47270_NORTWICK, GEORGE_20061002

I
❑CAMA / ❑ DREDGE & FILL
GENERAL PERMIT Previous permit#
❑New []Modification ❑Complete Reissue ❑Partial Reissue I 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 I SA NCAC
❑ Rules attached.
Applicant Name `'I'V Project Location: County
Address j s "' ' Street Address/ State Road/ Lot #(s)
City
- u State ZIP
Phone # ( ) `� ~ ` Fax # O Subdivision
Authorized Agent City ZIP
Affected ❑ CW o EW ❑ PTA ❑ ES ❑ PTS Phone # O River Basin
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body (nat /man /unk�
❑ PWS: ❑ FC:
ORW: yes / no PNA yes / no Crit. Hab. yes / no Closest Maj. Wtr. Body
Type of Project/ Activity
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 6
Beach Bulldozing
Other
Shoreline Length
SAV. not sure yes noj
4
Sandbags: not sure yes o
Moratorium: n/a yes rn
Photos: yes (no 1
Waiver Attached: yes ) no
A building permit may be required by:
Notes/ Special Conditions
(Scale: /V J " e ) I
E See note on back regarding River Basin rules.
2 2611b
Agent or Ap IicantPrinted Name Permit Officer's Si nature
M
Signature Please read compliance statement on back of permit Issuing Date Expiration Date
ApplicationFee(s) Check# Local PlanningJurisdiction Rover File Name

t
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
landowners).
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certifythat this project is consistentwith 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 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:
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
Fax: [phone]
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,
Orslow -below New River Inlet- and
Pender Counties)
Revised 06/29/05

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
{FOR A .PIERIMOORING _PILING.S71BOATI k'FTZB0A THO ,SF)
hereby certify that I own ntoperty acl}acent toj-02,(r^ ww�1102_lj.icks
(Name of Property Owner)
property located at . -1.o--
(Street Address, Lot, Block, Road, etc..)
on
(Waterbody) (Town and/or County)
fie/she has described to zn�,, as -shown below, the development he/she is proposing at that
location. and I have no objections to this proposal. i understand that a pier/mooring
pilings/boatliftJboathouse must be set back a minimum. distance of fifteen feet (15') from my area of
riparian access unless waived by me. I have indicated my intentions by initialing below:
I dono t'agree to waive the 15' setback requirement.
(initials)
kl1— _ . I do agree to waive the 15' setback requirement.
(initials)
Ltd 7
DESCRIPTION AND/OR DRAWING OF
(To be filled in by individ
3,),� �1. � F T -
---_-----------------------------------------
3POSED DEVELOPMENT:
ing development)
01" 1
3yWL
S ignatur
Print or Type Name
c/ct -t-76 -�-D0k�(
Telephone Number
Date: V (v

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Sep 27,06 05:20p vance edwards 919-581-0709 p.1
ADJACENT RIPARIAN PROPERTY OWNER S'I A'TEVIEItiT
(FORA PIF_RIMOGRING PII.ING&T OA TL.IFTIBOA THO UV E)
i
hereby certify that I own property adjacent to —Q I'd
(Nance of Property Owner)
proPertj located at —_/c;I 0 ?9t-5 02 tl• --
(Street Address, Lot, Block, Road, etc
on in N.C.
(Waterbody) (Town and/or County)
he/she has de_s ribed to me, as -shown below, the develepmen_ helshe is proposing at flat
location and I _ have no objections to this proposal I. understand that a picr/mooring
pilings/boadiXboathouse must- beset back a minimarn distance of fifteen feet %I S') from my area of
riparian
%access unless waived by me. I have indicated my intentions by inifkding bejaw.
I do not tag= to waive the I5' setback TaquiremenL
('initials}
I do agree to vraivc the 15' setback requirement.
(iuiti$is)
DESG_RIMON AIDIOR DRAWING OF PROPOSED WYE�.OPMENT:
(To be fdkd to by iA&Wduaf proposing develo
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Sig= -
C;� wAk�
Print or Type Name
g19- 5-�(-678
Tcicphone N amb,er
Date:
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MUD BUCKET DREDGING, INC. 1891
PH. 252-241-1504
507 HEDRICK BLVD. 66-112/531
MOREHEAD CITY, NC 28557 BRANCH 531
2201
DATE d ' Z ' O�1
x PAY
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� ORDER OF_
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BRANCH BANKING AND TRUST COMPANY
1-8W-BANK BBT BBwdT.com
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