31614_MALLARD, DONALD_20020508

❑CAMA / ❑ DREDGE & FILL
GENERAL PERMIT
❑New ❑Modification ❑Complete Reissue ❑Partial Reissue
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
,.r
Previo s permit #
Date previous permit issued_
❑ Rules attached.
Applicant Name ?. ,r, ir' ( i 0-C t , Project Location: County
Address ;; F'1 ('t l i 1F h t:c it rvy Street Address/ State Road/ Lot #(s)
31614C
City State CS(. ZIP—,
Phone # (__) 'A `:L Fax # ( ) Subdivision
Authorized Agent City ZIP
Affected ❑ CW ❑ EW O-PTA ❑ ES [IPTS Phone # ( ) River Basin I ;1 J) c-
• OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
AEC(s): Adj. Wtr. Body (c-'''mac r k �" `l 'i Vet (zflman /unkn)
PWS: ❑ FC:
ORW: yes / no PNA yes / no Crit. Hab. yes / no
Closest Maj. Wtr. Body kl-e
Type of Project/ Activity , Jr., , .)L' .
(Scale: N )
Pier (dock) length
Platform(s) _ _
Finger pier(s)
Groin length
number
Bulkhead/ Riprap�length
avg distance offshore
max distance offshore_
-- - - - - - --r------- ---- -
Basin, channel �--"-'-- — 1— —T
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
Shoreline Length
SAM not sure yes no
Sandbags: not sure yes no
Moratorium: n/a yes no
Photos: yes no
Waiver Attached: yes no
A building permit may be required by:
Notes/ Special Conditions
Agent or Applicant Printed Nam,
Signature Please read compliance s�tement on back of permit
IJ
Application Fee(s) Check #
See note on back regarding River Basin rules.
-"^'Permit Officer's S' re
Is Date/ Expiration Date
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: Fax: [phone]
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293 / 1-888-4RCOAST
Fax: [phone]
(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: [phone]
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico Counties)
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax: [phone]
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-395-3900
Fax: [phone]
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)
Revised 10/C

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FOLEY & FOLEY CONTRACTORS, INC.
1810 OLD AIRPORT ROAD PH. 252-636-2515
P.O. BOX 3482
NEW BERN, NC 28564 66-85/531
DATE —
PAY $QV
TO THE �'
ORDER OF
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Centura Bank®
New Bern, NC 60
FOR__1r1.1��J��� i�lii Ml AL
II10000 3 7 9 4o i:0 5 3 L008 50i:0 3 900 L 6 2 50Il'
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ADJECENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILING/BOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent t 1
(Name of pro erty owner) ! 1 A�~4
Property lacated at a3l / ,�� k,
(Lot, Block, Road, ect.)
on in V�N�In N.C.
(Waterbody) (Town and/or County)
He has decrided 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 piling/boatlift/boathouse
must be set back minimum distance of fifteen feet (15') from my area of riparian access unless
waived by me.
I do not wish to waive yhe setback requirement.
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
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Signature V r
Print or Type f4aine
2-52- 7 Ys l�4 y
Telephone Number
—/—a2,
Date
Foley & Foley Contractors

ADJECENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILING/BOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent toD46 /!It�l N
(Name of property owner)
Property lacated at �/�xe0) Dve
I"
(Lot, Block, Road, ect.)
on , in 6/_ 6z&P--2e , N.C.
(Wnterhody) (Town nnd/nr County)
He has decrided 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 piling/boatlift/boathouse
must be set back minimum distance of fifteen feet (15') from my area of riparian access unless
waived by me.
I do not wish to waive yhe setback requirement.
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
( To be filled in by individual proposing dev opment) �D
To 6 4� �e�fi d 5 Q �Ch�er �i'ivJ i�,#Ai44eNleke ��ec/e
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,'Ne,1j46(es 3 (=e�-t- os vVdoae co�s�'�eu� 'oa �Nc�
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Signature
Print or Typ Name
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Telephone Number
11 /-d 04-1
Date Foley & Foley Contractors