HomeMy WebLinkAbout38821_KELLY, HOBERT_20040603�. ,�.,'•R"•'� �L7,o:ir..:�"�[�+�Ji�."eP�?�;.-,r>i"i�a�►�.�.-'3C:�rsv..�-�as•:R±----r•--" �u� � ry :, - - -
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❑1CAMA / ❑ DREDGE & FILLS 9lJ
GENERAL PERMIT
Previous permit #
❑'New ❑Modification ❑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 I SA NCAC
/ 7-1 Rules attached.
Applicant Name. f �>i r.. r 1 < •� ('' Project Location: County
Address _ ___` yA Street Address/ State Road/ Lot #(s)
City._ State 0. ZIP
Phone # Fax # ( ) Subdivision
Authorized AgentCity___ ZIP
Affected a Cw ❑ EW ❑ PTA ❑ PTS Phone # ( River Basin J`4
OEA HHF IH ❑ USA N/A ! '
AEC(s): ElElElAdj. Wtr. Body - %(F ; t �.. frr �1 r.� r �- (�. L,.(� (nat mary /unkn )
1 " ❑ Pws: ❑FC: �1.1 y.i l t 'C._,..
ORW: yes / no PNA yes /(no Crit. Hab. yes / no Closest Maj. Wtr. Body
Type of Project/ Activity
Pier (dock) length
Finger pier(s)
Groin length
number r
Bulkhead/ Riprap lengtht_!—�
avg distance offshore
max distance offshore
Basin, cha�neJ. /
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
A' \ VN
. " �A �, \-t-- * \ \VA
Shoreline Length
SAM not sure yes (no
Sandbags: not sure yes no
Moratorium: n/a yes �o {
Photos: yes no h
Waiver Attached: yes ! no
i {
A building permit may be required by: f Z i Or ❑ See note on back regarding River Basin rules.
Notes/ Special Conditions
(Scale: N / )
Agent or Applicant Printed Name
Signature "Please read compliance statement on back of permit
4
Application Fee(s) Check#
Permit Officer's Signature
Issuing Date f 'Expiration Date
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 (910-395-3900) for more information on how to comply with thesebuffer rules.
Division of Coastal Management Offices
Central Office Elizabeth Cif 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 / 1-888ARCOAST
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
HOBERT KELLY DL 369572 (7t�s'g2� 5918
PATRICIA KELLY DL 365579
132 Shore Dr Ph 252-728-4467 srrzvsso
Beaufort, NC 28516 Date BRANCH "sis
Pay to the
Order of _
ftl
WACHOVIA
Wachovia Bank, N.A.
wachwie.00m
For
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�:0'S3p002 L9�: L05465 L9 L8088ii' S9 L8
■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
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A. Signature
X ❑ Agent
❑ Addressee
B. Re d by ( Printed Xe) C. Date of Delivery
D. Is Weivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
�ae4
�c�*�J3. rcert Type
UUU/(z Cl/�j L'J Certified Mail ❑Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number
(Transfer from service /a 7003 2260 0002 2078 6739
PS Form 3811, February 2004 Domestic Return Receipt 1 o25ss-o2-M-154o ,
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SENDER: COMPLETE THIS SECTION
COMPLETE THIS SECTION ON DELIVERY
■ Complete items 1, 2, and 3. Also complete
I A. Signature
item 4 if Restricted Delivery is desired.
X ❑ Agent
■ Print your name and address on the reverse
Addressee
so that we can return the card to you,
■ Attach this card to the back of the maiipiece,
B. Received by ( Printed Name) C. Date of Delivery
or on the front if space permits.
BQN� J�:f . , •,sst�
1. Article Addressed to:
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D. Is delivery address differapt from ite 1?° sal
If YES, enter delivery a�Jdress below: ❑ No
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3. Ser Oee Type
L'
RrCertified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number
(1ransferfrom service lab, 7003 2260
0002 2078 6722
Ps Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540
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