51185_WARREN, J K_20080606

❑ CAMA / ❑ DREDGE & FILL L %
GENERAL PERMIT
1QNew ❑Modification ❑Complete Reissue ❑Partial Reissue
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
Applicant Name
Address
City State ZIP'?
Phone # O Fax # (, )
Authorized Agent
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS: ❑FC:
ORW: yes / no PNA yes / no Crit.Hab. yes / no
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o S) 118 �+ i
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Previous permit # 1
Date previous permit issued
i
FTRules attached.
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision
City i i l i ZIP
�1
Phone # O River Basin
Adj. Wtr. Body ? (nat /man /unkn)
Closest Maj. Wtr. Body
M. M.
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Agent or Applicant Printed Name
Signature "Please read compliance statement on back of ermit **
LA
Application Fee(s) Check #
ii.
Permit Officer's Signature
Issuing Date Ekpiration C3ate
Local PlanningJurisdiction ' 11ver File Name
r 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, certify that 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 (252-946-6481) or the Wilmington
Regional Office (910-796-7215) for more information on how to comply with these buffer rules.
Division of Coastal Management Offices
Raleigh Office Morehead City Headquarters
Mailing Address: 400 Commerce Ave
1638 Mail Service Center Morehead City, NC 28557
Raleigh, NC 27699-1638 252-808-2808/ 1-888ARCOAST
Location: Fax: [phone]
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
Fax:[phone]
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico Counties)
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)
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 08/09/06

Jun 02 08 08:00a Bob Baskervill 252-249-3537 p.l
Facsimile Transmittal Sleet
To:,L} }
Company:
Fax Number:
'72, 35�
From: Basker%A
company:
Fax Number: 252-249-3537
Phone Number: 252-249-0900
Date: 6 /i
Number of pages, including cover sheet: D
Conu n.ents:
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Jun 02 08 08:00a Bob Baskervill 252-249-3537 p.2
May 2a 08 09:58a p.2
ADJACEW RJPARIAN PROPIMTX OWNER STAMMW
(FOR A PIERIMOORING PILING5/B0A77.TFT/B0AT1100SE)
T hereby certify that I own property adjacent to -J _ mR"n1 .s
(Name of Property Owner)
property Iocatcd at _ I '� i TWIN �� ks 1 V PuJ �, }; L
p (Lot, )Block, Roar d ek.)
on_ctt�, SQw�ve4 �A��.�zei� N.C.
(Waterbody) (Town andfor County)
hTe has described to me, as shown below, the development he is proposing at tha:
location, and, I have no objections to his proposal. 7 understand that a pier/mooring
pilings/boatliftAmthouse must be set back a minimum distance.of
fsfteen feet (15') fmm my area
Of riparian access unless waived by me'.
V/ I o not wish to waive the setback requirement.
I Oo -Aish to waive that setback requirement.
DFSCRWTIC-N A,XD/OR DRAINT iG OF PROPOSED DEVEWPMENM y
(To he filled in by ind4- dual proposing derelopment)
® -YYII4eri��
�'4 o",
Print or Type Nye
(Z 5 -2- ) 72 (c, _2
Telepho c Nomber

Jun 02 08 08:00a Bob Baskervill 252-248-3537 p.3
MaU 23 08 09:58a p.1
ADJACENT RIPARUN PROPERTY OWNER STATERMT
(FOR A PIERIAIOORING PIL1NGSIBOAMFTIR+OAMOUSE)
I hereby certify that I own property adjacent to � "eekf 's
(Dame of Property Owner)
1%�GJ
Property located at S -
(Lot, Block, Road, etc,) J�
one in N (, Fi �P�2L ,. N. C.
aterbody) a►in a dyor 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 pierlmooring
pilingslboatliffyboathouse must be set back a minimum distance of fifteen feet (15') from my area
of riparian ace-.ss unless waived by me_
l� I a t wish to waive the setback requirement.
I do wi5h to waive that setback requirement.
DESCRIPTION A.N`D/OR DRAIMG OF PROPOSED DEVELOP-N EW:
(To be fdW in by ind4 duaal "asing development}
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Signature %,%
Print or ?ype Name
Telephone Number

MELINDA B WARREN DDS 2341
JULIEN K WARREN III DDS 66-112/531
PH. 252-636-2797 BRANCH 019032)1
5105 TRENTWOODS DRIVE va
NEW BERN, NC 28562 1a r, $-N'
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BRANCH BANKING AND TRUST COMPANY
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