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HomeMy WebLinkAbout38065_HARRELL, DON_20040331!ICAMA / ❑ DREDGE & FILL GENERAL PERMIT ❑New ❑Modification El Complete Reissue El 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 City i - �? e a State 1 ZIP ' S J."' - 93231 Phone # ' . S " `' Fax # ( ) Authorized Agent Affected ❑ CW ❑ EW Z PTA ❑ ES ❑ PTS AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A ❑ PWS: [IFC: ORW: yes / no PNA yes / nR; Crit. Hab. yes / no Previous permit # Date previous permit issued I] Rules attached. Project Location: County Street Address/ State Road/ Lot #(sf) tj Subdivision City. I�' �� N (, � ;*0J ZIP ,C 51'?- Phone # ( ) River Basin [,,I k 1, Adj. Wtr. Body n,, v i+ to a A 4' ro h U i (nat /man /unkn) Closest Maj. Wtr. Body_ +te, f, Type of Project/ Activity 1,0p ;, ' el -4 f.I , . ) i (Scale: Nord j- Pier (dock) length Platform(s) Groi Basin Boat Othe Shor SAM Mo Phot Waiver Attached. yes no A building permit may be required by: Notes/ Special Conditions P Id N kc 7 Ro c l El See note c kw,/�r � drA '� �t Iv'4 ' � PA on lback regarding CI,,* d -`c River Basin rules. r c� o r Finge 11_ I I r pier(s) n length I I I number � I I i head/ Riprap length avg distance offshore max distance offshore — channel cubic yards ramp Boatlift r• i Lt i� x ' h Bulldozing r eline Length not sure yes bags: not sure yes ratorium: n/a yes os: yes I. l.040m� ��j/ �L�A w.i flee or Applicant Printed Name � Signature "Please read compliance statement on back of permit" Application Fee(s) Check# Permit Officers Signature Issuing Date tj Expiration Date t, V -(. � i4P N� l Local Planning Jurisdiction Rover File Name l.040m� ��j/ �L�A w.i flee or Applicant Printed Name � Signature "Please read compliance statement on back of permit" Application Fee(s) Check# Permit Officers Signature Issuing Date tj Expiration Date t, V -(. � i4P N� l 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 officerwhen 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 (910-395-3900) 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 / 1-888ARCOAST 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 ADJACENT 1111,AltlA.N PROPERTY OWNER STATEMENT (1•701r A PILBIAIOOBIN(Y'1'ILINGSIBOATLIFTIBOA'THOVSE) _ S I t,ereby certify that I own property adjacent to (Name of Propel-tyC) v11e1) l)COj->Crty located at --- (Lot, JTlock, Road, etc.) o n (Watcrbody) ('fowl alid/ol- C01111t)') Ile. has <i� :5crii,cd to snc, as shown below, the development hc. is proposing at that location, a��ci, I have no obj: ctions to his Proposal. I understand that a pier/ct,00rE i11 feet (l�') from my area I)ilin(;,ti/l)oa.tlift/l>oathot+sc= must he set back a minimum distance of fifteen of access t,,,less waived by 1110. I d�l_Z�U.t wish to waive the setback requirement. I i1_o wish to waive. that setb cck requirement. i' ON ANn/Olt DRAWING UI., I'IZ0110SED }.)T:VELO1'tiIEN}': (To be filled in by inrliri(lucrl P,•opnsi,lg development) Signature ,f-ki(fH /a /4,--en�s— }Tint or Type Name c 4)o cl Number l:)atc: --� ADJACENT RIPARIAN PROPERTY OWNER STATEMENT . (FOR A PIER/MOORING PILINGSBOATLIFT/BOATHOUSE) I herebycertify that I own property adjacent to �� LL. is Y p P (Name of Property Owner) property located at -IN NNVV �- � �RL�� �. (Lot, Block, Road, etc.()) on in N.C. (Waterbody) (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 do wish to waive that setback requirement. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: (To be filled in by individual proposing development) j z. Sign7tc GG cA141 e- Print or Type Name 02,5'- 2-7z6- 2GG� Telephone Number Date: T � G v J r ...� ,...r. ..�. .... -ter .� T"\V I 998Z 9ZZ ZSZ 4 t O -i a I- Nf b3d00o a 0 Wti 0©: T T b00Z-9Z-a33