51530_CLIFTON, LARRY_20071012

101)*l 15
❑CAMA / ❑ DREDGE & FILL 0^'A0'
GENERAL PERMIT Previous permit#
c
❑New ❑Modification El Complete Reissue ❑Partial eissue 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
City
State
Phone # O
Fax # ( )_
Authorized Agent
❑ CW
❑ EW ❑ PTA ❑ ES
Affected
AEC(s): ❑ OEA
❑ HHF ElIH 1-1UBA
❑ PWs:
❑ FC:
ZIP
❑ PTS
❑ N/A
ORW: yes / no PNA yes / no Crit.Hab. yes I no
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision
City ZIP
Phone # ( ) River Basin
Adj. Wtr. Body (nat Jman Junkn)
Closest Maj. Wtr. Body
Type of Project/ Activity
(Scale: )
Pier (dock) length
i
Platform(s)
Finger pier(s) r
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift f
Beach Bulldozing
Other
i
_
7
1
-I
_
I
( �
Shoreline Length 1
SAV: not sure yes no AA
/ i
(/ -4
Sandbags: not sure yes no If
Moratorium: n/a yes no
Photos: yes no, 1#
Waiver Attached: :yes no
A building permit may be required by: ❑ See note on back regarding River Basin rules.
Notes/ Special Conditions
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
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 I) 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 (910-796-7215) for more information on how to comply with these buffer rules.
Division of Coastal Management Offices
Raleigh Office
Morehead City Headquarters
Mailing Address:
400 Commerce Ave
1638 Mail Service Center
Morehead City, NC 28557
Raleigh, NC 27699-1638
252-808-2808/ 1-888-4RCOAST
Location:
Fax: [phone]
2728 Capital Blvd.
(Serves: Carteret, Craven, Onslow -above
Raleigh, NC 27604
New River Inlet- and Pamlico Counties)
919-733-2293
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)
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
910-796-7215
Fax: [phone]
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)
Revised 08/09/06

DIVISION OFCOA_STAI-NIANAG M YT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVU, F
FORT
Name of individual applying for the permit:_L—Y-)� r'—Ie-y �r C L-r FT'o (i
Address of p. (Jperty :- U =1'� ... C—,
(Lot Or ,Street#, street of road)
Mailing address:^� a crtC?
(City & County)
Phone number you can be reached at d 33 4 "7 ^ 5a-6 ,3(a- 7Z4 ! !
I hereby certify the I own propel q adjacent to the move referenced property. The
Individual applying for this permit has described to we (as shown on the attached drawirg)
the development they are proposing. A description or drawing, with dimensions, should be
provided whit this letter.
✓I have no objections to this proposm
If you have objections to what is being proposed, please write the Divi8ioxl 0£ coastal
Nfangemeat, 400 Commerce Ave., Morehead City,'NC 2855" or call (2,52) 808-2808 withiix
10 days of receipt of the notice. No response is considered the same ,as no objection if you
have been rordfied by C:erUrIcA iYIai 1.
Waiver Section
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift or sandbags
must be set bade a minimum dxsmee. of 15' From my area of riprap access aaniess waived
by me, (If YOU'wish tO waiIIe the setback, you -n-ast initial the appropriate blank below.)
�I dQ Wish to waiye the 15' Wback requirement
---- t dfl not wish to wai°ie the 1.5" setback requirements
Print Name
37
hPrt§ nub with ana

A AA- AA:/,V LTA17.iA1 ` AI, &/ 1 V ill t
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER
FORM
Name of individual applying for the permit:
Address of property: d'9 0-- h u V--c-h A-rc ?.._ n'U'C
(Lot or street#, street of road)
�� Po izT lIL A O S -70
Mailing address: oP- D Ct C�h v z2�t� G-r�T 14 nl
h1w Po.i NC— © e-i
(City & County)
Phone number you can be reached at a - 5 D y - 33 ; `7 ' d 2 a� 70 ! 1
I hereby certify the I own property adjacent to the above referenced property. The
Individual applying for this permit has described to me (as shown on the attached drawing)
the development they are proposing. A description or drawing, with dimensions, should be
provided whit this letter.
—/—I have no objections to this proposal
If you have objections to what is being proposed, please write the Division of Coastal
Management, 400 Commerce Ave., Morehead City, NC 28557 or call [phone] within
10 days of receipt of the notice. No response is considered the same as no objection if you
have been notified by Certified Mail.
Waiver Section
I understand that a pier, dock, mooring pilings, breakwater, boathouse, Lift or sandbags
must be set back a minimum distance of 15' From my area of riprap access unless waived
by me. (If you wish to waive the setback, you must initial the appropriate blank below.)
do wish to waive the 15' setback requirement
I do not wish to waive the 15" setback requirements
zitgz wrle j) I Date
� 'i/7 i ! f
Print Name
Telephone number with area code

" RRY G CLIFTON
VICKIE STOUT CLIFTON
PH- 252-504-3317
229 CHURCHGATE LN
NEJVPORT, NC 28570-W53 1809
91a ss-t 1vs31
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/o 01301
Blia S 1536f,
BRANCH BANpNG
�40REHEAD AND TRUST COMPANY IIIII�
�J ITY, NORTH C OLINq
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