38886_CAMPBELL, C RAY AND TERESA_20040706

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GENERAL PERMIT Previous permit#
[New -]Modification E.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 • : 54-1 Project Location: County
Address a "lj ► )>:. ,` Street Address/ State Road/ Lot #(s)
t
City �:`y� k _ State ZIP
Phone # Fax # ( ) Subdivision
1
Authorized Agent %,-j a ; <, , CityZIP - J t 1
Affected - CW ❑ EW VPTA ❑ ES I PTS Phone # ( ) - River Basin
AEC(s): OEA C HHF [IIH ❑ 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
Pier (dock) length I� `,•. I
Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards `
Boat ramp
f--r
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
T-
Waiver Attached: yes
no
A building permit may be required by: `t
Notes/ Special Conditions
. i k-, )7 V -A ' III � .1l
Agent or Applicant Printed Name
(Scale:
F— See note on back regarding River Basin rules.
c
t t4 i •
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, certifythat this project is consistentwith 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
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-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

TERRY C. CAMPBELL,, 2422
C. RAY CAMPBELL
DL 2370763 66-7704/2531
3013 CAMPBELL RD PH 851-6259
RALEIGH, NC 27606 z Z 0 0�z
PAY TO THE L'
ORDER OF
State Employees' Credit Union
101 Raleigh, North Carolina
FOR \ _ Fes/ (� �(./� p CA v • � M1„
1:25317 70491:086055720061" 2422
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FEB-04-2004 WED 01
AI)YAf-F,NT 1tYY'ARIAN PROPERTY OWNER STATI+:MFNyf
(FOR A PIF.RIA40ORIN(;I'ILIN(iS/I3OATI_ii.-rIBOATHOUSE)
ere�c� � L4'
I hcn,by certify that I own property adjacent to C , }�a, E� C. .�
(Nanic of Property Owner)
prol..)i:rty kx.'Ate t1 at 3 COY&- � 6 _..
Block, Road, etc.
(Waterbody) ('down urid/orComity)
He has described to me, as shown below, the development he is proposing at that location,
anti, I have no objections to his proposal. I understand that a pier/mooring
pilings/bcxitlift/t>oathousa 111List be set hack a minimum dislance of fifteen feet (15') from my area
of riparian access unless waived by me.
i� I ��� ►loll wish to waive the setback requirement.
I !j.Q wish to waive that setback requirement.
---------------- ----.•--------------------------•---
nrSCIt1T'TION ANT)/011 DRAWING' OF PROPOS1:ID DEVELOPMENT:
('fig he filled in by individual proposing development)
JUL 0 1 2004
Morehead City DCM
Sih aturc
Print or 'type Name
zsz-225-7%��
Telephone Niollber
Date: el, / ;�—> — d /

FEB-04-2004 WED 01:37 PM NC DIV OF COASTAL'�nMEF
ADJACIENI' 111PAMAN PROPEWIT OWNER STXfEMENT
(r,OR A PIERIMOORING PILINGSIBOAP1.11TII;OATHDUSE)
I hereby certify that I oNvn property adjacent to _C •�cr ���r� C'��%���f
(Namle of roperty Owner)
property located at _2 4L3 _CoY2; S OUKA t-oo 'o j ^,
(Lot, Block, Road, Cu.)
n n , in�cc�'t 'c, Pa eNe / Cot�x� , N.C.
can owOL T �'S
(Waterbody) (Town and/or C only)
He has dcscribul to me, as shown below, the development he is proposing at that location,
and, X have no objec ions to his proposal. I understand that a pier/mooring
l5ilinf+s/boattift/hoathc�use must be set back a minimum distance of fifteen feet (15') from my area
of riptirian access unless waived by me,
I sh(j_uA wish to waive.. the setback requirement.
I ()o wish to waive that setback requirement.
__ - - - ---
T)I,SCRIPTION AND/OR DRAWING Or PROPOSED DEVEIMMENT;
(To be filled in by individrtal ")posing development)
5 �e- At Ge-a e�
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JUL 01 2004
Morehead City DCJ�A
-re ei�honc Number
Date:

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