36762_BAWES, JOEL_20031223

❑CAMA / ❑ DREDGE & FILL
GENERAL PERMIT
❑New El 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 I SA NCAC
Previous permit #
Date previous permit issued
E] Rules
Applicant Name_ ` 1 Project Location: County
Address 1� i Street Address/ State Road/ Lot #(s)
City I State ZIP
Phone # (i} %'i Fax # O Subdivision
Authorized Agent City ZIP
F, CW a EW PTA ❑ ES _ PTS Phone # ( ) River Basin
Affected OEA ❑ HHF -i IH �_�� UBA 7 N/A
AEC(s): 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
Pier (dock) length
Platform(s)
Finger pier(s)_` __
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
Shoreline Length
SAM not sure yes no
Sandbags: not sure yes no
Moratorium: n/a yes no
Photos: yes no
Waiver Attached: yes no -------- �k - --- - — ---
A building permit may be required by:
Notes/ Special Conditions
Agent or Applicant Printed Name
(Scale: )
t
}
i
i
❑ See note on back regarding River Basin rules.
Permit Officer's
Signature *It Please read compliance statement on backof permit
41]j ..o .
Application Fee(s) Check #
Issuing Date; ' 1� ` l ` Epiration 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 (910-395-3900) for more information on how to comply with thesebuffer rules.
Division of Coastal Management Offices
Central Office Elizabeth City District
Mailing Address: 1367 U.S. 17 South
1638 Mail Service Center Elizabeth City, NC 27909
Raleigh, NC 27699-1638 252-264-3901
Location:
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293 / 1-888-4RCOAST
Fax: [phone]
Fax: [phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Morehead City District
151-B Hwy. 24
Hestron Plaza II
Morehead City, NC 28557
202-808-2808
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
910-395-3900
Fax: [phone]
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)
www.nccoastaimanagement.net
Revised 10/05/01

. ... ............ . ..
UPJl,.,TEDSTaTE5 t p PSTAL MONEY
Y ORDER 15-800
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SERIAL NUMBER YEAR. MONTH. DAY POST OFFICE U.S. DOLLARS AND CENTS
0272 0 720 2003-1 0-02 285570 W-T-110W 2 2
AMOUNTONE HUNDRED DOLLARS & Ooo
PAY TO TI
NEGUrIABLEABLE, ONLY IN THE U.S. AND�
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DEC 2 2 2003
ADJACENT RIPARIAN P OPERTY OWNER "ATEINIENT
(FOR A PIE `NCOV EREID BOAT L11, 71,
1 htrtby certify+ that I etwa property adjacent to _ ��__ s
(, me of Property Owner)
property located at
(Lot, Roxd, ete.j
�..___
in
Wat:rbodr) (Town attd/or County)
He hat described to aasat, as •bawn below, the davelopaanent he is proposi"g at that tioe:ataion.
mind 1 have no objectiofas to his proposal. I understand that a paer/v acovercd boat lift must be spe:t
back of ae MiSitunurim of fithesa (13') from easy are* Of ripaaf#aa tcress unless waived by me.
i do go wish to waive the setback requiraerntnt.
1 ilk wish to waive tbAt setback requirement.
DESCIUPTION AND/OR DRAWING OF PItOPOSED DEVELOPMENT,
(To be filled in by individual proposing development)
1
-5
I
(
r +` 7*_.
Saga�aiture .�.._ Pram or Tyke Name
Telephone Number Date
4

UM 2 2
ADJACENT RIPARIAN PROPERTY OWNER s'TATEI'v�ENT
(FOR A PIS NCOVERED BOAT Y, IVI
1 hertby certify that 1 own property adjacent to � _ _ ____�.'s
( ame of Property Owater;
property Wated at
(Lot, sl k, axa<:i� ete.)
on in _ _ _ __�� NC.
arterhndy) (Town att�d/or Couttty)
He has described to one, as sbown below, the development he is proposiMS at that lrocstion.
and 1 ►ave me objections to his propo®al, ! understand that a plerlancovere.d beat lift must be fret
back at # sainissum of fifteen (15') from my atv% of riparian ssscess unless ~valved by me.
1 wish to waive the setback requirement.
X 1g wish to waive That setback requirement.
DESCRIPTION AND/Olt DRAWING OF PROPOSED DE'V£LOPMENT:
(To be filled in by individual roposing development)
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� ��t►aataafe� �
Telephone N%jrnber
A 4�z) -Z-3 S
1
~.~ Print Ur Type Name
Date