47026_YELVERTON, CONSTANCE_20061114

16
❑CAtL`,t / ❑ DREDGE & FILL DDT
.. 3M- 1
GENERAL PERMIT
Previous permit #
❑New ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources u
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC
❑ Rules attached.
Applicant Name / r Project Location: County
Address Street Address/ State Road/ Lot #(s)
City State ZIP
Phone # () Fax # ( ) Subdivision
Authorized Agent City ZIP
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Phone # ( ) River Basin
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body (nat /man /unkn)
❑ PWS: ❑ FC:
ORW: yes / no PNA yes / no Crit. Hab. yes / no Closest Maj. Wtr. Body
Type of Project/ Activity
Pier (dock) length
Platform(s) k
Finger pier(s)
Groin length -
number
Bulkhead/ Ripraplength
avg distance offshore _ _ _ •__ —._ _ J
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
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: _
Notes/ Special Conditions
r i .
(Scale: )
- ! Lei' ��—�_❑! _:�_� �
---- — ---I
❑ See note on back regarding River Basin rules.
IkA-
Agent or Applicant Printte7d (jN'ame IVIU1011040%wa %W.0116 it Officer's Signature
Signature Please read compliance statement on back of permit Issuing Date Expiration Date
Application Fee(s) Check # Local Planningf urisdiction Rover File Name

A _4A
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:
El 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 Elizabeth City District
Mailing Address: 1367 U.S. 17 South
1638 Mail Service Center Elizabeth City, NC 27909
Raleigh, NC 27699-1638 252-264-3901
Location: Fax: [phone]
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
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

ADIACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSIBOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to's
(Name of Property Owner or Applicant)
Mailing address if different from location address ff t f ,
(town, state and zip) 'n rt w Poi,t h e�c.UG- U4, A 3 6 aP
phone numbers you can be reached at 757 k2U 3 7 L 4- ,
property located at
v0d
(Lot, Block, Road, etc.) on �J -l..t c/ )PdtZ 4iut4-1 , in -/11 6"-e-d �Z CA4ce% °c-�' . , 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/moor' t ift/boathouse
must be set back a minimum distance of fifteen feet (15) from my
waived by me.
&I _ I do not wish to waive the setback requirement. NOV 1 2906
initials
D W SqZ I do wish to waive that setback requirement. MweNled Gity ®C;M
initials
1-- �J to
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
K'1 „T,C4e— 2-`/2-
------------------------------------------------------------------ ---------------------------------------------
sigature
coo y G Li
Print or Type Name
Telephone Number
Date: �( —[ — 0

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGS/BOATLIFT/BOAMOUSE)
I hereby certify that I own property adjacent to (11 A Al CC, U%V7otJ 's
(Name of Property Owner or Applicant)
Mailing address if different from location address Y1 F )ndAhdai
n,
(town, state and zip)"n-&--) Ik • -23 b-d ,
phone numbers you can be reached at 1,5 7-Y'?�
property located at
J (Lot, Block, Road, etc.) a
on-h 2c�J P l� AlvtV , in tom[ �M % C- 'CetA • , N.C.
(Waterbody) (Town and/or Count
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. �;191VED
. �• I do not wish to waive the setback requirement.3
(�l`
initials
I do wish to waive that setback requirement. N©Y 1 ?QQ
initials _
Moreh6ad MY DCM
-------------------------------------------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
E.E. , --r, d ,: 2 12 -
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----------------------------------------------------------------- ---------- - - --------------
----------
tgn ure
Print r T e Name
Telephone Number
Date: 11116O6
www.nccoastalmanagement.net/Permits/ADJACENTRIPARIANPROPERTYOWNERSTATEMENT.pdf

JEWELL V GREEN
508 N 11th St
Morehead City, NC 28557
WACHOVIA
Wachovia Bank, NA.
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