47395_RICHARDSON, BRUCE_20060810

CAMA % ❑ DREDGE & FILL 4
�
GENERAL PERMIT
Previous permit #
[]Mew --1 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 15A NCAC
1 ! D Rules attached.
Applicant Name 1 Pro'ect Locations Coun
Address ' 1 1 -
City State
Phone # (�' �) s Fax # O
Authorized Agent
Affected ElCW ElEW ElPTA ElES
AEC(s): ❑ OEA ❑ HHF ❑ IH ElUBA
❑ PWS: ❑FC:
ty
Street Address/ State Road/ Lot #(s)
ZIP
ElPTS
ElN/A
ORW: yes / no PNA yes / no Crit. Hab, yes / no
Subdivision
City
ZIP
Phone # ( ) River Basin
Adj. Wtr. Body (nat /man /unkn)
Closest Maj. Wtr. Body
Type of Project/ Activity
Pier (dock) length
(Scale: )
Platform(s)
Finger pier(s)
i
I
_
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel -
cubic yards "%
Boat ramp f ._
Boathouse/ Boatlift
Beach Bulldozing
Other
- -- _ —
—_
I
Shoreline Length
SAM not sure yes no
I
Sandbags: not sure yes
Moratorium: n/a yes no j
Photos: yes
i
Waiver Attached: yes
A building permit may be required by:
Notes/ Special ConditionsRIM
I
_
i
I
See note on back regarding River Basin rules.
Agent or Applicant Printed Name
cn
Signature Please read compliance state i Application Fee(s) Check #
Permit`Officer's Signature
Issuing Date Expiration Date
Local Planning Jurisdiction
Rover File

4
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 consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
❑ Tar - Pamlico River Basin Buffer Rules F1 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

Appendix A
Adjacent Riparian Property Owners Statement
(for a bulkhead, dock/mooring pilings)
I hereby certify that I own property adjacent to •S
(Narne oPproperty owner)
property located at t��oo c 4,- -7
(Lot, Block, Road., etc.)
on I d 4 c e- , 4-va- ( , in / xf G � NC
(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 of?jections to his proposal. I understand that a dock/mooring
pilings must be set back a minimum distance of fifteen fret (15') from my area of riparian
access unless waived by me.
!�r I do gyt wish to waive the setback requirement.
I dgwish to waive that setback requirement.
Description and drawing of proposed development:
(To be filled in by individual proposing di-velopment)
j Jrt. r—
Signature
k� I T V
Print name
(f 1 c,
Address
o / V
A-2
Date
Telephone number

Appendix A
Adjacent Riparian Property Owners Statement
(for a bulkhead, dock/mooring pilings)
I hereby certify that I own property adjacent to ��4c� a�c.��-�yG^� 's
(Name o property owner)
property located at 6 /,z t 0 -s fl�1011 � G-�-.7 7
(Lot, Block, Road, etc.)
on I o ire ✓+ , & 4-;w - ( , in r,4<4 l , NC
(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 dock/mooring
pilings must be set back a minimum distance of fifteen feet (15') from my area of riparian
access unless waived by me.
q I do not wish to waive the setback requirement.
N 14, I do wish to waive that setback requirement.
Description and drawing of proposed development:
(To be filled in by individual proposing development)
signature
Print name Date
Cees1/ C� - z s- y� 3 3 -
Address Telephone number
A-2

e
Ew' . I-

BRUCE H. RICHARDSON 1142
BETTY J. RICHARDSON
6121 CASTLEfON CT. 7-163/520 MD
_ �
NEW BERN, NC 28560 Date_ 8133
252-637-7604
PayTo
The
Orderer Of
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BankofAmerica
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