37273_BETTIS, TIM AND MARGO_20040120

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❑ CAMA / ❑ DREDGE & FILL
GENERAL PERMIT Previous permit #
❑New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
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
O Rules attached.
Applicant Name
Address
City State ZIP
Phone # ( ) ;'y- 1'�t�" Fax # (,
Authorized Agent 47, A4 c,�
Affected ElCW ❑ EW 2 PTA ❑ ES ElPTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS: ❑ FC:
ORW: yes / no PNA yes / no Crit. Hab. yes / no
Type of Project/ Activity
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision
City ZIP
Phone # ( ) River Basin "i+4
Adj. Wtr. Body ! iCnat. /man /unkn)
Closest Maj. Wtr. Body. t ' •?
(Scale: A, Ivl )
Pier dock length
Platform(s) '(- '. I ( 1 � L' r - v ►- 1
Finger pier(s)
Groin length r
number --- --- — --
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
;- V
Basin, channel _ — -- -- --
cubic yards_
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
j
y?• J
1 \
anoreune Lengtn
SAM not sure yes no i
Sandbags: not sure yes no
Moratorium: n/a yes iho
Photos: yes no
Waiver Attached: yes q_o
A building permit may be required by:
Notes/ Special Conditions
i
Agent or Applicant Printed, Name
See note on back regarding River Basin rules.
r.
Permit Officer's Signature
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
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 consistentwith the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
1 l Tar - Pamlico River Basin Buffer Rules [ ] Other:
[1 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 / 1-888ARCOAST
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.nccoastalmanagement.net
Revised 10/05/01

OUTER BANKS MARINE CONSTRUCTION BB&T
1501 FIRST AVE BRANCH BANKING
MOREHEAD CITY, NC 28557 AND TRUST COMPANY
[phone] MOREHEAD CITY, NC 28557
66-112/531
PAY TO THE
ORDER OF .
D.E.N.R.
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MEMO 61 C 3 72 7,3 / 3 )Z S�4
u'0063lCo' 1:0531011 211:1 2310 15 2951I'
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DOLLARS 8;
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OUTER BANKS
MARINE CONSTRUCTION
1501 First Avenue, Morehead City, NC 28557 DOCKS - SEAWALLS - FLOATING DOCKS
[phone] Dealer for Tide Tamer Boat ifts
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OUTER BANKS MARINE CONSTRUCTION
1501 FIRST AVE
MOREHEAD CITY, NC 28557
[phone]
6255
12/17/2003 -
PAY TO THE
ORDER OF D.E..N.R. I $**100.00
One Hundred and 00/100***************************************�`**************`**T ***** DOLLARS 8
193OWN
BB&T
BRANCH BANKING AND TRUST COMPANY
MOREHEAD CITY, NC 28557
66-1121531 --
MEMO robinson _
11600625511' ':05310LL21I:L2310L529511'
OUTER BANKS MARINE CONSTRUCTION
D.E.N.R,
12/ 17/2003
AV
6255
100.00
BB&T Checking robinson 100.00

ENDORSE HERE
DO NOT WRITE. STAMP OR SIGN BELOW THIS LINE
RESERVED FOR FINANCIAL INSTI TUl ION USE *
4 FEDERAL RESERVE BOARD OF GOVERNORS REG. CC
CheckLock Security System. Chemically Reactive Paper, Micro -Print
Signature Line, Padlock Icon on the front and Original Document
1 Security Screen on the back.
Padlock design is a certification mark of Check Payment Systems Association

Tim Bettis 252-727-9052 p.2
C z sZ) D k C I�, 2003
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIl? WUNCOVERED J30AT 1AFT)
I hereby certify that I own property adjacent to S
(nW- a n VY
property located at 1� I
on _ , in �C NC
He has described to me tis shown below, the development be is proposing at the
location and I have no objections to his Pwl? al_ I understand that a pier/uncovered boat
lift must be set back a minimum distance of fifteen feet (15') from my area of riparian
access unless waived by rne.
I do not wish to waive the setback requirement-
1 do wish to waive the setback requirement_
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filed in by individual pmpnsing development)
r
d
b
Print or ype Name
elcphone NLunber
Date'

Tim Bettis 252-727-8052 P.1
DEC 17 2003
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/UNC OVERED 13OAT LIFT)
1 hereby certify that I own property adiacent to I_� / "af'
(nuaic u1 ptl!T-Fl uev 1C
property located at 3m BC0101
put, blwk. it,
on NC
( r bodY) n and/or county) -
iie has described to me as shown below, the development he is proposing, at the
location and 1 have no objections to his proposal, i understand that a pier/uncovered boat
lift 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
T do wish to waive the setback requirement_
DESCRIPTION AND/OR DRAWING OF PROPOSM DEVELOPMENT
(To be filed in by individual proposing development)
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mature
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Print or Type Name
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Telephone Number
Date: //r- 2 3 ^ o 7