46089_PILSON, RICHARD_20060917

[�j CAMA / ❑ DREDGE & FILL
NERAL PERMIT
Previous permit #
rNew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As autby the State of North Carolina, Department of Environment and Natural R ources
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
❑ Rules attached.
Applicant Name a Project Location: County
Address Street Address/ State Road/ Lot #(s)
City r�. State ZIP
Phone # ( ) ? : ' i Fax # ( ) Subdivision
Authorized Agent
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ElUBA El N/A
ElPWS: ❑FC:
ORW: yes / no PNA yes / no Crit. Hab. yes / no
City ZIP
Phone # ( ) River Basin
Adj. Wtr. Body (nat /man /unkn}
Closest Maj. Wtr. Body
Type of Project/ Activity
)
Pier (dock) length (Scale: ,,! / TJ
Platform(s)
Basin
Boat
Othe
Shor
SAV:
Sand
Moratorium: Waiv
A building permit may be required by: El See note on back regarding River Basin rules.
Notes/ Special Conditions
Groin
Bulk
Boat
Beac
Phot
Finger
r pier(s)
n length
number
head/ Riprap length__ � �� 4 � -• . � , � - � � - I � i
avg distance offshore
max distance offshore
' I
channel
cubic yards
I i
ram
house/ Boatlift
j — --
i r ,
h Bulldozing
P
eline Length �'
not sure yes no I
I i i
bags: not sure es no
--
Y •�} ,
ratorium: n/a yes no
os: yes no
er Attached: yes no -- - - -- ! -- -
Signature
.I r
Agent or Applicant Printed Name
Signature "Please read compliance statement on back of permit / /
Application Fee(s) Check #
t
Permit Offic-'r's
, '•,,� . - )
Issuing Date �- Expi i n
Local Planning Jurisdiction Rover File Name
.I r
Agent or Applicant Printed Name
Signature "Please read compliance statement on back of permit / /
Application Fee(s) Check #
t
Permit Offic-'r's
, '•,,� . - )
Issuing Date �- Expi i n
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 (910-796-7215) 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

A.,
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSIBOA TLIFTIBOA THO USE)
I herebycertify that I own property adjacent to 4,,4a r- d 4 /-
Y r r y J
(Name of Property Owner)
property located at
v
(Lot, Block, Road, etc.) '
onin �0�,0 �!`�J'�/� , 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/boatlift/boathouse must be set back a minimum distance of fifteeet 15') from my area
of riparian access unless waived by me. C�
I do not wish to waive the setback requirement. PI
JUN 2 7 2006
I do wish to waive that setback requirement.
Morehead City -ACM
------------------------------- --------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by inditi'idUal proposing development)
rgoc� �tjlf
M
'Signature
Print or Type Name
(,;25,2-) 3 53 3S
Telephone Number
�-6 �74/1 6
Date:

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSIBOATLIFTIBOATHOUSE)
I hereby certify that I own property adjacent to R(Cln
(Name of Property Owner)
property located at tA- I ra i •k T (— rz'fi r
(Lot, Block, Road, etc.)
on 0e-t"C C LZT�C- ,in N.C.
(Waterbody) (T wn 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 my area
of ripariaxr ccess unless waived by me.
I do not wish to waive the setback requirement.
I � wish to waive that setback requirement.
ti
------------------------------------------------------------------------------------------��--------- j ---
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOR T:
To be filled in b individual proposing development)�6' Q
( .%.Y P P a �n
•.f/40,
Signature
)I I
Print or Type Name
a sA- 3<. 3- 2 11 7
Telephone Number
Date: �I I

RICHARD E. PILSON
NCDL 2120245
220 CLUB POINT DRIVE
CAPE CARTERET, NC 28584
6019
///� ✓�11 DoIe
Pod 66-I9/530 NC
Orderr off--�L� �C / 3500
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