HomeMy WebLinkAbout54353_BEGGENSTAFF, MICHAEL_20090804❑CAMA / ❑DREDGE & FILL
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GENERAL PERMIT � Previous permit # i
❑New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued i
i
As authorized by the State of North Carolina, Department of Environment and Natural f rces
and the Coastal Resources Commission in an area of environmental concern pursuant toNCAC '
i ❑Rules attached.
Applicant Name Project Location: County j
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Address
City
State ZIP
Phone # O _
- Fax # O
Authorized Agent
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❑ EW ❑ PTA ❑ ES ❑ PTS
Affected
AEC(s): ❑ OEA
❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
❑ FC:
ORW: yes / no
PNA yes / no Crit.Hab. yes / no
Street Address/ State Road/ Lot #(s)
Subdivision {
CityZIP
Phone # ( ) River Basin
Adj. Wtr. Body (nat /man /unkn)
Closest Maj. Wtr. Body
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Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit
Application Fee(s) Check #
PermitOfficer's Signature _.
Issuing Date Expirationq to
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 (910-796-7215) 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/ 1-888ARCOAST
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
CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Individual applying for Permit: j ]1fi-0qt-jC-SJAT1
Address of Property: Lf � o 14 K 7 D W• �
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(Lot or Street #, Street or Road, City & County)
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
roposing. A description or drawing, with dimensions, should be provided with this letter.
I have no objec ions to this proposal.
objections to what is being proposed, please write the Division of Coastal
Management, 400 Commerce Avenue, Morehead City, NC, 28557 or call (252) 808-2808 within
10 days of receipt of this notice. No response is considered the same as no objection if you
have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, boatlift or sandbags
must be set back a minimum distance of 15' from my area of riparian access unless waived by
me. (If you wish to waive the setback, you must initial the appropriate blank below.)
do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback-F@.%uirement
(Applicant Information)
o OQU IV
Mailing Address
gre,e�u�f�2 4
City/State/Zip
�5 - Rtto - 014- 91
!e ephone Number
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Date
nType Name
r Information)
0u-
07/29/2009 17:24 4134584876 MAIL BOXES ETC PAGE 02
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A Pff-R✓.V00R1'WG ,PXUNGS180ATUFT BOATHO USE)
certify that t Own property adjaccnt to
(Name of Property ner)
I.n•operty io�:utcc� at _�____�_ �:��a�? .- _...L�_�L�. �L _ -
1r , (Lo , Block, RoAd, etc.)
On in
('v3 aCerbod,*) (Town and/or County)
MailingAddxess:�, L U✓1ir ,LA G,11
He has dccrineti tonic, as Shown below, the development he is proposing at that location, and, .t
have rro objectjoais to his pmposai. I understand that a pier/mooring pilings / boatlift / boathcuse
must be set pack a minimurn �istlnce of fifteen feet (15') from my area of riparian access unless
waivcd r,y n: (If y,)u -%h,ish to w aive the setback, you must initial the appropriate blank
.)6iij',.,.)
I du not veish to waiv;,
[ (I�� w=;_,b :o waiN,c that setback regwrctncnt.
)E(Sc''R.(PTJON AND/OR DRAWING OF ;PROPOSED-DEV LOPMENT:
(To be jified in by iridb4dual proposing develop►new)
-Inforrcation for Property Owner Applying
for Permit)
;�Cailin� �.ddzess
I elcphne Number
ia.tzgr' D,ate
ra-
(Riparia)t Property Owner Informration)
Si�ta.ure
"LA tf
pru t or T) Ye N-ame
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North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue, Governor James N. Gregson, Director Dee Freeman, Secretary
Date '7- zC-09
Name of Property Owner Applying; for Permit:
Mailing Address:
33b4 C 6uK4-� ood LQne-
,----
I certify that I have authorised (agent) r �Uf�'J/� 5 L # tOreyc. e to act on my
�S- aqf- 3&6 11-11
behalf, for the purpose of applying for and obtaining all CAtMA Permits necessary to
install or construct (activity)
at (my property located at) � q o HW � -70 (A r (I j S f -D ,(\ A) C-
i
This certification is valid thru (date) / Z- a 9
Property (r Signature p
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: 252-808-28081 FAX: 252-247-33301 Internet: www.nccoastalmanagement.net
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