53376_MCDOUGALL, DAVID_20090326

i11 CAMA D DREDGE & FL&L
GENERAL PERMIT Previous permit # llNew -,141odification 0 Complete Reissue EPartiai Reis e Dateprevious permit issued fl6/("
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
Address !ice Me vy...
City
-trAl
i Statef-JC
zip-
7") 12Q57Phone # ) . 45'— F. #—
Authorize Agent,
Affected D CWO EW 'N PTA 5ES ❑ PTS
AEC(s): 0 OEA D HHF 01H D UBA El N/A
El PWS: OFC:
ORW: yes / no PNA yes / no Crit.Hab. yes no
Project Location: County y -1 \1
Street Address/ State Road/ Lot #(s)
Subdivision
City ZIP
River Basin 1J CO
Phone # (—Y
Adj. Wtr. Body_ - -----Jnat Lrnanjunkn)
Closest Maj. Wtr. Body
Type of Project/ Activity
(f
(Scale:
7VV
River Basin rules.
Pier (dock) length
Platform(s)
Finger pier(s)
Grain length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yar ds
Boat ram
p
Boathouse/ Boatlift
Beach Bulldozing
Other-
Shoreline Length
SAV: notat s sure ye
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
f
-7
4.
4-1
I
See note
on back regarding
Ci
PermitOfficer s
n Date
C,
Local
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
Si
nature
Issuing Date 4 Expi
Planning Jurisdiction f Rover
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
Si
nature
Issuing Date 4 Expi
Planning Jurisdiction f Rover

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
Raleigh Office
Mailing Address:
1638 Mail Service Center
Raleigh, NC 27699-1638
Location:
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
Fax:[phone]
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2868/ 1-888-4RCOAST
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

YARDBARBER MOWING
LANDSCAPING
CONSTRUCTION
PO BOX 328
ORIENTAL, NC 28571
[phone]
I »''1=ALL , GIVE MILES C. SHOREY IV
PERMISSION TO DRAW ANY PERMITS FOR CONSTRUCTION
ON MY PROPERTY.

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to O AL)i (J p1c_ 6 c (_--, p L(_ 'g
(Name of Property Owner)
property located at 9711, 20
(Lot, Block, Road, etc.)
on !�''� S �� t2 , in CJLt} c= �! �r :�%v i , N.C.
(NVaterbody) (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.
-------------------------------------------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development)
17116i vi E S---
l�
-----------------
-- - --------------- / ----------------- — ---- --
(Applicant Information) (Riparian Property Owner Information)
/%//L C_S ,''' tl;'
Alailing Address
n 1 t_
I L%X 1164 GTjc k'7fl C- t.
CioZtatelZip
Telephone Number
Date
Signature
Print or Type Name
9 1 u — 75'T —C; jl L
Telephone Number
Date
( -S' -- �g

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to OAui J < ,S
(Name of Property Owner)
property located at
(Lot, Block, Road, etc.)
on li US 416 a , in �Z i V%=A-i 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.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development)
(Applicant Information)
Affailing�address
cw
Ciry/State/Zip
Telephone Number
_%/ " f — Q h,
Date
cv-c lac c;
----- ---------------------
(Riparian (rope
Signature
Print or Ppe Name \ f
Telephone Number
l i -- 10 c
Date
livner Information)
C:) tvr-4-"'

YARD BARBER MOWING
MILES C. SHOREY, IV
NCDL# 2986772 PH# [phone]
PO BOX 118
ORIENTAL NC 28571
2999
66-30/531
a ` 0 472
! Date
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