47282_SCOTT, TOMMY_20060913

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/ ❑DREDGE & FILL V
`GERAL PERMIT Previous permit #_
❑NewModification ❑Complete Reissue ❑Partial Reissue Date previous perm
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
❑ Ri
Applicant Name Project Location: County
Address Street Address/ State Road/ Lot #(s)�
City State ZIP
i
Phone # O Fax # ( ) Subdivision
Authorized Agent City ZIP
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Phone # () River Basin
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body (nat /man /unkn)
❑ PWS: ❑FC:
ORW: yes / no PNA yes / no Crit. Hab. yes / no Closest Maj. Wtr. Body
Type of Project/ Activity r
(Scale: )
Pier (dock) length
Platform(s)
Finger pier(s)
Groin length - - - —
number
Bulkhead/ Riprap length 4
avg distance offshore
max distance offshore
I
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
Shoreline Length fir'
SAM not sure yes no
Sandbags: not sure yes no --
Moratorium: n/a yes no
Photos: yes no
Waiver Attached: yes no
A building permit may be required by: ❑ See note on back regarding River Basin rules.
Notes/ Special Conditions
0 C: T 6 2006
Agent or Applicant Printed Name
' rnt, ,�.� �► Moretioad City ®C
Signatures Piease read compliance statement on back of permit
Application Fee(s) Check #
( z l/
Issuing Rate / lExpiration Date
Local Planning Jurisdiction Rover File Name

A 1
It
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 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/ 1-888ARCOAST
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,
Orslow -below New River Inlet- and
Pender Counties)
Revised 06/29/05

M�r- n� ---

f
¢�A / ❑DREDGE & FILL
�-v �T ? 4 t 2 8 2
:,ORAL PERMIT
Previous permit #
ew ❑Modification []Complete Reissue C1Partial Reissue
Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources
NCAC
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA
❑ Rules attached.
Project Location: �Ay ��Pa��4
Applicant Name `
County
/
Address ` c � " `' ! �_
Street Address/ State Road/ Lot #(s)
City i1I��'1 fir-. State C—ziP 2-7i
T
--- - /_
�/,—�
Phone # (3X) -7/ r �ax # ( )_
Subdivision
Authorized Agent
City _,Aje _ ZIP
1" 'A El ❑ PTS
Phone # ( ) _ River `'4 �' tr o/} !/Q
Affected
[I� ❑ El
AEC(s): OEl HHF IH USA N/A
(c
Adj. Wtr. Body �f A I-e/ Cv-hat man /unkn
❑ PWS: ❑ FC:
(�'
Closest Maj. Wtr. Body ��-� J G �-tr✓%
ORW: es' yno PNA yes / no') Crit. Hab. yes / no
Type of Project/ Activity 2' L4 x
Pier (dock) length_—
Platform(s)
Finger pier(s) ' x2'0
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel -- -- -- --- -
cubic yards
Boat ramp
Boathouse/ oath
l3X0
Beach Bulldozing
Other
(Scale:
n Ar'
� xa�
FT
Shoreline Length
SAM not sure yes no —
Sandbags: not sure yes o
Moratorium: n/a yes
Photos: yes
Waiver Attached: yes ----------
A building permit may be required by: P r3A See note on back regarding River Basin rules.
Notes/ Special Conditions A)b CA 0kl — .P-� y( P2 (21 c.-f t' i IQ—'
Agent or Applicant Printed Name
IL//3
Signature ** Please read compliance statement on back of permit" Issuing DAte fExpinrtion Date

t
HCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Michael F. Easley, Governor Charles S. Jones, Director William G. Ross Jr., Secretary
September 14, 2006
Tommy Scott
11635 N NC HWY 150
Winston Salem, NC 27127
Attached is General Permit 47282C
In order to validate this permit, please sign the permit as indicated. Detain the white copy for
your files and return the signed yellow and pink copies to us in the enclosed, self-addressed
envelope. If the signed permit copies are not returned to this office before the initiation of
development, you will be working without authorization and will be subject to a Notice of
Violation and subsequent civil penalties.
We appreciate your early attention to this matter.
Sincerely,
Ryan Davenport
Field Rep
lsb
Enclosures
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: [phone] \ FAX: [phone] \ Internet: www.nccoastaimanagement.net
An Equal Opportunity t Affirmative Action Employer— 50% Reavded 1 i o% post consumer Paper

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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERAV100RING PILINGSIBOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to jlp7L- I
(Name of Property Owner)
property located at /" r% SOIIN 46,l ly ,
(Lot, Block, Road, etc.)
on e�"I'&zk: —,in e,4,P7_CKc , N.C.
(Waterbody) (Town and/Cr 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 riparian access unless waived by me.
I do not wish to waive the setback requirement.
I dQ wish to waive that setback requirement.
--------------------------------------------------------------------------------------- ------------------
DESCRIPTION ANC/OR DRANVING OF PROPOSED DEN' 1�t"`
(To be filled in by indi►-idual proposing developtnei
SEP 8 - 2006
300'
Morehead City DCM
Signature
Print or Type Name
Telephone Number
Date: q - .a 5

T
T
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSIBOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to
%o '-.1 Sc
(Name of Property Owner)
's
property located at 57G;-,-,e,41 /,-clr
(Lot, Block, Road, etc.)
on ot (t-!� (, rce �` , in CU , 4 �- t- f , N.C.
(Waterbody) (Town and/o Count
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 riparian access unless waived by me.
I do not wish to waive the setback requirement.
I dD wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWItiG OF PROPOSED DEVELOPMENT:
N Sip 8 - 2006
Morehead Gay
I-3 00 -A
Sig
Print or Type Name
Zs-z - 7zC� --0CW
Telephone Number
Date:

.= NEW 1330
66-21/530
TOMMY F. SCOTT a BRMCH 7T676
JOAN C. SCOTTfp
11635 N Nc Hwy C 27127 Date
Winston Salem,
Pay to the r✓� pt ./Y s
Order of
Dollar
WACHovIA l
.rlr� Wachovia Bank, N.A- � IVP
wachovia.com-----
For
580468
1,03000 2 L91: 10873
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