36669_BREWBAKER, DOUG_20040416

~ QCAMA / ❑ 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
❑ Rules attached.
Applicant Name la `�) Project Location: County
r
Address ' %i - l r, 1' Street Address/ State Road/ Lot #(s)
Cis' State ZIP
ty
Phone #
Fax # (
)
Subdivision
Authorized Agent Y
City
ZIP
Affected C cW ©'EW
❑ PTA DES ❑ PTS
Phone # (
) River Basin
AEC(s): ❑ OEA ❑ HHF
❑ IH ❑ UBA ❑ N/A
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
(Scaler )
Pier (dock) length
H,r
_
�i' v 3, Al'�2
Platform(s)
Finger pier(s)le_�
Groin length
number
Bulkhead/ Riprap length
distance
avg offshore
max distance offshore
'
Basin, channel
J:
cubic yards
Boat ramp
Boathouse/ Boatlift
vr-
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;
A building permit may be required by:
Notes/ Special Conditions
See note on back regarding River Basin rules.
Agent or Applicant Printed Name r Permit Officer'sSigmifure
i x'- /
Signature ** Pleaserdacl Jcomplance siatement on back of permit"
ApplicationFee(s) ��y� Check#
Issuing Date
Local PlanningJurisdiction
Expiration Date
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
Iandowner(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:
Meuse 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
Mailing Address:
1638 Mail Service Center
Raleigh, NC 27699-1638
Location:
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293 / 1-888-4RCOAST
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
151-13 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

„
- -
FOLEY & FOLEY CONTRACTORS, INC.
MATERIAL ACCOUNT
PH. 252-636-2515 66-85/531
1810 OLD AIRPORT RD.
P.O. BOX 3482
NEW BERN, NC 28564'” DATE^o�
PAY AJ, �' - --- J s 36O of
TO THE - —
ORDER OF
1
J ✓j L -- -- - - - -- -- DOLLARS L
RBC
Centura
RBC Centura Bank
Jew ern, NC 28560 - w
FOR 32 �/� �FIL — I"UL&ia.L r
r� 36 c 3 o 4PL 36 �. 9 0 0 L 6 3 6 511'
G u 1.0 3 L008 5 .0 3 _
II 0000 2 9 2 2 _ -
L...�<_.Rlll.xgyl/) �«� �RtC;^>:Rl//1 _«_-•tRSx�wT.]))li-:�<= \R6.FS'Jl/Jr-;�_-"RL+Z£GJ121

m �
0
04/14/04 14:37 FAX Rol
To: Stephen Lane (Cams)
Fax#: [phone]
Date: April 14, 2004
Page#: 4
From: Foley & Foley (Sandy)
Phone#: [phone]
Customer Work Sheet
Customer Name: Doug Brewbaker Date: Aaril 14, 2004
Mailing Address: 308 Madame Moore Ln. New Bern, NC 28M2
Job Address: Saume Phone: [phone]
Adjacent Property Owners
Left Side: Dees Right Side: Cook
Job Type Description
Dock/Walkway 4'ft wide 100'ft long
Platform end of dock 8'ft wide 16'ft long
Finger Dock 3'ft wide 16'ii lobe total
Boathouse
Boatlift/jet ski
Piling See attached drawine
Ramp/Jetty.
Dredge
Rip Rap

04/14/04 14: 37 KAX [a 02
ADJACENT' RXPA RUN PROPERTY OWNER STAT
EMENT
(FOI? A PIER/MOORING PJLJNGS/BDAZ'I.,IFI)BDATMOUSE)
I hereby certify that I own property adjacent to ( - �s
(Nome o[ Proptrty Owner)
property located at ,,,
(tot, block, Road, etc.)
on l k�� .�c'vc , in /Z 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 nd objections to his proposal. I understand that a pier/mooring
pilings/boadift/boathouse must be set back a minimum distance of fifteen feet (151) from my area
of riparian access unless waived by me.
I do no wish to waive the setback requirement.
I d4 wish to waive that setback requirement,
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
Aets /0,
Signatu
Print or Type Name
Telephone Numbe
Date, a

04/14/04 14:37 FAX Z 03
ADJACENT RIPARM Pit oPEtTy OWNER STATEMENT
(FOR A PIERIIKOORING PILINGS1Ro4TLIFI1N0ATH0USE)
I hereby certify that I own property Adjacent to ��� Is
(Name of Property Owner)
property located at _ raj rh0-�
(Lot, Illock, Road, etc.) -
►—W __
(Waterbody) (Town and/or County)
He has described to me, as shown below, the development he is proposing at that
location, and, I have nil objections to his proposal. I understand that a pier/mooring
PilingilboatliR/boathouse must be set back a minimum distance of fifteen feet (15') from my area
of riparian access unless waived by me,
I do no wish to waive the setback requirement.
I AQ wish to waive that setback requirement.
__--_.-__ -- _----•--- —--------- -----------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMiENT:
(To be filled in by individual proposing development)
---------------------------------
signasur,� - - —
Print or Type Name
Telephone Number /
Date: � 5` 64

3D? Mo41&wto Adamwi Aki z
- - ' wC �f
t
Is
Aj
2 1
a � }
/la I
ri D` O