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Home My WebLink About59785_WALL, BETTY_20120322I� ' ❑ CAMA / ❑ DREDGE & FILL GENERAL PERMIT Previous permit# ENew ❑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 n ❑ Rules attached. Applicant Name_ _. /f-{ Project Location: County Address_ Street Address/ State Road/ Lot #(s) _ City State ZIP -- — ----_--------_-- � Phone # ( -)- _ _- -_-_ _ Fax # (�) Subdivision Authorized Agent City ZIP Affected I Cw -i EW ❑ PTA Il 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 Type of Project/ Activity (Scale: _ ) Pier (dock) length Platform(s) ` Finger pier(s) Groin length number Bulkhead/ Riprap length avg distance offshore max distance offshore Basin, channel cubic yards Boat ramp Boathouse/ Boatlift Beach Bulldozing Other ' j � I / I � I LJ I/' I Shoreline Length SAV: not sure yes no Sandbags: not sure yes no Moratorium: n/a yes no Photos: yes no I I Waiver Attached: yes no .- A building permit may be required by: ❑ See note on back regarding River Basin rules. Notes/ Special Conditions Agent or Applicant Printed Name PermitOfficer's Signature Signature ** Please read compliance statement on back of permit ** Issuing Date Application Fee(s) Check# Local Plan ningJurisdiction Expiration Date 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 Mailing Address: 1638 Mail Service Center Raleigh, NC 27699-1638 Location: 2728 Capital Blvd. Raleigh, NC 27604 919-733-2293 Fax: 919-733-1495 Morehead City Headquarters 400 Commerce Ave Morehead City, NC 28557 252-808-2808/ 1-888-4RCOAST Fax: 252-247-3330 (Serves: Carteret, Craven, Onslow -above New River Inlet- and Pamlico Counties) 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 ERIC B. ELLIS JASA M. ELLIS 205 NOTTINGHAM LN 252-726-6775 4533 MOREHEAD CITY NC 28557 e.LcZ 66-3CV531 Pay to the Date 133 Order of 4/</ Al $ Dollars First Citizens Bank For 1:0531003001:001301,11678Jim A.oplicant: Date: Describe bolo the Him] rATdisturbances for the application. found in your Habitat code sheet. All values should match the name, and units of measu DISTURB TYPE Habitat Name Choose One TOTAL Sq. Ft. (Applied for. Disturbance total includes any anticipated restoration or temp impacts FINAL Sq. Ft. (Anticipated final disturbance. Excludes any restoration and/or temp impact amount) TOTAL Feet (Applied for. Disturbance total includes any anticipated restoration or L temp impacts FINAL Feet (Anticipated final disturbance. cxc: Jes any restoration and/or temp impact amount Dredge ❑ Fill ❑ Both ❑ Other 4((7�7 i Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ . Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ '_i2.302- Z, 21.) .. 1-"i193• a7uUA:3T-anv:!r.n1-- !,. 4t ,. 205 Nottingham Lane Eric Ellis Marine Construction DOCKS • SEAWALLS • BOAT LIFTS DECKS & REPAIRS Phone & Fax: 252.726.6775 Cell: 252.342.6775 Morehead City, NC 28557 ADJACENT RIPARIAN PROPERTY OVVN� STATEMEM�� (FOR A PIERIUNCOVERED BOAT LIFT) I hereby certify that I own property adjacent to 4A is (Name o operty Owner) property located at 612 141 X _!Cm \144 (Lot, Block, Road, etc.) W -:%, on �.� iva / , in 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. cl"-' I do wish to waive that setback requirement. -------------------------------------------------------------------------------------------------------------- DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: (To be filled in by individual proposing /development) Il --------------- -------------------- ----------- Signature Print or Type Name - 7a c0 -o ff Telephone Number Date: �� CERTIFIED MAIL -- RETURN RECEIPT REQUESTED DIVISION OF COASTAL NNIANAGE-NEENT ADJACENT RIPARI_�_N PROPERTY" OWNER itiOTIFICA.TIONAVAINTR FORM Name of individual applying for permit:_ Address of property: 4; 6`73 �'-S ��"'� °`Y (tot or street #, street or road) VIJ4 C -ff'� c (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 they are proposing. A descri tion or drawing, with dimensions, shoul e provided with this. letter. 64 I have no objections to this proposal. 10-S4� 14 t 4 ' If you have objections to what is being proposed, please write the Division of Coastal Management, 400 Commerce Ave., 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, lift 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.) �-I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. �a e Date '1Z /�/ Print Name zS2- 726- (l'(�Z6 Telephone Number With Area Code q. 41 :,'.sl £d:;.i.S i'v o.:; .! is 'i':'i'Y': t $''�f :v.`S t'? 4 a i ERIC B. ELLIS 4533 JASA M. ELLIS 205 NOTTINGHAM LN. 252-726-6775 ss-3o * ) MOREHEAD CITY, NC 28557 / 3`; Date i Pay to the 6 r" Order of J d�� /V , Dollars i_. �i First Citizens Bank Qve',, For u` ___ __ __ . _.__ __,_- 4...__ 1:0531003001:00131744a780i1" 04533 m