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CAMA / L7 DREDGE & FILL WGENERAL PERMIT
New r_1Modification CComplete Reissue LIPartial 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
Previous permit #
Date previous permit issued_
11 E Rules attached.
Applicant Name C 1,v � o _>c 4 Project Location: County / r+ I
Address r A Jilrf Street Address/ State Road/ Lot #(s)
City--! h, ,.- f i jl State "Jt ZIP
Phone # O ,; r - ?t'�'�i Fax # O Subdivision
Authorized Agent t 110 City P''nri f,c, < < - ZIP !C 'L
Affected ❑ CW C7 EW PTA ElES ❑ PTS Phone # O River Basin
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ USA ❑ N/A Adj. Wtr. Body ti r, r Wo r t !oy.c ( i ' nat /r»an /unkn
❑ PWS: ❑FC: - )
Closest Mal. Wtr. Body
ORW: yes / no PNA yes /rnq/ Crit. Hab. yes / no
Fc.f' Jcy'^tl
Type of Project/ Activity i is G 1, d o (11 .1
Pier (dock) length
Platform(s) t c ' /f I:
Finger pier(s)
j
(Scale: n,cIv )
Groin length
number
Bulkhead/ra
PP 8t Ri length___
avgdistance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramptR,
Boathouse/ Boatlift
Beach Bulldozing__ .
Other ---
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Shoreline Length
SAV: 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:
Notes/ Special Conditions
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I
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❑ See note on back regarding River Basin rules.
Agent or Applicant Printed Name "
er ' —7
Signature ** Please read compliance statement on back of permit
.4 r- <,.i ( ;. ((VI
Application Fee(s) Check #
Permit Officer's Signature
Issuing Date Expiration Date
�
/ L t NFU[ J
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: 919-733-1495
Fax: 252-264-3723
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Morehead City District
15 I -B Hwy. 24
Hestron Plaza II
Morehead City, NC 28557
202-808-2808
Fax: 252-247-3330
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico Counties)
Washingtton District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax: 252-948-0478
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-395-3900
Fax: 910-350-2004
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)
www.nccoastaimanagement.net
Revised 10/05/01
WA'j -rs �2� -
fve-0
ERIC B. ELLIS NCDL 65047 (- 3S-3S� A�A�Gv`,�l ��`� 2764
JASA M. ELLIS PH (252) 726-6775 3�
205 NOTTINGHAM DR. ZoUis`A 66-36r531
MOREHEAD CITY, NC 28557 B�� Date e 133
mil. E4.J A L
Pay to the
Order of �C /il I a00' o d
T-(&2pyAzwr-c C " ���� _,Dollars 8 =x__.
FIRST CITI7CN5 »> Qg5l
��I First tsc ftns Bank 8 Trust Company
I� Atlantic Boach. N C. 28512
www.firstcitizens.com Ir
ForA Y1Et'9atf-cx fFl"McyS
':053L00300 0013L7448780)102764
GUARD IANP SAFE1`I BLUE ESBL
ADJACEMI' R)--Ai11VFTY 0WNJ',T ATENE 4UtA I11RRSIT-
"FOR A PIERAINCO VERED B 0A 7- 11 !F7)
I hereby c!rtfy that I own property adjacent to &cc Cj
I I e of Proper
L
property located at of
(Lot, Block, Ruad, etc.)
.n tie i, (a -1
N. C.
"(Waterbody) (Tow-u arid"OrIC-o nty)
He has described to me, as shown below, the devriupt;icn[ he is propcsin at that
loc-ation, and, I have no objections ections to his prot>oszxJ. I undeTst',nd i;hiar a plerlunco,,,cr-ce boat HE,
must be sell back a minimum distance of fift=q fc—1 (15') from ni -a of riparian acc,-,s unless
WalVea by Me.
I do not wish to waive the setback re::juir-,--nent.
I do wish to waive that setback reauLrernent.
--------------------------------------------------------------------------------------------------- — --------
DESCREPTIOLN A-N-D/OR DRAWING OF PROP01 -SEI) DEVELOP_NLE:-I_T:
(To be jUied in tit I adi Y udu.,_-d 0 --171 E ILI 6!1111?-n ef7f)
-T f
ale WAq
Mean Low U_Vler 4
wn 0(4�61_m
-Ilea, h 15 AOCVI- _VS :SC* ba-CV, 0A_ 1eck,<S14
V3 -lj�. Cr(�� ii,�e- 100urdour,
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--------------------
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000��
Signature
Print or t�Ojlle
Tz-1,--phone Nurrib,�.
Date:
0.-
•
A-DJACEMI' Rj.rr ur !- x 1' s
(FOR A PIERIUNCOV.ER.ED BOAT 1 IM
I hereby certify that I own property adjacent to
(Ni'4rtre of Property O i"ner)-
property located at_215otritre. fll�,�;c��cGr 1s�e Lo+
(Lot, Block, Road, etc.)
on We , in _ k6vy4ie-'�, N.C.
(Waterbody) (Town andi orI Co nty)
He has described to me, as shown below, the deve!opment he is propesin at that
location, and, I have no objections to his proposal. I underst.-.nd 1-,hat a pier/uncovered boat lift
must be set back minimum distant~ of rirter:c fit (15') from my, rea of riparian ac, e-s unless
waived by me.
I do not wish to wawa the setback requirement.
I do wish to waive that setback requirement.
- - ---------------- --- --------------------
DESCR.LP (D A-NFD/OR DRAW -PG OF PROP05EDi DEVELOPNIEN-I':
(To be filled in by iadividu -J y-;.,yosing "e.•e ,crnent)
Min Law
S 15 c ocW ►5 Sep jC oc� eC64
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Print or Typ,2 t'•L.Iaile --
Telephone Nuinb,;-r
Date: