30652_PIERCE, BARTOW K_20020205

CAMA /!❑DREDGE &FILL I lx( I � 11965'2--f"
GENERAL PERMIT Previous permit# `
JNew ❑Modification [-]Complete Reissue ❑Partial Reissue Date previous permit issued I
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
Rules attached.
Applicant Name �lt� {fi, r
4 �= • '
f Project Location: Coun
ty ty d
Address , r, `•� f- is Street Address/ State Road/ Lot #(s)
City '`'.,! �-� { \ _State`�'!ls .,ZIP � "'1.
Phone # O j�'�" f(... Fax # O Subdivision
7 �
Authorized Agent city K .'- City r ZIP
Affected ❑ Cw ❑ EW L`u••PTA ❑ ES ❑ PTS Phone # O River Basin.�C--
C OEA C HHF ❑ IH ❑ UBA ❑ N/A
AEC(s): Adf, Wtr. Body L PWS: ❑FC: (hat /man /unkn)
ORW: yes / no PNA yes / no Crit. Hab. yes / no
Closest Maj. Wtr. Body
Type of Project/ Activity
(Scale: j i )
Pier (dock) length i -
g pier(s) - --' Platform(s)- L i
Fingerr ,T
r r ✓� u �iF I -
Groin length —
number
Bulkhead/ ra RiP P length
__ _ L_ . f _ �❑ 1
gt -
avg distance offshore -
max distance offshore
i
tl
Basin, channel � ;:>. - - _ ,,, ..✓� i y ' ,. � r r { �
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing _� __ _ y. r _ •-�' — —c
Other
Shoreline Length_�--
- - r. -�--- ---
S AV:
not sure Y r-es no --- .�
Sandbags: not sure yes
Moratorium: n/a yes no
Photos: yes no
Waiver Attached: yes no
---
i _.
A building permit may be required by: ❑ See note on back regarding River Basin rules.
Notes/ Special Conditions Y
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
Permit Officer'5Signature
Issuing Pate 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 (9 l 0-395-3900) for more information on how to comply with thesebuffer rules.
Division of Coastal Management Offices
Central Office
Mailing Address:
1638 Mail Service Center
Raleigh, NC 27699-1638
Location:
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293 / 1-888-4RCOAST
Fax: [phone]
Elizabeth City District
1367 U.S. 17 South
Elizabeth City, NC 27909
252-264-3901
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 10/05/01

MR. BARTOW K. PIERCE, JR. NCDL 952144 C�%�#,jp�Z 4 0 5 5
MRS. BARTOW K. PIERCE NCDL 882355
128 PIERCE LN 66-152/531 CC
P O BOX 516 PH 919-728-7029 cJ C/
HARKERS ISLAND, NC 28531 Date
Pay 7b The
Order Of ��. 061- .I
Iz
Wachovia Bank, N.A.
Ilunc�ro 1.1—d, NC 28531
Menrn ',� ( c
1:0S3101S 291: 5461 600073110 40SS
JIW"-ND 2—

SYNOVUS EMP SERV'1ed 4 Cal No.204 P.2/4
----- 25RB388849 p_2
ADJACENT RYPN PROPERTY OWN STATEMENT
I hereby certify that I own prnp�rty adjacent to s�Y �ffl�T'Cr yq
Pt'operty Owner )
(Hama 01 $
Pr0PCxty located at �� �' /�y �' /h
on z� / (Lot, Block) Road, etc.)
aG/f( SCC
(Waterhody} v�,G1 �" N.C.
(own :d/�orCou�nty;7�
He has described to me as shown below,'the development he is proposing at that location
and, I have no objections to his proposal. '
DESCRIPTNJN AND/OR DRAWING OF PROPOSM DEVELOPME, 7
�
/(To
be fzlled'o by individua�lrop
+p0sing development) L'7n6vi YGk'�hd�e /�/ -U /
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Telephone�lt umber
Date; d/ '302,
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F.i.a OIL' 02 10: 13a R J Harve9 919-782-0549
Feb 01 02 09:32a East Coast Medical 2520368049
P.
p.2
—DJACE1NT RIPARIAN PROPERTY OWNER STATEMENT
/
I hereby certify that I own property adjacent to13 r
(;`tame of Property Owner)
property located at % aL / / C� 7" C Z h
(Lot, Block, Road, etc.)
on G!t S(Tc1 , 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_
DESCRIPTION AND/OR DRAWrgG OF PROPOSED DEVELOPMENT
(To be filled in by/individaal proposing development)
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Telephone Number
X Dat`: oA - /— D o21
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Feb Ol. 02 10:13a A J Harvey 919-782-0549
Feb 01 02 09:32a East Coast Medical 2528388849 P.1
BK 1111'.Itf'1?
252-728-7029 FAX [phone]
FACStNIIL.E TRANSMITTAL, sbLEE't•
I AS Nl'1,!;ti i, _
919 782-0549 01 AI. NO OI c .: ,;c l cDIN(. CoVvR
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252 728 7029
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Owners Statement
❑ Iittc.rN 1' ❑ rf>R iU'.�'ili�X'
U P';.h,�aF, tti•PLl' ❑ 1'i.1:A�;�, iil�.i_�'CLI.
Nk111 �5/Cc7p1n7!-r;; --
Get�r�c;
"CRse Sig') and fax back dle owners statement. If you would also mail the )1 ginal t(t
file at P.O. Box 516 Harken Island NC 285 i 1. Your attention to this matter is heady appreciated.
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