43617_PERRITT, SUSAN_20060118

�' 1 CAMA / = DREDGE & FILL 13617
j
GENERAL PERMIT
Previous permit #
New Modification Complete Reissue-1Partial 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
44- �-- ❑Rules attached.
Applicant Name -J ` 1 `'t�P� r ` Project Location: County
Address / �,✓ Street Address/ State Road/ Lot #(s)
City °`` State.! % ZIP ' i — — - --
Phone # (�" )' 'rb �� J��Fax # (�)
Authorized Agent
Affected CW EkPTA DES ❑ PTS
AEC(s):
OEA ❑ HHF ElIH ElUBA ❑ N/A
PWS: F FC:
ORW: yes / no PNA yes / no) Crit. Hab. yes / no
Type of Project/ Activity
Subdivision
City �� (e��- ``/ ZIP'
Phone # ( ) A r River Basin ' e,
Adj. Wtr. Body nat man unkn
Closest Maj. Wtr. Body
(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
Shoreline Length
SAM not sure
yes ( no
Sandbags: not sure
yes � no
Moratorium: n/a
yes 7l��
Photos:
yes
Waiver Attached:
yes no'
A building permit may be required by:
Notes/ Special Conditions
Agent or -Applicant Printed Name
' See note on back regarding River Basin rules.
Permit Officer's Signature
Signature Please read compliance statement on back of permit
Application Fee(s)
Issuing Date Expiration Date
Check # Local Planningf urisdiction
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 (252-946-648 I) 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

Jaya 11 06 11:03a Bob & Missy Baskervill 252-249-3537 p.3
12/36/2005 11:26 12526377566 THEUPSSTORE PAGE 01
• Dec 29 CS 11:37a Bob & Missy HasRervill 252-249-3537 p.2
�.DJACRiV'I' RZPARL4N PROPERTY O1 STAT1rh I'
(FOR A PIEW.i,100"NG piZINGS1jI0ATZ pT1A ATHOUSE)
I hereby certify that 1 own psuperty adjacent to r ,s
Name or Property O N uer)
proper r dxaleciat ,3Z(� C I1 t A/Ab
(Lot, Block, Road., ctc.) '
on j4_r:: {: I VIM , in
(Waterbody) , N.C.
CI'omr andlor CoIInty)
$r: has described to me, as shown below, the development he is proposing at that
Iocalicu l , wid, I have no objections to his proposal. 1 understand that a pierlmeoring
piling;:rf "I-AiihrWathouse must be M back minimum distance orrfieen Poet (15') from my area
Of zips; r !LMI access unless waived by ma.
do not wish w waive the setback requirement.
1 i wish 10 waive that se-iback requirement.
f O'SCRIPTION ANmioR DRAti'VItiG OF PROPOSED Dn'ECAP.M'CN -r. ^-----
(To be filled in by indit•idua p}rvp0rirrg developmcrrl)
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Signature
Print or Typc. Name
9Iq- 9�6- S3($K
Telephone Number
LOeE986404 LINT 588Z/5z/LI

Jan 11 06 11:04a Bob a Missy Baskervill
EAST CAROLINA BUS FORMS Fax : [phone]
Doe 20 05 10:40a Bob & Missy Bsskervill
252-249-3537 p.4
Dec 20 '05 11:02 P.01
252-?43-3537 p,2
ADJAC r P-WARI.AAt PROPERTY OWNtR S><,ATEMMq*r
{FOR A PIERI/tfOORING PILINGSMOATLIMBOATHpvSi7
I hereby certify that I own Properly adjacent in AA/ C .eR,e►
Qrlamc 4f ProParf "a
Property located at 3 b Ck t Al y owner}
o e
(Lot, Block, Road, etc.)
LR
an �Q.t.,-t_ 1pn n-r% I ti -(.� J . N.C.
(Wsterbody) Crown andfor Cou�y) ,
H* has W me; aS MOW beldw, the devd=a opmt he is Proposing at that location, and, I have no objections to his proppsa!_ I understand that a
pierlmuaring
PifingsIbmadtlboathtwse must be set back a minimum disbw= Of fifteen foci (15') from my aria Of xtparian a=U Wen waived by ax
I do not wish to waive the setback requirement.
I sjQ wish to waive that setback requirement.
DESCAIP' ON &NDJOR DRAti'4 WG OF PROPOSED DEYELOp.% EN-j--
(To be fiilltd in by indir&ual propocdevelvpmtnt)
Ive t t. iie 4L � t d 2 (L
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1 rlm or Type Name
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Tekphonc Number

384 BEARDS CREEK RD j��,•' - \r, '` l O63
ARAPAHOE, NC 28510-9554 ! �' ' ti ��
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Pay to the Date l L / 9 0
66-112/531
i .)01901
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—Classic— >`.: ,�'
BRANCH BANKING AND TRUST COMPANY
NE C� fry
R ,NOR H CAROLINA BAD ) t
For 1ci r7 I �l J ; j \Y.
!�O 5 3 10 L 12 11: 5 2977.
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