48958_ROSE, JOHN_20070529

-
❑ CAMA / ❑ DREDGE & FILL
GENERAL PERMIT
Previous permit#
❑New ❑Modification El Complete Reissue
❑Partial R 'sue 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
Project Location: County
Address I �) 3
Street Address/ State Road/ Lot #(s) ' % ' % %y , : C) 4�
City c) \ C- State ZIR;
Phone # (II r l )9 -3 s,- 3 r,1 Z- Fax # (_)
Subdivision
Authorized Agent ._ ," J •; ,"\ �: A; \ \
CiZIP �2 `SS 5 9
El '❑ EW 0 PTA ❑ ES El
Phone # ( ) River Basin 2 >>^ \ c
Affected
AEC s : ❑ 0EA ❑ HHF ❑ IH ❑ USA ❑ N/A
Ad'. Wtr. Bod tVman /unkn
ORW: yes / no PNA yes / no Crit.Hab.
yes / no Closest Maj. Wtr. Body Lk fL
Type of Project/ Activity
Pier (dock) length
Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore -
max distance offshore
Basin, channel
cubic yards --
Boat ramp
Boathouse/ Boatli 12 x 12
Beach Bulldozing
Other ` -
s
Shoreline Length r
SAV: not sure yes l no
Sandbags: not sure yes n
Moratorium: n/a yes n
Photos: yes no
Waiver Attached: yes no
A building permit may be required by:
Notes/ Special Conditions
fir~/! M r
Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit
Application Fee(s) Check #
1 Z bC,.
(Scale: 1'; )
❑ See note on back regarding River Basin rules.
Permit Officer's Signature
�j- fi
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
landowners).
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/ 1-888ARCOAST
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

FEB-19-2007 10:35 From:NC DIV COASTAL MGMNT 2522473330 To:2523936146 P.1/1
ROW,
North Carolina Department of Envi'roinment and Natural: Resources
Division of Coastal Management
Michael F. Easley, Govemor Charles S. Jones, Director William G. Ross Jr., secretary
Date 5- 2-2- 0�
Applicstnt NameZl'1c�5.
Mailing Address � � I IT a �► l�
I certify that I have authorized (agent) �.� �" to act on my
behalf, for the purpose -of applying four and obtaining all CAMA Permits necessary to
install or construct (activity) -�.-
at (location)
This certification is
Signature
thru (date) _

Ap

AUG-11-2006 FRI 00:22 AM NO DIV OF COASTAL MGMNT
FAX NO, 4
OWNER
�l'(3Ii A I'Tlsl;lillool,71V(, PIL[t\'G.VIBOf4 rl,l 'TIIIO l Tf[OUSL)
f l+rrr-hy t.cEfify 01A 1 owit pry o0ay ndja-ent to _��1_`--
(M-1131c of Property OW110r)
P. 02
I
Huj,,, _ ljly i0clei:d SQL J 1� A �A-
- � ,
- - -- - -- ------
(,Steect Addi css, Loi,131ack, Road, etc.)
N.C.
ff ovyn amIlor County)
t lip/ l�; isr�y ticst:tihccl to itw, ass shown below, the development he/shc 'is proposing at that
lrycrttit��� �u;<l 1 ljavc lu, ()l)jcctio«s to this proposal. 1 understand iliat a pier/mooring
Faomc t1111st he set biok a minimum disi&nce of liilcen feet (15') from my uca elf
t i,?}l7'l�ti� i1CCi ;t4; tli3lt` �5 w.,jivocl by me. 1 have indicated my intentlon.5 by initialing below:
�l l (1,; etot w"rcc to N4.tivc: the 1 S' seffiack mquirciul,nt.
1 (t.) 71git!e, Iv waive tl.;; 15' setback rwquiremerlt.
_ 1)K8X" ,l l`'D f0N AND/O1t DRAN'VING 01? PROPOSEP DEVELOPMENT.
(1o hj! ft11c•rl i)r by hu1!v dual prqltoshuq develojima )
T 4 V Q k v. c, Al.,. At 1 O 1C 12 4 a
b o •-
7—& to x 1 Z
1.1
O
5ignalure
ftAV ILN
Piint or Type Name
0]10' 32 & - &
7: rkphonc Number
Onfur S l 2 4- � 0 7

AUG-11-2006 FRI 03.22 AM NO DIV OF COASTAL MGMNT FAX NO, 4
iAIMFt,CENY RH'Aib,IA R'14OPFI STY Oi'Y1`IER STXCEA'lleNt'
� (ol? A PIE'R/1110011UNG 1'11, i't\C '') ?IlI .1 `I'I. Ft' T/IIO/l MOUSE)
P, 02
i 1+rrr-fey c:citify th,lt ( owil props -fty adjamit, to f7j!�\fl ,5 e-- 'S
(i'ti,1131C of Property Owlccl)
(ic. i"oty Ioc"iti:d i1i ..- - -S 1p �-\; \\ - --- '- Q3, v-----
(,Steect Add css, Loi,Mack, Road, etc.)
cliff W k� _ O e. k (Z;�et; i'►-- - s.,a Ac.3 o ra , N.C.
MI'li=.,i lw'il) -.-..- .. - ..- (Town amII/or County)
Iltr,y cicsc:iihcd to it�u, its shown below, tllc developiii.ent he/she •is proposing at that
l,w.1, 6 a and I NIVU nu objectioi)s proposclt. I utxlcrstalul thit a picr/mooring
I�i!itiL;�:(l�nsltli! Ut�c�,:,l�ausc awst he set beck a minimiun disiwice of fillaen feet (1 S) irons my nrea d
lipaliaa liiilens waivtA by inn. I have indici led lily iliteiition3 by initialing
l Ela igq tk;ircc- to Nv.dve, the 15' se,& Wk requireiw,'nt.
_ I (I.) «gfk�e to waive tl:c 15' setback ivquirement.
AND1011 D dANVVlNG 01?PROPOSE)) I)EVLLOPME.NT:
("1,o Jie_ 11t•jl is:r !)y individual prvl+osius develol)MC111)
5 t o x 2 Ada. c� -fr •� Q, e Q
L,Stk
s
L]
IRI
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Si a ure
Print or Type Name
Tolophone Number

DOCKSIDE DOCKS
1406 WHITE OAK RIVER RD [phone] 1325
MAYSVILLE, NC 28555
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PAY DATE �'— C, Q 2 ss-3D/342
TO THE /, 342
ORDER OF
---- DOLLARS
t F)R.ST CITIZENS �
www.firstcitizens.com
FORAP
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