43493_MUNOZ, RON_20051101

C7GAIVIA / ) DREDGE & FILL �rl )� 493
GENERAL PERMIT
Previous perm t
EJNew Modification uComplete Reissue ❑Partial Reissue Date previous p it 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
Rules attached.
Applicant Name /� ;ice i / %"�'�l�,U,.',- Project Location: County
Address ,a // r, ?/,i5 /�-� , Street Address/ State Road/ Lot #(s)
City /liC'I'v /7}�r 1,f State Al(
ZIP
Phone # ( ) Fax # O Subdivisionia/�l=
Authorized Agent �jr'f : /�4 �, z'S City ZIP -
Affected ❑ CW ❑ EW -R.PTA EJES ❑ PTS Phone # ('�� - L' River Basin 4,1,0S '
s ElOEA HHF ❑ IH ❑ UBA El N/A
AEC: ❑ PWS: ❑FC: I y Ad'. Wtr. Body- - naY man nkn
ORW: yes / no PNA yes / no i Crit. Hab. yes / no
Closest Maj. Wtr. Body
Type of Project/ Activity
Pier (dock) length
Platforms)
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
Shoreline Length t 'vy
' _—
SAM not sure yes e no _
Sandbags: not sure yes 6? ——
i
Moratorium: n/a yes Cp
Photos: yes
Waiver Attached: yes `0 -
A building permit may be required by:
Notes/ Special Conditions
Scale: _�,
( 7- S )
=w6--- - --
t`z? Ja f- Cit-
-
)� 4 ! ` f- ❑ See note on back regarding River Basin rules.
/
Agent or Applicant Printed Name -
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
Permit Officer's Signature' j
Issuing Date Expiration Date
U1111L 1, 1 ) NL
Local Planningjurisdiction 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
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
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
400 Commerce Ave
Morehead City, NC 28557
202-808-2808/ 1-888-4RCOAST
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
910-796-7215
Fax: [phone]
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)
Revised 06/29/05

APPENDIX A - I
WATERFRONT CONSTRUCTION PERMIT APPLICATION
REFACING, REPLACEMENT, OR NEW--BULKBLEAiy, DOCK, PIER,
WALKWAY, TIE -POLES, MOORINGS
OWNER & /1ld� ,%%'N y / "" PHONE -�,� ' � ' ATE
ADDRESSr C" c1 71,4 S S C'i; CONTRACTORZZj2-f�,,S
SECTION LOT# WATERFRONT LENGTH /C�c? / t-�` 7
DLMF_,NSIONS (attach scale drawing) APPROVAL
DOCK PLATFORM
WALKWAY W L '
DOCK SUPPORT SIZE "
TIE -POLE DIA 13
---
MAX. DOCK DIST. TO BULKHEAD/SHORE
DOCK DIST. FROM RIPARIAN LINE LT ' RT
MAX. TIE -POLE DIST. TO BULKHEAD/SHORE
TIE -POLE DIST. FROM RIPARIAN LINE LT ' RT '
MOORING LOCATION
B ULKIIEADING
NO. OF FEET BEHLND WALKWAY OR DOCK '
NUl�IBER OF CRACKS IN BULKHEAD _
REPAIR CRACKED SECTIONS _
REFACE ENTIRE LOT LENGTH YES �-' NO_ _
BACKFILL REQUIRED YES_ NO —
COMMITTEE COMMENTS/ DATE. PCC APPROVAL DATE.
B'26-40
8

ADJACENT RIPARLAN PROPER` Y C)NVNER STATEMENT
FOIE A PIER /MOORING .FILINGS / BOA TLIfT / BOA THOUVE)
t hereby certify that 1 own property adjacent to Tl c Z L �iC, �'' `> _ 's
(dame of Property Owner)
property located at � ,
(Loot, Block, Road, ect.)
on3/ ____. , in Z Z>
(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 / mooring
pilings / boatlift / boathouse must be set back a minimum distance of fifteen feet (15')
from may area of riparian access unless waived by me.
I sin not wish to waive the setback requirement.
l Am wish to waive that setback requirement.
DESCYRIMON AND / OR DRAWING OF PROPOSED DEN EILOPMENT:
(Tip befilled 1lled in by irdh dual proposing A-velopment)
4-`rfcA .s,Df
13u L.'leC/c z; h e /
( See the attached drawing )
Nignature 1
Print or Type Name
Telephone Number
Date

ADJACENT RIPAMA PROPERTY OWNER STATEMENT
(FOR A PIER I MOORLIV G' PILLNGS I BOA TLIFT I BOATIIOUSE)
t hereby certify that I own property adjacent to �ijf �f%u .s�C „� °s
(Name of Property Owner)
property loc2ted at U1 f1_ ( � ///_
(LoL Block, Road, ect.)
on ` ri?l✓'�q�- in L- s( r�,� /�1_r�✓i; 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 / mooring
pilings / boattift / boathouse must be set bads a minimum distance of fifteen feet 0 g' )
from my area of riparian access unkm waived by me.
I sicinak with to waive the setback requirement.
¢�I A. vanish to waive that setback requirement.
DESCREMON AND / OR DRAWING OF PROPOSED DEVELOPMMN"T:
(To be tUkd to & Indiv dual proposing Anw1 spmemti
( See the attafhed drawing )
Signature
Print or 'Type Name
Telephone Number
C -Yk
Date

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\v` iOBERT.N HASKINS SR: GIL HASKINS
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`lr , >`/ 410CHURCHRD. 252-6355242.':
\�fNl� �f�tlXs� 60 -NEW BERN,. NC 285F 'l '! `'r' `f � it f
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PAY ll ��`':'.-%%�
ORDER
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