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Home My WebLink About39696_LANE, BILLY_20040907CAMA ❑ DREDGE & FILL M� 7 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 15A NCAC Rules attached. Applicant Name �} I j y f G h Project Location: County ��- Address 1`j} t� S L., 4i" r f fZJ Street Address/ State Road/ Lot #(s) City .1 - J State 4,' ZIP 1-427(✓4W Phone # (. ) .%1'(,yq Fax # ( ) Authorized Agent (.-J• %L - CW ❑ EW 1 PTA ❑ ES ElPTS Affected -1 OEA AEC(s): _ Hill ❑ IH - UBA ❑ N/A -1 PWS: ❑FC: ORW: yes / no PNA yes / no Crit. Hab. yes / no Subdivision o City I11!� �, �i `�FUcI ZIP %C, r Z Phone # ( ) River Basin 14 !y �k Adj. Mr. Body p 6r e 11 .4 (Or w, ' (nat /man /unkn) Closest Maj. Wtr. Body &c,Zf Lyl cl Type of Project/ Activity < < r r. -J x i } (Scale: ,i\A(/F ) Pier (dock) length Platform(s) Finger pier(s) Groin length number Bulkhead/ Ri ra P P length gt 1 avg distance offshore�V1 max distance offshore _ Basin, channel cubic yards Boat ramp Boathouse/�4oatlift Beach Bulldozing Other -- Shoreline Length - ASAM not sure yes noSandbags: not sure yes no Moratorium:n/a yes noPhotos: yes no ! Waiver Attached: yes no - building permit may be required by: 1 jttN Notes/ Special Conditions i fit' k -�bo C - i I _ - -- I i 3 10L- - - - DO - - I 2177-1--Fl— & �C . � // j� f�' �� 1❑ See note on back regarding River Basin rules. MVJ4 � �' Plow, � T j Agent or Applicant �Prri te�dName Signature *4 Please read compliance statement on back of permit ii ;(,(.., L' Permi- ),� -, / �4, - X, t Officer's Signature q- .7 . t Issuing Date Expiration Date 0 Application Fee(s) Check # Local Planningf urisdiction 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 consistent with the North Carolina Coastal Management Program. River Basin Rules Applicable To Your Project: Tar - Pamlico River Basin Buffer Rules _J 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 151-13 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 WESTERNI 11 1 MONEY INTEGRATED PAYMENT SYSTEMS fNc. - ISSUE ,Englewood, Colorado UNION , ORDER°" ----- t 06-538230814 82-40/1021 PAY EXACTLY PAY TO THE ORDER OF / .ry aCHIEFI.YOGVOU AGREE TO THE [jf"Ci TER SON THE REVERSE SIDE CtZI �� I ,n, ��39(o9ly AUTH. F i ED^.EPRESENTAT� IVE , .-.I rvice mark of Western Union Uot&gs. Inc. I Payable at Wells Fargo Bank Grand Junction - Downtown, N.A., Grand Junction, Colorado Western Union Money Order and Design Is a se L00 400�: 4006 5 38 2 308 L 4 21" ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIER/UNCOVERED BOAT LIF7) I hereby certify that I own property adjacent to /1',CU 1� l%l �!� I y� (Name* of Property Owner) property located at O ') S = t'v�� Cr}� I �. �>l' I i C. l>FX c/t , (Lot, Block, R ad, etc.) on d%iccjb' /,i 'f f)X &Jjf SekNJ , in 7�,/+N �i c 15Ll /fit' /1 , 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/uncovered boat lift 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. GFO TV I do wish to waive that setback requirement. SEP 0 2 2004 -- -- -------------------------------------------------------------------- ------------ - - x� ��-------��aa�� ,fir DESCRIPTION AND/OR DRAWING OF PROPOSED DE�MLMi'1VIENi r�� (To be filled in by individual proposing development) 11 Kr � L �C@ _ 12 I l� 13o 1 ------------------------------------------------------------------------------------------------------------------- Signature Ciecec .( Print or lype Name Telephone Number Date:: .... f� ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIERIUNCOVERED BOAT L.IFI) I hereby certify that I own property adjacent to � 1-�, ✓L'� 's (Nam6 of Property Owner) property located at C / 6 J7Ly (Lot, Block, Road, etc.) on jnui-,1 i` rC 19ay 9.'v "t 64, in /fi/�)'l-C /, /7C'�i , N.C. (Waterb dy) (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/uncovered boat lift 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. SEP 0 2 2004 -------- ----------------------------------------------- DESCRIPTION AND/OR DRAWING OF PROPOSED ELOPMENT: (To be filled in by individual proposing development) , AT 141-le"V_C41 EIS -- 1�:�` I l'! 13cir�PP.l" dP 7:5- Kle �k $ t P S ' �'� Signature,-) ; 3 jjc, jj L, Print or Type Name % E - sY/ Telephone Number Date: � _ 7� M";Pp "Lt 3 to -:� n�� SVQWI L�1S��C�` (l C -7 --Z-? �4�VZ � �`� 1�) "73