HomeMy WebLinkAbout51279_ARTHUR, BART_20080909/S 6
❑CVLNA / ❑ DREDGE & FILL
GENERAL PERMIT Previous permit#
❑New ❑Modification ❑Complete Reissue ❑Partial Reissue `F-' ; . 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
Applicant Name i ! j. `T Project Location: County
Address } Street Address/ State Road/ Lot #(s)
City _ State ZIP -
Phone # ()_ Fax # (_ ) Subdivision
Authorized Agent I,- t City ZIP
Affected ❑ CW ❑ EW &I PTA ❑ ES ❑ PTS Phone # ( ) River Basin
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body (nat /man /unkn)
❑ PWS: ❑FC:
ORW: yes / no PNA yes / no Crit.Hab. yes / no Closest Maj. Wtr. Body
❑ Rules attached.
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Agent or Applicant Printed Name
Signature "Please read compliance statement on back of permit"
Application Fee(s) Check #
Permit Officer's Signature
Issuing Date expiration Date
Local PlanningJurisdiction
Rover File Name
I I s
r 11
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 consistentwith 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 (910-796-7215) for more information on how to comply with these buffer rules.
Division of Coastal Management Offices
Raleigh Office
Morehead City Headquarters
Mailing Address:
400 Commerce Ave
1638 Mail Service Center
Morehead City, NC 28557
Raleigh, NC 27699-1638
252-808-2808/ 1-888-4RCOAST
Location:
Fax: 252-247-3330
2728 Capital Blvd.
(Serves: Carteret, Craven, Onslow -above
Raleigh, NC 27604
New River Inlet- and Pamlico Counties)
919-733-2293
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)
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
910-796-7215
Fax:910-395-3964
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)
Revised 08/09/06
BRANDON MANSOUR 66_7704/2531 2256
NCDL 25635492 08629187024
PO BOX 84
MERRM, NC 28556 DATP
( /c,
PAY TO -("N n
THE ORDER F
3
State Employees' Credit Union®
New Bem, North Carolina
156
MEMO — —
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Noilkri C"PrNina DepF.,i-implit o- - ," '
nd
-ant Minn
&T-tiling Address LU
I cercir.l., IbAl I bavenutharized (agen kl?�- .. Si CX a&-4� W act: 0 11 . WT'
b0b:xlf, for the purpme of aprlyinn for and obtaining a]) C.A&I.-k Pa-mits necc3sary to
instntl or construct (nettrity)
at (location)
TI.Ifs rcrtifimtion is -valid Vim (ditta) 06
Sit
40C,:-' 0 M, M e 7- Z A ve nUe. [4 1 r; r ai 12 ad N- areY-- Caf',n! in a 2 7
F-hor,=: 252-808-283U FAX- 291 im
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A JACEN`!' .R,.1A u.,y..A N PR4PE.w-ry nt)vANE :R STATEMENT
( POR'A MRIMOORIN€a;PILINW8UA'17.IFrl,,60A7',i:OUSEj
T l,P.reby cervfy ti,at I own property, a4jacetit !e � a ✓� ���� is
(Name of Fr4perty'Owner)
p; o� r '.,w tcd ai i I
Block; Rom, ems)
(Watery) (Town 2RWQ t n ►� )
ATnhirPnt'g ?h+DA2 ##- 7i �- 113 �j ��MAiI_
19
. Ii. i,a5 Cris-,Sc,—. �o inc as sho—vri
rr_ �.. �i3C� ` � (?e�o�J} t,�iC CaC'YG�U11�14.:41� IncIBC i5 �iG-'"kvbiug ai �+11i. �OCSioi}� S:i(�,
have no objcv ions to his.pmposal. i under wnd that -a ,pier/mooring pilings I bomliR I-boa[house
--_ . hr� c_: Lar:t n rL'?i^?it cls' <'2�� ^f -itt;� c'ye.-. �n�� r atv_s� .�f -->-.::>-„� �.___33 'ilit c
waived by me. (if you wish to waive the setbacic, you must initial the appropx'i me Wank
below.)
I do not wish to waive
1DE—SCRFPT ON ANDIOR-DRI AWING OR PROPOSED DEVE LOPMT'NT:
(To 6e fiVed in ny' indiriduai ,proposing aerriapmmr)
(lnformation for Property Owner Anplyiug
For Perre it)
f V4
-Mai
l'efephone N-umber 1�� L g'S 6 ti
(Riparian Property Owner Information}
Signature
rdut of Type Name
T.etmhone Number
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ADJACENT .RIQARUN PROPERTY PERTY OWN ER gmATEMENT
WOR A' FIEEI1MV URING IJPT LI;VGS10UA )TIJJ,'x/IIUA'f HOCSFI)
I hereby certify that I --wn property adjacent to-_ (30 Vf r �4y\j 'g
(Nairne ttfProperty 6z er)
proper- located a: 11 1 V Shy S_- - {,1Vyt
- -
(Lot, Block, Road, etc.)
(Wuterbody) (Town and/or CouRt�)
AnsllCaf7�t'g phone #: '2•SZ•� 3 b1 �-�7 Mailing Address:
Tle has desc-l:bcd to mc, as shown bcJcrv, the dcvciop„ ic;it he is proposing at that location,, and, I
Eta vc no objections to his pruposaL'x twilcrstarld that a picrlmaoring pips lfiaatii11 t boathouse
i?3L?3t be set back n t?'d-st-ance o ?;�CCI? It;r (11�3 ,inse? !u;' rs_a of ripwarian �L�CSS unlr.,c
vwai.ved by mc. (If you wiisb to waive the setback, you must initial the appropriate blank
heltnRr_l
i do not wish to waive
I do v;, waive that seth.- " c r cquircmcrt.
tVIEMSCRiMON ANDIOR DRAWING OF PROPOSED DEVELOPMENT:
(1-4 be jWed in by irrdiviauai proposing dem opmem)
(information far Property Owner A imlyin►g
for Permit)
Mailing Address
City/SiaWt'7ip
Telephone Number
(Riparian Property Owner Information).
Signature
I '( "'4'W 3'�9
r q n Print of Type 14amc
Telephone Number
1�>v�r -7.�� Z
Sep 02 08 12:05p
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