52308_WELLS, WARNER MCNEIL IV_20080619

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GENERAL PERMIT Previous permit #
New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued J
i
As authorized by the State of North Carolina, Department of Environment and Natural Resources J
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
O Rules attached.
Applicant Name
Address
City
State �' ZIP
Phone # (,)
Fax # ( )
Authorized Agent
-
Affected ❑ CW
❑ EW
❑ PTA C7 ES ❑ PTS
AEC(s): ❑ OEA
❑ HHF
❑ IH ❑ UBA ❑ N/A
❑ PWS:
❑FC:
ORW: yes / no.
PNA
yes / no Crit.Hab. yes / no
Project Location: County
Street Address/ State Road/ Lot #(s) .r CY
Subdivision
City ZIP
Phone # O River Basin
Adj. Wtr. Body (nat /man /unkn)
Closest Maj. Wtr. Body
_
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Agent or Applicant Printed Name
Signature "Please read compliance statement on back of permit
Application Fee(s) Check #
Permit Officer's Signature
Issuing Date Expiration Date
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, 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.
(Serves: Carteret, Craven, Onslow -above
Raleigh, NC 27604
New River Inlet- and Pamlico Counties)
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)
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

'MAY-05-2008 13:20 FIRST TENNESSEE 901 523 4477 P.01/01
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' NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Michael F. Easley, Governor Jams H. Gregson, ©Sector Mriam G. Ross Jr., Secretary
Date l { 0 Q ? n -0
,Applicant None R
Mailing Address _C% l LUts� IV
[certify that ! have authorized (argent) �tti! Cl to act ou my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
i
install or construct (activity) I QQ i nc-K a Ylri
.F !
A ThN ce ` -O j valid tbru (date) J �t ' i 20
5ignathre r'i 1� �' } �� i,�0-'O"00011A
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i11CMC_iIi LA) .E4iSr tV
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400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: [phone] FAX [phone] hemet www.nccoasWmawrrtent.net
An 84uai Opportw?q 1 Aflamej" Acton Employer- 54% Reaydod k 10%PaaCvww Paper
TOTAL P.01

111
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERINOORLYG PILINGSBOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to J 1VV & I&, k L C s
property located at %Ot
Pr
(Lot, Block, Road, etc.)
(Name of Property Owner)
%lnt A 70
on .60QUe-SoaAji'J , in krveR4LZ-L-SLE, &der_ N.C.
(Vt1alterbody) (Town and/or County)
He has described to me, as shown below, the development he is proposing at that.location,
and,1 have no objections to his proposal. I understand that a pier/mooring pi li ngs/boatl i ft/boatho use
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.
V I do wish to waive that setback requirement.
-------------------------------------------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To.be filled in by individual proposing development)
ram:
f.r
------------------------
(Applicant Information)
yid wa�nP,- � If WQ-1 IS, I v
Mailing Address
e4/f l trroi /It, /V 3go/ %
City/State/Zip
q01--523- 4351
Telephone Number
Date
(Riparian Property Otivner Information)
Signature
Print or Tyhe Name
q_.10 4b f�Z
Telephone Number
v-v�
Date —_--- ----

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGSIBOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to R V K4- �� �� . L 's
(Name of Property Owner)
property located at
(Lot, Block, Road, etc.) rr
on 060 Uey t , in 4-t-� e��L6 --S/P-. e0,-f e N.C.
( aterbody) (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 pier/mooring pi11ngs/boatl1ft/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.
,J I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(Try be filled in by individual proposing (levelopment)
J
�i
---------------------------------------------r�_wS----
(App licant Information)
11/0 w,a A-1,vF-e AC Eve il�GfJc
Mailing Address
City/State/Zip
q,y 5C43- yI331
Telephone Number
L'Q�1-J6eu
Date
LYE' 1� za
o
CD
---------------------�.---------
(Riparian Pro ert3Vbw r ai ion)
Signat i \ U
D c
Print or Type Name
Telephone Number
Date

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FORA PIER/MOORING PILINGSBOATLIFTIBOATFIOUSE)
I hereby certify that I own property adjacent to J 8 V & 1& , L L C s
(Name of Property Owner)
property located at 4 Ot
f (Lot, Block, Road, etc.)
on IGJOQCl ��©i l.4n eRA7l_6J S'LE, &g/'&r , N.C.
( aterbody) (Town and/or County)
He has described to me, as shown below, the development he is proposing at that Iocation,
and, I have no objections to his proposal. I understand that a pier/mooring pilings/boatli ft/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 do wish to waive that setback requirement.
- - - - - ---------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To. befilled in by individual proposing development)
e .N
oS�
(Applicant Information)
G/e-Warrtet-l),aMelli Lt�.u.l(S, tv
776 PkekChex o�d .
Mailing Address
— /p %l'ecoli'. `;k/
City/State/Zip
Telephone Number
Date
r
ti
J`
CD
------------� ------ ----- ---------
(Riparian Prouty Owner Intion)
Signature a
Print or Type Aip;e
_ `.,
Telephone Number
Date

BOBBY J BRIGHT 1236
[phone]
228 OCEAN SPRAY DR d� 55-30/531
CEDAR POINT, NC 28584 342
Date
P�ito the '
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order o
Dollars In
First Citizens
Bank
firstchizens.com
Forywm e2 �U( NP
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