61029_JARAS, GLENN_20120913

W5 No. 61029
JCAMA / '❑ DREDGE & FILL
GENERAL PERMIT Previous permit#
❑New ❑Modification []Complete Reissue —]Partial Reissue Date previous permit issued
As2uthorized 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 Project Location: County
Address Street Address/ State Road/ Lot #(s)
City
Phone # ()_
Authorized Agent
Affected ❑ Cw
AEC(s): ❑ OEA
—' PWS
ORW: yes / no
State ZIP
Fax # ( )_ --
❑ EW C] PTA -L] ES PTS
❑ HHF a lH Ll UBA :� N/A
FC:
PNA yes / no Crit.Hab. yes / no
Subdivision
City _ ZIP
Phone # ( -_ ) River Basin
Adj. Wtr. Body (nat L-an /unkn)
Closest Maj. Wtr. Body__
Type of Project/ Activity
(Scale: )
Pier (dock) lengttp
Platfor
Finger piers)
Ott
Agent or Applicant Printed Name Permit Officer's Signature
Signature Please read compliance statement on back of permit
5 b .
Application Fee(s) Check #
Issuing Date Expiration Date
Local Planning Jurisdiction 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:
,1 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
252-808-2808/ 1-888ARCOAST
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)

iBx 1289
PO BOX 190
ORIENTAL, NC 28571 Gt J, ? 66-30/531
I J > 472
Date
Pay to the 1 V C D E N Z
Order of 1 I $ 600.00
5 -X 60
Dollars
First Citizens
/ + t � t�l ens.co i c�
For
l:053 L00300i:0047 L 20 2 L 2SL.m' 01289

MAPLINIK
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Michael F. Easley, Govemor James H. Gregson, Director i+W'ifiiam G_ Ross Jr'., Secretary
Date 8//71 IL
Applicant Name G lehh
Mailing .Address
9q 1 A -A, "
Of %CvAc1, NC. �,8 5V
I certify that I have authorized (agent) ! V la�- V1 M to act on any
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) Nev Y-� c r + ink^ J�
at (location)
5"V",C.
'Phis certification is valid thru (dated X
Signature

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILIIVGS/BOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to 61 zhy\ ) t'\f o
(Name of Property Owner)
property located at � 1 ' - loll S
(I.ot, Block, Road, etc.)
I
on 6Aa eUv\ 61e4,- ,in o,',<-�'A 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/boatliffi/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 wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
e e (To be filled in by individual proposing development)
o
m
s ( \
s
vA q '� A, 01�
(Applicant Information)
Mailing Address Dv-, CvA,%\, !�'nnII
City/State/Zip
a#11- lgl�`1
Telephone Number
9 tl 7
Date
(Ri party er atio �'
Signature tu
Print or Type Name
X 2-5z 2-119-1?gp 3
Telephone Number
Date
C---. / �- —Z v i z.

>l+4ck`
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FORA PIER/MOORING PILINGSBOATIIFTBOATSOUSE)
I hereby certify that I own property adjacent to 9) ev\Vt J ADO 's
(Name of Property Owner)
property located at g � � f ; \l S U
(Lot, Block, Road, etc.)
on %iAcov\ ,Yee\(, ,in 0, ,t,A�� ,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/boatli#T/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 wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
s e (To be filled in by individual proposing development)
A
p ,
(Applicant Information) (Riparian Property U" Information)
Mailing Address
CWSiateOp
Telephone Number
2/,71,k
Date
Print or Tine Name

Pamlico County, NC
ParcelNumber:
K081-141
NC PIN:
74098 8382
Owner Name:
JAROS GLEN T ET UX
PROPERTY MAP
Owner Name2:
JAROS CHERYL
Owner Address:
541 MILLS RD
` '
"
Owner City:
ORIENTAL
r,.
!•-'•
Disclaimer:
The data provideon this map are prepared for the inventoryof real property found within
d
deeds,
Owner State:
Owner Zip:
NC
28571
J
.-",•
Pamlico County, NC and are compiled from recorded plats, and other public records
and data. This date is for Informational purposes only and should not be substituted
Situs Address:
541 MILLS RD
for a true tide search, property appraisal, survey, or for zoning verification.
Le al Desc:
GIDEON CREEK
g * IN-
hill
Deed Book: 538
Deed Page: 65
Plat: PCA 127-1
d 16
Dee Acres.
Land Value:
122394
Building Value:
74878 N
Value:
197272
Sale Date:
20091202
Sale Price:
185000 One Inch = 100 Feet
SUR

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