51897_FRENCH, JERRY_20080104

❑ CAMA / ❑ DREDGE & FILL
G'%ENEL PERMIT
❑New Modification ❑Complete Reissue ❑Partial Reissue
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
aq�11s,6
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Previous permit #
Date previous permit issued
Applicant Name r Project Location: County
Address
_ ..
City
State
Phone # ( )
Fax # ( )
Authorized Agent l
❑ CW ❑ EW
O PTA ❑ ES
Affected
AEC(s): ❑ OEA ❑ HHF
❑ IH ❑ UBA
❑ PWS:
❑FC:
ZIP
❑ PTS
❑ N/A
ORW: yes /. no PNA yes / no Crit.Hab. yes / no
Rules attached.
Street Address/ State Road/ Lot #(s) _t ;
Subdivision
City ' r y,• % ZIP
T
Phone # River Basin f
Adj. Wtr. Body(nat-/man /unkn)
Closest Maj. Wtr. Body ? f L: r"}
Type of Project/ Activity
i
(Scale: )
Pier (dock) length
_
Platform(s)'
Finger pier(s)
Groin length
number
I
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
-
cubic yards_
... ..--
....... -
-
—
-
-
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
l
Other
_
Shoreline Length
SAV: 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: IZ i i, i `^ See note on back regarding River Basin rules.
Notes/ Special Conditions
r
Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit
Permit$Dfficer's Signature
Issuing Date Expiration Date
i
ApplicationFee(s) Check# Local Plan ningJurisdiction 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, certifythatthis 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/ 1-888ARCOAST
Location: Fax: [phone]
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
Fax:[phone]
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico Counties)
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

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/NIOORING PILINGSBOATLIFTBOATHO USE)
I hereby certify that I own property adjacent to J r-JZ-15A-)C %4 ,
s
(Name of Property OwDer)
property located atZ_03 4� J O C /f �S�rvu i Z/rNif- ,P uC lZ
(Lot, Block, Road, etc.)
on,DOCIZr CQi/LK , in CZ4A,' 5 Q 0/1-0 %34Mi -/Cu
It 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 no objections to his proposal. I understand that a pier/mooring pilings / boatlift / boathouse
must be set back a minimum distance of fifteen feet (15') from my area of riparian access unless
waived by me. (If you wish to waive the setback, you must initial the appropriate blank
below.)
I do not wish to waive
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
0 (To. befitted in by individual proposing development)
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--------------------------------- c-7,
Signature
Print or Type Name
o
Telephone Number
Date: 2 2,7 D

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Label/Receipt Number: 7006 2760 0003 4246 0533
Detailed Results:
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1-1� Delivered, December 21, 2007, l 2:03 pm, HAVELOCK, I} Enter Label/Receipt Number.
NC 28532
l' Acceptance, December 20, 2007, 3:30 pm, AYDEN, NC a- -
28513 —'
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12/24/2007

POLYWOOD, INC.
1371 STRICKLAND RD. PH. 252-753-4296
WALSTONBURG, NC 27888
PAY TO THE
ORDER
MEMO 1 �ZC'!'�lT L5 I(�� `1 /'
RBC CENTURA
RBC Centura Bank
II600 1, 2 L $II' i:0 5 3 L008 50l:0 7 30 68 5 3 5 SII.
66-65/531
004215
$ 200, 0 v
DOLLARS

GP 51897 C
n
Subject: GP 51897 C
From: Brad Connell <Brad. Connell@ ncmail.net>
Date: Wed, 09 Apr 2008 09:18:19 -0400
To: Lowana Barrett <[e-mail]>
Please modify this permit to show a 5' X 32' platform area for Mr. French. Thank
you!
Brad Connell <[e-mail]>
Coastal Management Field Representative
NC Department of Environment & Natural Resources
Division of Coastal Management
1 of 1 4/9/2008 9:51 AM