60263_KLEMIC, JAMES_20120530

C�CAMA / DREDGE & FILL
�1�0. 60263
GENERAL PERMIT
Previous permit#
New lModification --:Complete Reissue
,—Partial Reissue
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 I SA NCAC
❑ Rules attached.
Applicant Name__
Project Location:
County
Address
Street Address/ State
Road/ Lot #(s)
City__ State ZIP
Phone # ()_ Pax # ()
Subdivision _ _
_
Authorized Agent _
City . _
ZIP
CW F; EW DPTA ES ; PTS
Affected
Phone # ()
_ River Basin
OEA = HHF ❑ IH Li UBA L N/A
AEC(s):
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
r1 s
Platform(s) 17
7
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
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
(Scale: ) I
7 See note on back regarding River Basin rules.
Agent or Applicant Printed Name Permit Officer's Signature
Signature ** Please read compliance statement on back of permit ** Issuing Date
Expiration Date
Application Fee(s)
Check # Local Planningjurisdiction
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
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.
Raleigh, NC 27604
919-733-2293
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)

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APR-18-2012 01:45 From: To:12527264092 Paae:1,'3
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A)DJAI,.'ENT HPAR.JAi PROPERTI, OWNER STATEMENT
I hereb;+ ceO y that) own propert , adjacent to
tt � `imme of Property Owner)
ro located .3 � L � � �a
property
(I_ I st, Block, Road,
on _130Q UU� J oy �+� ( in cat- '.
(iv , terbod ►) 0
— - , N.C.
awn and/or Citunty)
Applicant's phov M. 9 � �! �� ailing AdO -ess: RAG rJ s 61a 4—
r - 9a2
He has descr+ed t; me, as hown below the developmen se is proposini! at that location, and, I
have no objeci.ion.s o his pi �.fposal.
DF,s CRI U V TON) , ND/OR DR i ► VM G OF PR( POSED DEVELOPMENT:
10 be fi Hed in by, prr;tertKOwner.pro/ ring developirrent)
i
(Inforrmntion. for x'r i l perty C'-vner ,A.pp h, i ag (Ripariai . Iroperty (honer Information)
%►r laeKmit)
Mailing Address
City/State/Zip
6phone Numb .r
igrratnre I �; rf c:
(Signature
Print or Type Name
Te ephone umber
Date

A.IDJA .."ENT RIPAWA % PROPERTI, OWNER Srli'.A T.EMENT
I hereto; i cert i 'y that 1 own propert r adjacent to J of /
I 'lame of Prol►erty Owner)
property loc<<ted .3:! � `1 �{ �� � ! �-�)
(L r it, Block, Road, te.) —
an -- � � �.. �� � . C a E- 1 c i- �
�k', i t.erbod-in — , N.C.
(7 awn and/or Ct,unty)
Applicant's S
phoir #: q I S ?1 _1,ifailing Adi -ess• O � RO 7 �!�t /��
-.. 1��
Ike has described t( me, as hown below the developxner" ,e is proposint! at that location, and, I
have .no objecit:ion s o his pr )posal.
DES [M P IJON A ND/OR DR, ► WING OF PRc VOSED DEYI:LOPMEINT:
,, ;'obe fA !ed in by pro, t erty Owner prop, t•ing developn rent)
t
(Wormration fbr Pi r 1 perty C ,wner Appl, - i fig (Riparia) roperty Owner Information)
for Permit)
Mailing Address Signature
�'ityl5[atelZi -
p Print or Type Name
TeleghXone Number
M
^� Telephone Number
Date

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INTRACOASTAL MARINE CONSTRUCTION
3515 WHITE DR.
MOREHEAD CITY, NC 28557
Pay to the ---�
Order <7 —ill
2825
Date. S---3 0 66-112/531
BRANCH BANKING AND TRUST COMPANY cM
BST.co,
1140000 28 2 So NP
1: 0 S 3 10 112 11: 0 0 0 s 1 34994
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