43152_SIGRIST, BOB_20051005

❑CA7VIA / ❑DREDGE &FILL
: C; ERAL PERMIT
Previous permit #'✓
❑New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit i
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
/ l 'st ? ►`4 ❑ Rules attached.
Applicant Name 'gJ" Project Location: County
Address 1 j 61� �' �rlcr Street Address/ State Road/ Lot #(s)
City i)l , 1= jJ C State ZIP.:'
Phone # ( )_ Fax # (,) Subdivision
�.
Authorized Agent �' " ' 'r ' City ZIP
Affected ❑ CW ❑ EW [ 3OTA E3'ES ElPTS Phone # ( ) River Basin
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
AEC(s): Adj. Wtr. Body '(,at,/man /unkn)
❑I PWS: ❑ FC: d,
ORW: yes / no PNA yes / no Crit. Hab. yes / no Closest Maj. Wtr. Body
Type of Project/ Activity
Pier (dock) length
Platform(s)
Fing4
Groi
Bulk
Bash
Boat
Boat
Beac
Othe
Shor
SAV:
Sand
Mors
Phot
Waiv
(Scale: iv -�' )
�r pier(s)
i length
✓'
I
H
i
i
I
i
'
number
lead/ Riprap length
avg distance offshore � J
T'11
�
_
----
�
I
—
I
_
_
—
max distance offshore
-J
I
—
—
-
--
—I
,channel
cubic yards
ramp-
1-�
—
louse/ Boatlift
_
—
i Bulldozing
l
r
aline Length
not sure yes no
Sags: not sure yes `no
torium: n/a yes no
1 _ _1
)s: yes (�nq' —
r Attached: ves nol _
—
—
r
—
A building permit may be required by:
Notes/ Special Conditions
or Applicant Printed Name
—'See note on back regarding River Basin rules.
Permit Officer's Signature
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
Issuing Date Expiration Pate
AA
Local Planning Jurisdiction Rover File Name

1
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 ❑ 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 (252-946-648 [)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

FROM : ALEXRHDER,DDS
v
PHONE HO. : 3362201464 Oct. 04 2005 10:59AM P2
Auj'N
���I
I hereby certzfy that I own property adjacent to
,Name of Property Owner)
;pmpwty lid at
(Lot, Block, Itaad, etc.)on .
kk-oozi—
in ».
(Waterbody) (Town an&'or County)
ge has de=lied to the as shown below, the development he is proposizg at that location,
and, I ba a na objections to his in.-rz�.
DUL'ItJMON ANDXR DRAWihWG OF JPR4"POSED UEV-ZLOPkEI '; '
{�'a be, f�Led in by indYridurzl prapasi��g dsvElnpra�ra)
c `
\c
Sign
Print 4r `type Name
Uephcne Number
za 3E)Vd 00,2i1SNLO UJ3 0 CMUZHE &a0zir0/BZ

OCT-04-2005 TUE 11:54 AM 3 FAX NO. 03 P, 02
z t�erciy � tx�y olat 10'Wo A rty adjaeant in r.
(Nsuue of � apt► Owuer)
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HO Yu�s d��rt��t1 lO nle RS shown bOow, the development be is propodng at that juca& '
0 his pjapoma,
EKRIPTION AND/FOR DRAWWG
of, PRc��P�OSJ�ri
DR P
r 4[propa$� g development}
i
Prir t or Type Name
Telephole Kurnb
Day: —J 0 -- '--/ ---, .2 0
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66-112/531
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BROAD CREEK CONSTRUCTION
PH. 252-745-4252
11 CREEMEW CT
MERRfTT, NC 28556-9572