37585_CUSHMAN, LARRY_20040315

❑' CAMA / DREDGE & FILL
GENERAL PERMIT
[)'New Modification ❑Complete Reissue Partial Reissue
Previous permit #
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 !j %"• %/U "
Applicant Name �7
Address "� U ,S'/ 7e— i) GG/i1�
City /L/,eb St�l State A)C
Phone # Fax # ( )
Authorized Agent
Affected ❑ CW AE�-
W �PTA JES 71 PTS
- OEA [IHHF ElIH - UBA
AEC(s): N/A
—
C PWS: ❑FC:
ORW: yes / no PNA yes / no Crit. Hab. yes / no
❑ Rules attached.
Project Location: County 'V•,
Street Address/ State Road/ Lot #(s)
Subdivision
City CJ,y�' ,/ - ZIPSs C
Phone # 77/5• 3 River Basin I
Adj. Wtr. Body. %o '(nat `/man /unkn)
Closest Maj. Wtr. Body
Type of Project/ Activity
(Scale:_ )
Pier (dock) length
Platform(s) i
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshorr _�
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach BulldozingA
Other
Shoreline Length
SAM not sure yes no
Sandbags: not sure yes j no
Moratorium: n/a yes no
Photos: yes (no
Waiver Attached: yes--
A building permit may be required by:
Notes/ Special Conditions
l
_
..
__+I__
G
I
i
--
- _
i
-�
I
L
- -
i
I
1
%`
].
/ %
i rules.
S River Basin s
!!'
In
� �
• �r
�
r
0
'
� See note
4.-Y
on back regarding
8
Agent or App(iant Printed Name
Signature Please read compliance statement on back of permit
leo r✓
Application Fee(s) Check #
/1� Ile
r
Permit Officer's Signature,
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 consistent with 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.nccoastaimanagement.net
Revised 10/05/01

1247
Cushman r 66-152/531
Sheila A RCushman J DArL
y
0626
68DpointSL 'it 2PH 252`74544483 $ ��
Merritt, NC 28556-9655 A
PAY TO THE �/
ORDL•R,Pr , , „ ,�
WACHOVIA BANK OF NORTH CAROLINA, N.A.
WACHOVIA BANK OF NORTH CAROLINA, N.A.
BAYBORO, NC 23515
� rOR 3 � �'` 7
'
■ 0 fJ L 2 Wh,e 5�1 G�e�' fleSOn G�ao��cs'" 1997 All RIghls Heservetl
1:053LOL5291.
UES,UNEP CHECKS.' LIGHTHOUSES BY UONNA ELIAI

14 January 2004
Larry and Sheila:
Sorry if it seemed I was holding on to this. I just got it two days ago. I've been on the
road lately.... Work has been calling me to San Francisco. I was hoping to bring it in
person as I had plans to visit Oriental and reservations for this weekend, 1/15 through
1/18. The forecast for snow tonight and tomorrow caused me to postpone my trip there.
7 hours on the road without snow is more than enough driving for me.
Good luck with your project and I hope to see you all soon.
Regards and Happy New Year.
C+�V\

ADJACENT RIPARIAN PROPERTY OWN7ER STATEMENT
I hereby certify that I own property adjacent to Lgge^4 I
(Narneiift Property Owner)
property located at
(Lot, Block, Road, etc.)
on P in Ca C. se , N.C.
(''rti'aterbody) (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 DRA«'LNG OF PROPOSED DEVELOPMENT
(To be felled in by individual proposing development)
�v C v� $�f'" CJG/ cc Y�'i► / S � a/ /� �,/C U cJ/ K �j Ca u�c
GW
v
C..Li•�'+� er �� G��i /ice -: / �� �J/`CnG.. 4 30
00
11
�ec,). <3e-41 C-f17,aL4J
Ao-. To4., T /✓a.-r-i 3
i1�3 f?w.J, 41 �Z "ot D,'
i nature J
Print or Type Name
- s z �-
Telephone Number
Date:

�v
ADJACENT RIPARIAN PROPERTY OWNER S'I'ATENIIENtT
I hereby certify that I own property adjacent to Is
(Same Proper3 j Owner)
located at
property
(Lot, Block, Road, etc.)
(� 1 ' , N.C.
/Waterbody) (Town and/or County)
He has described to me as shown below, the developmtrit he is proposinIg at that location,
ard, I have no objections to his proposal.
DESCRIPTION ,A N'DIOR DRAWNG OF PROPOSED DEVELOPMENT
(To be filled in by ind:viduall proposing/ development)
G Vla
�
4 w� Gq �a7
��o roiic .-�• 7/ 2 F- G
G c
.�
Coe-'7 e� ✓! 4 ,�.�� �� r 71�le o
/Je. 0
fe
------------------------------- ------------------------------------------------------------------------------
13 e .-i
Signature
3 too % Print or Type Na,-e
c
'Telephcc�e tVumY�er
Date,-��' --