r�ii�i%rt Agent or Applicant Printed Name Signature "Please read compliance statement on back of permit C) Application Fee(s) Check # Permit Officer's Signature .7 Issuing Date Expiration Date 1 . 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, certify that this project is consistent with the North Carolina Coastal Management Program. River Basin Rules Applicable To Your Project: Tar amlico 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 Elizabeth City District Mailing Address: 1367 U.S. 17 South 1638 Mail Service Center Elizabeth City, NC 27909 Raleigh, NC 27699-1638 252-264-3901 Location: Parker -Lincoln Building 2728 Capital Blvd. Raleigh, NC 27604 919-733-2293 / 1-888-4RCOAST Fax: 919-733-1495 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 -- 8948 HOWARD AND CAROLYN ELLIS NCDL 615889 NCDL 1774438 66-7704/2531 918 MURPHY FARM RD MERRITT, NC 28556 !/ 252-745-3359 U pay to the 0 / y Order of � 8 Dollars ' State Employees' Credit Union I New Bern, North Carolina 34 . 3�ssJ 1:2531770491:086047978381I■ 8948 ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIER/MOORING PILINGSIBOATLIFT/BOATHOUSE) I hereby certify that I own property adjacent to ffo— W (A r- W , r— I ( l S 's (Name of Property Owner) property located at ..Ss� ((?�, (Lot, B15ck, Road, etc.) / on X(a t i/e-�in r Q Psi/I D COt4yt �y , N.C. erbody) (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. 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. I do not wish to waive the setback requirement. I d_Q wish to waive that setback requirement. --------------------------------------------------------------------------------------------------------- A' DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: Itt od;R rr ,` (To be filled in by individual proposing development) .511 det- Fa ----------------- ----------------------------------------------------------------------- 4e. 11) %>qI/C l Signatur �� (d "T`Cbr.d woo �4sed) SCi S eNcer -�--� t? 2C C4 4 Print or TypeName Telephone Number ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIER/MOORING PILINGSIBOATLIFT/BOATHOUSE) I hereby certify that I own property adjacent to //0 Vl o1 I—Q � I ( l S 's (Namne of Property Owner)) / property located at -1 L4 I-FAf-� /( r ` `� C �� I s �!, (Lot, Bl ck, oaad, etc.) on 45�ate'rbody) (/�'� in IG. l� 1 G O C � ►mot �/ N.C. (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. 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. I do not wish to waive the setback requirement. I & wish to waive that setback requirement. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: a .,�, (To be filled in by individual proposing development) P e, m c e �at-,C Ao14r0e. FG Prd pe�-� ------------------------------------------------------------------------------------------------ C, ps, t( ' lJ l -e Signature �hGdly C�a w, 4je) Mi %ce �o are it 1� -f--� e. � t S�t �' + e I" `%- r a,, Print or Type Name Telephone Number