37560_CANNEY, PAUL AND ADA_20040308

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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
❑ Rules attached.
Applicant Name '
Address c
City State ZIP
Phone # O Fax # O
Authorized Agent
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❑ CW
❑ EW © PTA
Affected
AEC(s): ❑ OEA
❑ HHF ❑ IH
❑ PWS:
❑ FC:
ORW: yes / no
PNA yes / no
❑ ES ❑ PTS
❑ UBA ❑ N/A
Crit. Hab. yes / no
Project Location: County
Street Address/ State Road/ Lot #(s)
R. 1
Subdivision �6 . , r . ' !
City ZIP
Phone # ( ) River Basin
Adj. Wtr. Body ! i - l (nat /man /unkn)
Closest Maj. Wtr. Body !
Type of Project/ Activity r-
(Scale: NG/''� )
Pier (dock) length
Platform(s) I
Finger pier(s) j
Groin length
number
Bulkhead/ Riprap length r
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp—
Boathouse/ Boatlift
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Beach Bulldozing
Other
Shoreline Length
SAM not sure yes no
Sandbags: not sure yes no
Moratorium: n/ a yes no
Photos: es no
Waiver Attached: yes
A building permit may be required by:
Notes/ Special Conditions =
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Agent or Applicant Printed Name
Signature* Please read compliance statement on back of permit
Application Fee(s) Check #
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Permit Officer's Signature
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Issuing Date Expiration Date t
J�1L30,4
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:
U 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 / 1-888ARCOAST
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
151-13 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

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RONNIE CHADWICK
CHADWICK CONSTRUCTION COMPANY
207 STEAMSHIP LN
NEWPORT, NC 28570-9688
PAY
TO THE
ORDER OF
BUT
BRANCH BANKING AND TRUST COMPANY
MOREHEAD CITY, NORTH CAROLINA
FOR�
0
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860311. I
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PH. 252-728-6878
66-112/531
DATE 02302
$
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UNITED STATES POSTAL SERVICE First -Class Mail
Postage & Fees Paid
o Permit No. G-10'
• Sender: Please prim out , riaddress, and ZED'+4 Iry.jhis bo i

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Information visit our webafte at
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ALEXANDRIA VA 22310
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Postage
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Certified Fee
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Return Reciept Fee
(Endorsement Required)
Postmark
Here
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Restricted Delivery Fee
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(Endorsement Required)
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$4.42
02/19/2M4
Total Postage &Fees
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Sent To !I
Street, Apt. No.;
or PC Box No. 7 L G a V 1
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PS Form :0, June 2002
■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
o that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on.the front if space permits.
1. Article Addressed to:
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A.
Zir' Agent
//(, �❑ Addressee
B. Received (Printed Name) I C. Date of Delivery
D. Is delivery address dif
If YES, enter delivery
3. ice Type
0 Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Articl- ,..1—
(Tram 7003 0500 0003 3917 7238
PS Form 3811, August 2001 Domestic Return Receipt 102595-02-M-1540

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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
FEB 2 4 2604
I hereby certify that I own property adjacent to _ �J4 u L �%� V'i 'f'q /-/,y �d
(Name of Property Owner) f
property located at eg.s-+
f (Lot, Block, Road, etc.)
on 41 U /2 in _ L V
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(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)
oC— -4:) Gov
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Signature
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Print or Type Name
Telephone Number
Date:
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