46767_THOMPSON, NORWOOD_20061121

❑CAmA / ❑ DREDGE & FILL
GENERAL PERMIT
❑New ❑Modification ❑Complete Reissue ❑Partial R i ue
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
Applicant Name
Address
City
State ZIP
Phone # (�)
Fax # ( )
Authorized Agent
❑ CW
❑ EW PTA ❑ ES ❑ PTS
Affected
❑ OEA
ElHHF ElIH El USA ElN/A
AEC(s):
❑ PWS:
❑FC:
ORW: yes / no
PNA yes / no Crit. Hab. yes I nc
Agent or Applicant Printed Name tuft
Signature ** Please read compliance
Application Fee(s) Check #
Previous permit #
Date previous permit issued_
[41kules attach(
Project Location: County(._.rs
Street Address/ State Road/ Lot #(s)
Subdivision
CityZIP
Phone # JUver Basin
Adj. Wtr. Body -O ^ ' } �, '` (nat /unkn)
Closest Maj. Wtr. Body
Permit Officer's Signature
Issuing Date Expiration Dat�
Local Planningf urisdiction 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 (910-796-7215) 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,
Orslow -below New River Inlet- and
Pender Counties)
Revised 06/29/05

P�
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F' 7
Morehead Oity DOM

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSIBOATLIFT/BOATHOUSE)
V •
I hereby certify that I own property adjacent t�- -mpeow 's
(Name of Propert Owner or Applicant)
Mailing address if different from location address 6�
(town, state and zip)
phone numbers you can be reached
property located at
_iwl l-Dry
(Lot, Block, Road, etc.)
on �o �Ca c?r.� , in , N.C.
aterbody) (Town an or County)
He has described to me, as shown below, the development he is proposfp"D
and, I have no objections to his proposal. I understand that a pier/mooring pilingmust be set back a minimum distance of fifteen feet (15) from my area of ripwaived by me. SEP - 2006
I do not wish to waive the setback requirement. Morehead City DCM
initia s
I do wish to waive that setback requirement.
initials
-------------------------------------------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
Signature
Print or Type Name
Telephone Number
ho
Date: 6 - 2" ` " � l�
www.nccoastalmanagement.net/Permits/ADJACENTRIPARIANPROPERTYO WNERSTATEMENT.pdf

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGS/BOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent i- �k � 's
(Name of Property Owner or Applicant)
Mailing address if different from location address �-/'D
(town, state and zip) _
phone numbers you can be reached at $�
property located at OAN\A
(Lot, Block, Rd�, etc.)
on "�I� CA�►``� , in , N.C.
(Waterbody) t— (Town and/or County) 1
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.
"✓ Ld I do not wish to waive the setback requirement. Lela \4y Itu
initials S E P 7 - 2006
I do wish to waive that setback requirement.
initials —
------------------------------------------------------------------------------------------ Morehead_City DCM
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
Print or Type Name/
�X`��
Telephone Number
r
Date:
www.nccoastalmanagement.net/Permits/ADJACENTRIPARIANPROPERTYOWNERSTATEMENT.pdf

4 d rnl e � I e a C k b r d e t a i I s.
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BLUE WATER MARINE 3966
CONSTRUCTION INC.
PO BOX 93
MOREHEAD CITY, NC 28557-0093
66-112/531
DATE. 02301
PAY
TO THE
ORDER OF c io o9v,
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DOLLARS
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BB,&-T N'll BRANCH BAMIGNG AND TRUST COMPANY X"e', x
MORE -HEAD CITY, NORTH CAROLINA (`/'1r_�=._.-.:_�._. ` _ .
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NORWOOD THOMPSON KS BANK, INC. 42125
442 112 East Main Street Clayton, NC 27520
Clayton, NC 27520 66-7075/2531
919-553-5400
9/6/2006
u PAY TO THE NC DEHR
ORDER OF $--100.00
One Hundred and 00/100—.******.***.**.****.,*.***.*.******..*************.****�****,************�*****�***�
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DOLLARS
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Division of Coastal Management
151-13 Hwy 24, Hestron Plaza II ota
Morehead City, NC 28557
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