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Home My WebLink About39352_WORKMAN, JIM_20040715n' M ❑ CAMA / ❑ DREDGE & FILLC� GENERAL PERMIT Previous per��. � t ❑New ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued j 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 i ❑ Rules attached. Applicant Name '' V ��V Project Location: County Address City - State f ZIP Phone # ("f) .'�'j Fax # O Authorized Agent ❑ CW ❑ EW E"A ❑ ES ❑ PTS Affected AEC(s): ElOEA ElHHF ❑ IH ElUBA ElN/A ❑ PWS: ❑ FC: ORW: yes / no PNA yes / no Crit. Hab. yes / no Type of Project/ Activity Pier Platfi Finge Groii Bulkl Basir Boat Boat Beac Othi Shor SAM Sanc Mor Phoi wain 7 Street Address/ State Road/ Lot #(s) Subdivision i City �.'r< . ZIP Phone # O River Basin Adj. Wtr. Body �xs 1 yes r nat /man /unkn) Closest Maj. Wtr. Body n (Scale:e,�- ) Norm■0 ■■■■■■■■■ ME ■■■■■■■■■■■■■ EIRM M■ EM! M■■■■ ■■■■■■■■UI■M ■■■■■■■■ M fflffis ME MEN ■ ■ MEN ■■■■■■ ■ME ■■■ NEEM Fif WIN ■■i ■1s0■�■�■�:■■■■ii i�i■ �■■■■ ■i�,■■IMMUMMEMIN ■■■■■■■■ ■■■■■■■■■■ ■ �■■��■■■■■■■■■■ m�mm■■M■M■EMM■MM■■■ ■■■■■■■■■■■■■■MU■ a1=00■■■■■■■■■■ ■■■M■■■■MEMO■■■■■M■' r ■M■■■■■■■ ■■M■■EMEMOMEM■■011■ 1M■■EMM■■■■■■■■■ ■EMEM■EMEMM■M■■■�f ! EMM■■■■MOM■ ■ Ed ■■■■■M■MI! EMEMImm■■ I ,, ■MIN EMEM■■■■■E _ _ • ■■ ■■.■■■■■. �, •'r►li:[�IA511`, _�----�■ �Qliif)JP�►r•,i�a17i/li�!�_ rTil�i}I�....%�M�i .w!_ ME M■EMM■oMMr.Ed MMAI ■ ■■■OEM■■ A building permit may be required by: Notes/ Special Conditions Hew VYCv1 ,1,)Y1 Agent or Applicant P-61ted Nam Signature Please read compliance statement on back of permit vu j Application Fee(s) Check # [95ee note on back regarding River Basin rules. Issuing Date Expiration Date g�1 cJ i � i �4 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 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 c5�I 1 InY�0W V�a ),7 V AeXio�� rUJJti%-rAN 1 icarl u A l rKVYILcl Y V V NEK , 1A1kiY hN't' (FOR A PLERIMOORING PILINGSBOAMUTIBOAMOUSE) I hereby certify that I own property adjacent to a`'`"� V10 ` k m AV\ 'S (Name of Property Owner) pi°Perty located at 0 T,c i( 5 A e of C' p \ (Lot, Block, Road, etc.) on U e o�y� t� e c�� . in V 0\ 4 C-\\%, 0 �, , 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 piilings/boatIift/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 f filed in by individual pmposing development) Signature Print or Type Name Telephone Number Date: k4i'"� e ■ Complete items 1, 2, and 3. Also complete A. item 4 if Restricted Delivery is desired. X ■ Print your name and address on the reverse so that we can return the card to you. g ■ Attach this card to the back of the mailpiece, or on the front if space permits. 1. Article Addressed to: Ct e&L i7eZ;vim y) ��► ►�c�, nc. ❑ Agent by (Printed Name) I C. D. Is delivery address different 4r6m Rem 11 ❑ Yes If YES, enter delivery address below: ❑ No 3. Service Type ❑ Certified Mail ❑ Express Mail ❑ Registered ❑ Return Receipt for Merchandise ❑ Insured Mail ❑ C.O.D. 4. Restricted Delivery? (Extra Fee) ❑ Yes 2. Article Number 7004 0550 0000 3921 6552- (Transfer from service [abet) PS Form 3811, February, 2004 Domestic Return Receipt 102595-02-M-1540 UNITED STATES POSTAL SERVICE NO .itli�� ss Mail PQP Posta ' Fees Paid tee' USPS s Permit No - • Sender: Please print your name, address, an4 ZIP+4 in this'hok • U2 b a Uc-��+Ci p•G. r�;c--x y en Bn ti ced d a c a nre n I. See back Lo r details. N.— ---------- rwj 1652 "-INNERBANKS MARINE CONSTRUCTION, INC. v P.O. BOX 190 ORIENTAL, NC 28571 66-30/531 252-249-1429 472 DATE PAY,,, TO THE.''.'.' ORD��P'F $ -A DOLLARS .1,FIRsT CITIZENS 472 13ANKFirst -Citizens 4� First s Bank Trust Company Oriental, N.C. 2BS71 www.firstcitizens.com , U zv— FQ l 0 L C3 S 2 110 1:0 S3 100 3001:00L, 7 120 L 2B 2 2110