45753_PRIDGEON, MARK_20060605

U- io C- I h
❑CAMA / ❑ DREDGE & FILL
GENERAL PERMIT Previous permit#
❑New ❑Modification ❑Complete 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 I SA NCAC
E] Rules attached.
Applicant Name Project Location: County
Address Street Address/ State Road/ Lot #(s)
City
State' ZIP
Phone # O
Fax # O
Authorized Agent
,°�-.
Affected ❑ CW
. I] EW
❑ PTA ❑ ES ❑ PTS
AEC(s): ❑ OEA
❑ HHF
❑ !H ❑ UBA ❑ N/A
❑ PWS:
❑ FC:
ORW: yes / no
PNA
yes / no Crit. Hab. yes / no
Subdivision
City ZIP
Phone # ( ) River Basin
Adj. Win Body (nat /man /unkn)
Closest Maj. Wtr. Body
Agent or Applicant Printed Name Permit Officer's Signature
Morehead City DCiVI
Signature Please read compliance statement on back of permit Issuing Date Expiration Date
Application Fee(s)
Check #
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, certifythat this project is consistentwith the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
J Tar - Pamlico River Basin Buffer Rules _' Other:
IFS 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

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05/01/2006 16:18 2522374587 MARK PRIDGEN PAGE 03
ADJACENT RIIARIAK PROPERTY OWNER STATEMENT
(FO)" P'18"J OORINO PUING"0A t<! /20A WOUSAP
r
S hcreav eertily that i own prppsttr at 'a
(Name of Propert- 0%% r)
properly located at ,'Z-V
(Lot, Black, Road, etc.)
onA4M& in 4du NC
(NN aterbt y) (To •od/or County) ?
fie has described to mc w lho%%o% belam, the developntent he is proposin= w thm location,
:tind. I here no o1�;scttons to his proposal I understand that a pier/moortn�pllln:s'boatl� attto►as
n-= be Set back a mintrtlttm distance of riReen fat (► $') Born my area of riparian ac eas unless
►vatvtd by roe.
I d„pg wish to N alvis the setback requirement.
tg wish to Nome that setback requirement.
.... _......._.....,...............................................................
......_....i........._..
DESCRJFTION AND/OR DRAWING OF PROPOSED DEVELOPNIENIC'
-jTa oIAllerf IN i►-1'r�f�lVlffhd/O10I0/lilt rrvtlO��NeNt)
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MAY 1 5 2006
Moreheab City DCM
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