43595_POWELL, JOHN_20051128

;Li CAMA / ❑ DREDGE & FILL
GENERAL PERMIT Previous permit
GNew ❑Modification LComplete Reissue ❑Partial 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
} El Rules attached.
Applicant Name / v t Project Location: County
Address ! .J Street Address/ State Road/ Lot #(s)
City 6-4", / Statey ZIP
Phone # (I`') t' a l C7`r JG Fax # ( ) Subdivision
Authorized Agent Z,.r City zip �J 7r
Affected Cw CQEW EiPTA ❑-ES ElPTS Phone # River Basin
-1 OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A r� /
AEC(s): Adj. Wtr. Body (nai /man /unkn)
❑ PWS: ❑FC:
ORW: yes / no) PNA yes / Cq; Crit. Hab. yes / no
Closest Maj. Wtr. Body' F; J
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
Beach Bulldozing_
Other
Shoreline Length
SAM not sure yes no
Sandbags: not sure yes (nto
Moratorium: n/a yes o
Photos: yes n
Waiver Attached: yes
A building permit may be required by:
Notes/ Special Conditions
(Scale: f U e )
E See note on back regarding River Basin rules.
Agent or Applicant Printed Name Permit Officer's Signature
Signature Please read compliance statement on back of permit Issuing Date Expiration Date
1 ��A
Application Fee(s) Check # Local Planning Jurisdiction Rover File Name

ri
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, certifythatthis project is consistentwith the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
�17 Tar- Pamlico River Basin Buffer Rules F_1 Other:
El 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

clam l tin Nr_•We i i
ADJACENq pjpAYj.AN PROPERTY ONNrNrER STATEMENT
ner* ..y ce:tif; that. l cwn propecty ad acenr to `�'R'me of Property Owner
Aroperry locat4d at _
?I,nt, Bio(i:, Road, a c.)
4 C IC �"er et— , N.C.
can., S ;,�__-, it n(,: �1 �.w t. _._ -----
ierbodyl (To;wn a�ndfor UUUMY)
rie has desvibed t,,) me ass shown b ,low, the development. he is propos- " at that location,
and, I have no oklaCtiornS to his p Ol=c5al
OESCRI:JiJ'i0N' AINW R I)Ri,Wr's;G OF PROPOSED DEVELOPMENT
(To 5e,;c'fer.' ire >;y i�rrlividual proposing dercloprneni}
I ) CwtA ; l
W i 11;t.
tc�^Lk;i
ti� ,12t'3rti1 C�
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-)z , 3-56 5'-1 I-L�r `
;,i; �2ttire
Print Cir TL•c:�. Barn,
Tc ephon° N-Ir ber

WJACENYf RIPARIAN PROPERTY Citi1•NE11 STATEMENT
I hereby certify that I awn prop�.rty ad acent to jokrx * G_:_._M1� '4 .\ ?Ut�(_�
(N,anie of Property Owner)
property located at Lo -� J t KJo-uJ Ca...._
t
I.o Block, Roan ete
on C.t.-�c. J�—1 , in C'Y�„�C+_ 9 N.C.
__ _>
(Wa erbody; (Town and/or County)
He has described to ine as shown: Wow. the development he is proposing at that Location,
and, i have no objections to his proposal..
DESORIIYFION ANWOR DRAWM OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development)
Sign pure �
r
Print or Type Name
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Telephone Nuinber
Date: f 0 W 1 8" 01IS

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EARNEST BUILDERS BAYSDEN, JR. (BUDDY)
PO BOX 528
SALTER PATH, NC 28575
IPay to the
Order of
6041
Date
J 66-30/531
133
Dollars 6
FIRST CITIZENT,uv c az
FV—tjl i8 Bank. 851 C p—
I. Atlantic Boarh, N.C. 28512
For N ( �
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