38088_BRAZELLE, DAVID_20040402

1CAMA / -I DREDGE & FILL
GENERAL PERMIT
Aevv ❑Modification Complete Reissue
i-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 —._ �c �` ,T%t . o r /0S,
City -i State lV C ZIP 7 /
Phone # /019 Fax # ( )
Authorized Agent d1i1,1' ., /X//
❑ CW
IKEW
PTA ❑ ES ❑ PTS
Affected
❑ OEA
❑ HHF
❑ IH ❑ USA ❑ N/A
AEC(s):
❑ PWS:
❑ FC:
ORW:
yes / no
PNA
es` no Crit. Hab. yes / no
(✓! t o a� Q
C
Previous permit #
Date previous permit issued
j
N'Rules attached.
Project Location: County '
Street Address/ State Road/ Lot #(s) A/vul.-
Subdivision
City t6,•.er , Ik ZIP ,1S5 `/
Phone # ( -'-2 ) Z,'/1�- Av0(, /River Basin
Adj. Wtr. Body �,fGt + fL, ! _�fr 4 nat man /unkn)
Closest Maj. Wtr. Body
Type of Project/ Activity
(Scale:
Pier (dock) length
Platf
Finger
Groi
Bulk
Basin
Boat
Boat
Othe
Shor
SAV:
Sand
Phot
Waiver Attached. • yes no
A building permit may be required by:,y, j p. XS
Notes/ Special Conditions
ee note on back regarding River Basin rules.
Beac
Mor
n length — G
number
head/ Riprap length
avg distance offshore
i
max distance offshore
channel
cubic yards r � f _
ram
house/�BoatliftJ {� Y�
� �
h Bulldozing_
� I _
eline Length
not sure yes /no r � : -•-_ # - i A
bags: not sure yes no
atorium: n/a yes
os: yes �o ) ...
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
.� �./d ! -11 rt V
Permit Officer's Signature€
Is niusls gExpiration Date
Local Planningf urisdidion Rover File Name
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
.� �./d ! -11 rt V
Permit Officer's Signature€
Is niusls gExpiration Date
Local Planningf urisdidion 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 [)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, certifythatthis project is consistentwith the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
❑ Tar- Pamlico River Basin Buffer Rules ❑ Other:
XNeuse 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 complywith thesebuffer rules.
Division of Coastal Management Offices
Central Office
Mailing Address:
1638 Mail Service Center
Raleigh, NC 27699-1638
Location:
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293 / 1-888ARCOAST
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)
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

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DECKS NI DOCKS 3155
CONSTRUCTION, LLC
PH. 252-637zl595 NCDL 8929001
499 CRUMP FARM RD. 66-112 53
ell
"NEW BERN, NC 28562 DATE C 0190
PAY
TO THE 7
ORDER OF —
DOLLARS
BIB&T
BRANCH BANKING AND TRUST COMPANY
NEW BERN, NORTH CAROLINA
FOR A-ALlA':i—'&"ZC L-L� 6-f-r-- SPOISk
00031,SSO :DS31011I,20:5]I,95626296iil
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGS/BOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to�)62- 's
(Name of Property wner)
property located at A4 , k-
(Lot, Block, Road, etc.)
N.C.
on �'� �17r� ��,/ �a� � , in �t/,.�,,v ,
(Waterbody) (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
pilings/boatlift/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 ISQ wish to waive that setback requirement.
------------------------------------------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
----------------------------------------------------------------------------------------------------------
,� "94
Signature
Print r Type Name
S
Telephone Number
Date: �-�`�

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
(Name of Property Owner)
property located at
(Lot, Block, Road, etc.)
on �w� �:- �, ,� , in e-�-i . , N.C.
(Waterbody) (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.
----------------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPiVIENT
(To be filled in by individual proposing development)
I
1
I �
------------------------------------ -----------------
Signature /
lam-
Print or Type Name
2� T-
Telephone Number
Date. Ly"

ADJACENT RIPARIAN PROPERTY OWNER STATENLENT
I hereby certify that I own property adjacent to %��� ��``�'��'� is
(Name of Property Owner)
property located at /,2- J L-
(Lot, Block, Road, etc.)
on in, N.C.
(Waterbody) (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.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development)
I
Signature
Print or Type Name
2-
Telephone Number
� G
Date: