55224_MITCHUM, ANNETTE_20100114

❑.CAKAA / ❑ DREDGE & FILL rY
GENERAL PERMIT Previous permit # F ��
�
Z7New ❑Modification ❑Complete Reissue ❑Partial Reisst,k 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 t� 2 E � +.
g �^ j RRules attached.
Applicant Name A �t, vr^� Project Location: County l at -tc�
Address 9j Ytl r 3 Street Address/ State Road/ Lot #(s)
City D.,.t,-s State Nl _ ZIP_
Phone # (2r) `1z1-?zf Fax # () Subdivision
Authorized Agent City ZIP `65<`1
Affected
❑Cw �Ew XPTA DES ❑PTS Phone # ( ) 72=1• -�4711 River Basin
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A Oft �} ctvn j
AEC(s): Adj. Wtr. Body nat /man /unkn)
❑ PWS: ❑ FC:
r Closest Maj. Wtr. Body O ro dvr�
ORW: yes / no PNA yes P no Crit.Hab. yes / no
Type of Project/ Activity
(Scale: )
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
1
I
Boathouse/ Boatlift
O
20
Beach Bulldozing
Other
I
Shoreline Length 2-50
SAV: not sure yes o
C
�
Sandbags: not sure yes -
Moratorium: n/a yes n
Photos: yes o
Waiver Attached: {yes
A building permit may be required by:
n j 4
❑ See note on back
regarding River Basin rules.
Notes/ Special Conditions��^,
l
1 (^)py�
1I\ 'tp ��,t }p,r ,�
p� pk•dk
Agent or (Applicant Printed Name
r
Signature Please read compliance statement on back of permit
-S2g,--- nls
Application Fee(s) Check #
111,46 11�r,II�
Issuing to Expiratidn Date
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, certifythat this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
❑ Tar - Pamlico River Basin Buffer Rules El Other:
,El 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/ 1-888-4RCOAST
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

DAVIS SHORE FERRY SERVICE
148 WILLIS RD. P O BOX 45
DAVIS, NC 28524
PAY
TO THE
ORDER OF
1713
66-21/530
J / BRANCH 77613
DATE f — / Cf
LLARS
WACHOVIA J
Wachovia Bank, N
wachoWa.co �-'"` •�
FOR .-�' br 1 ✓ �/%
/ -�4-
11'00 L 7 L 31I' 1:0 S 3000 2 L 91: 20000 2640 36 L13n,

DEC-01-2009 16:47 From:DCM MHDCTY To:97298411
I
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/1vI0ORINGPILLYGSIBOATLIF'TIBOATHOUSH)
I hereby certify that I oven property adjacent to A n o e-+ rn_4c ho m s
(Name of Property Owner)
property located at
on Co t--e-
lqW W/LJ-1 s ,2c1
sv4 "ci
(Waterbody)
(Lot, dock, Road, etc.)
in C ct, r-k re-f-
i
Applicant's phone #: f7R9 ^ 34 7 y
;'77-5-ZZqg'
(Town and/or County)
N.C.
page: 1I1
Mailing Address: �` O
�G V1 5 �`1G a ��
He bas described to me, as shown below, d)e development he is proposing at that location, and, I
have. no objections to his proposal, I understand that a pier/mooring pilings / boatliti / boathouse
must be set back a min,iz>jl-urn distance of fifteen Feet (15') from my area of riparian access unless
waived by me. (If you wish to waive the setback, you must initial the appropriate blank
below.)
I do not wish Ito waive
lW191 do wish to w1aivc that setback requirement.
---------------------- -...... --------------------------------------------------------------------------- .----------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To Le filled In by individual proposing development)
--------------------------------------------------------
(Information for Property Owner Applying
for Permit) j
F� 4�
Mailing Address
City/ tat&Zip
Tc�ephone Number '
Signature i rate
(Riparian Property Owner information)
i Signature
rL.� c-��5
Ffint or Type Nwyic
Telephone Number
Date

DEC-01-2009 16:47 From:DCM MHDCTY To:97298411
I
ADJACENT RIPARIAti PROPERTY OWNER STATEMENT
(FOR A FEER111100RING PILINGSIBOA /T�LIFTIBOA;IHOUSE)
I hereby certify that I own property adjacent to PI VI ° �k w ` cI /--e.'s
(Name of Property Owner)
I 7�
gropei'ty located at j ` `� W / S �J !ACC ✓ �s
(Lot, Block, Road, etc.)
m
to 0A1-4rr-�' _,N.C.
(Waterbody) (Town and/or County)
Applicant's phone #: 1'7,)Ci ` y .7
I- U
page:1/1
Mailing Address- P- U . /- X Y -5
0 u V, S "c a k-:, --�Y
Ue has described tome, as shown below, the development he is proposing at that location, and, 1
have no objections to his proposal. I understand that a pier/mooring pilings / boatlift / boathouse
must be set back a miyu tm
distance of fifteen feet (I T) from my area of riparian access unless
waived by me. (if you h to waive the setback, you must initial the appropriate blank
below.)
I do not wish to waive
I
I do wish to v waive that setback requirement.
------ --- ---------------- ---------------------------------------------------------------------------------------
DESC.R1[PTI0 AND/011 DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
i
i
(Information for Property Owner Applying
for Permit) j
M •1• Acid
at rub rc.ss ,
�uv, C,
City/State/Zip
r7 -A5- - a �q R v6 `�'A s> s
Tel one Number '
(Riparian Property Owner Information)
Signature
ryint or Type Naffiu
Telephone Number
Signatare Date (late

DAVIS SHORE FERRY SERVICE
148 DAVIS,
RD 80X 45
DAVIS, NC 28524
PAY
ii TOTHE
ORDER OF
Wachovia Bank, N
A wachov,
oij
FOR 264
00 1? i:o S 30DC3 2 1 200
M3
66-21/530
,,RANCH 17513
DATE
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DEC-01-2009 16:47 From:DCM MHDCTY
To:97298411 pa9e:1"1
I
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PI.EB/AIOORING PILINGSIBOATLIFTIBOATIIOUSE)
I hereby certify that. I own property adjacent to Atr WV- % ! eD jm7r;e�yy& s
(Name of Property Owner)
I
property located at 1l tj g - co ; I ( , S'ad. &r!•; 5 }U cC- �L9 5 :?-q
(Lot, Block, Road, etc.)
I
on i ",Ucl in .. >) r (Q 'A •e ( -�, N . C.
(Waterbody) (Town and/or County)
Applicant's phone #: ' 3 41 Mailing Address:
IBC- 4543- /
I
Ue bas described tome, as shown below, the developtru:rit he is proposing at that location, and, I
have no objections to his proposal. I understatid that a pier/mooring pilings / boatlitt / boathouse
must be- set back a mini�utn distance of fifteen feet (I T) from my area of riparian access unless
waived by me. (If you wish to waive the setbstck, you must initial the appropriate blank
below.)
I do not wish to waive
i
r do wish to v waive that Setback requirement.
----------- ----------------- -------------------------------------- ------------------------------------ --..----------
DESCRIPTION AND/OIi DRAWING OF PROPOSED DEVELOPMENT:
(To be filled In by individual proposing development)
(Information for Property Owner Applying (Riparian Property Owner Information)
for Permit)
4-4
Mailing Addresss
City/Staudzip
Telephone Number
Signature
rate
OG,o
Signature
��Y
Fflat or Type Nhllii:
sa-- q- 3 s-ki
Telephone Number
l�2 —/—/ 0
Date

DEC-01-c009 16:47 From:DCM MHDCTY To:97298411 page:1"I
I
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(H-0.1Z A FI ER/rLlOORING PILINGSIBOATLIFPBOATHOUSF)
I
I hereby certify that I own property adjacent to X1 ee7 T e- . /� / 71VA-, &�s
(Name of Property Owner)
property located at I% 1)>d. &t/,
(Lot, Block, Road, etc.)
on 1^6, Se,- "Jd , in _ ......0 Ig fie /'•C % „u, N.C-
(Waterbody) (Town and/or County)
Applicant's phone #: V- 2 3"i'7q Mailing Address: 1' () . tY D
Ue bas 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 / boatlitt / boathouse
must be set back a min4um distance of fifteen feet (15') from my area of riparian access unless
waived by me. (If you wish to waive the setback, you must initial the appropriate blank
below.)
I do not wish to waive
I
I do wish to waive that setback requirement.
------------------------------------------------------------------------------------------------ ..----------
DESCRIPTION AND/012 DRAWING OF PROPOSED DEVELOPMENT:
(T + be filled In by individual proposing development)
I
i
(Information for Property Owner Applying
for Permit)
a60
Mailing; Address
i
City/Stat&Zip
Telephone Number
Signaturz Date
(Riparian Property Owner Information)
Signature
Fi-Int or Type Naz,,e
9� -woe -�--
�L—
Telephone Number
iC
Tate