47066_SCHAUMLOFFEL, TODD_20061204

❑CAMA ! � DiriEDGE &FILL
GEIVEiiAL 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. I
Applicant Name j ID ✓,^
Address c.
City ; -�+. �. '� • t h o State h C- ZIP.-'
Phone # ( '' �) L(+� - '� 3 Lj I Pax # ( )
Authorized Agent
71 CW ] EW PTA El ES ❑ PTS
Affected -
AEC(s): E OEA HHF ❑ IH ❑ UBA ❑ N/A
PWS: ❑FC:
ORW: yes / no PNA yes / no Crit. Hab. yes / no
Project Location: County f L& rnl , LC
Street Address/ State Road/ Lot #(s) 2 S i 1.` e, a r c s
Subdivision
City ZIP .� . s- l 0
Phone # ( ) River Basin t,�C.,>S 2
Adj. Wtr. Body (nat an /unkn)
Closest Maj. Wtr. Body
Type of Project/ Activity �t-L or
/ G
(Scale:
Pier (dock) length
Platf
Finge
Groin
Bulk[
Basin
Boat
Boatt
Beac}
Othe
Shore
SAM
Sandi
Morai
Photc
Waive
orm s
r pier(s)
length — I -
number
ead Ri ra length
-r---= --
Riprap gt
avg distance offshore - ---- -�- - -� --- - i - -- - -- --i-II i
I
-- - - -
max distance offshore --
channel -
rubic yards -
amp --: ji - -
_ - -LJ- --
OUS4 Qatri � • i-. I '
_ I
Bulldozing
I
II _
line Lengthnot sure yes •no)
-
no
ags: not sure yes gn� 1--orium: n/a yes \ -- - -
s: ye no --- - - - - -
rAttached: ayes no - _ ---_-_
A building permit may be required by: See note on back regarding River Basin rules.
Notes/ Special Conditions
Agent or Applicant Printed Name l / Q E C 1 5 0 0 0 bPermit Officer's Signature
� ,�
Signature Please read compliance statement on b Expiration Date
i�l�ead City MY k i,.o
rr� !
Application Fee(s) Check # Local Planning Jurisdiction Rover File Name
A building permit may be required by: See note on back regarding River Basin rules.
Notes/ Special Conditions
Agent or Applicant Printed Name l / Q E C 1 5 0 0 0 bPermit Officer's Signature
� ,�
Signature Please read compliance statement on b Expiration Date
i�l�ead City MY k i,.o
rr� !
Application Fee(s) Check # Local Planning Jurisdiction Rover File Name

'i.
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 consistentwith 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
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
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
400 Commerce Ave
Morehead City, NC 28557
202-808-2808/ 1-888-4RCOAST
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
910-796-7215
Fax:[phone]
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)
Revised 06/29/05

ADJACENT RIP:ARLAN PROPERTY OWNLR STATEMENT
(FOR A PIERAMOORING PILINGSIBOATLIFTIBOATHOUSE)
I hereby certify that I owns property adjacent to -7—OW %AvML-Dr-Ff--G- 's
(Name Of Property Owsaer)
Property located at 4�A �� bye- fir— WAff 7F--
9
(Lot, Block, Road, etc.)
on ��A��� ��- , in AP7&rM0'F-- , FAML1G� (�j.
(Waterbody) ,. N.C.
(Town and/or County)
He has described to me, as shown below, the development he is proposing at that
Iocation, and, I have no objections to his proposal. I understand that a pier/mooring
pilings/boatlifl/boathouse must be set back a minimum distance of fifteen feet (15') from my area
of riparian access unless waived by me. -
I do not wish to waive the setback requirement.
I do Kish to waive that setback requirement.
DESCRII'TION AN-D/OR DRAINT iG OF PROPOSED D�LOP.N�'To
(To be fiUed in by indit dual proposing development)
K�- �K Ex�s-tlr�v Plt✓IZ
� poGK. AS N E�DED�
J
BOAT L-IFT
Signature
Print or Type Name
Telephone Number
P-�AIQ
-- L AOMlDf ft:, �
GM1;N7

ADJACENT 1U PAARIAN pR®PER I
{FOR A PIERIMOORING p2UNGSBt
I hereby certify that I own property adjacent to
property located at�'����
(Lot, Block, Road,
on ����✓�� L am- , in AV W22\ffp'F-- , FAML-) - D
, - 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 (I5') from my area
of riparian access unless waived by me. -
I do not wish to waive the setback requirement.
I do wish to waive that setback requirement. f
DESCRIPTION A-NL -D/OR DRA*VlT G OF PROPOSED DEVELOP.�JEN7o
(To hefilled in by inditidual proposing development) F—�'Z TAt-J
K�- �K Ex�szir�v P1i✓IZ
DaGK AS N E:eDeD�
Signature
SGE4A0MlDfI=ft-
E3oA-r W FT -
fA1: �T
CIEVAE4
Print or Type Name
Telephone Number

TODD J. F.SCHAUMLOFFEL
NANCY 1 L. SCHAUMBE�SDS CREEK p OFFEL
ARAPAHOE, NC 28510
TO THE
ORDER OF
WA+cIM01 7U
Wachovia Bank, N.A.
gcnovie.cmc
L
FOR`-
u•006LL2" --_
W2
6&21/530
BRANCH 44717
DAT�E(��