59374_WALKER, GEORGE_20111102

❑ GAMA / ❑ DREDGE & FILL
59374c
GENERAL PERMIT
Previous permit #
❑New El Modification ❑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 15A NCAC
❑ Rules attached.
Applicant Name 1
Project Location: County
` 3
Address { r. ' ^. f ,,. }_,r ;r
Street Address/ State Road/ Lot #(s)
City State ZIP
Phone # () Fax # ()
Subdivision
Authorized Agent
j
City ZIP >
❑ CW 0 EW ❑PTA ❑ ES ❑ PTS
Phone # River Basin
Affected
AEC(s): ElOEA ❑ HHF ElIH ElUBA [I N/A
Adj. Wtr. Body C (naf /man /unkn)
Q PWS: ❑FC:
ORW: yes / no PNA yes / no Crit.Hab.
yes / no Closest Maj. Wtr. Body
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Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
Permit Officers Signature
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:
❑ 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)
Revised 08/09/06

ISLAND MARINE CONSTRUCTION LLC
1286 ISLAND RD
HARKERS ISLAND, NC 28531
PHONE: [phone]
PAYTO THE
ORDER OF
1630
66-21/530
BRANCH 77513
DATE 7 - l/
1 s 51-oa ,o 0
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wacxovia'
Wachovia Bank, N.A.
1 w,ac_hmiia.corn 2�
FOR
11800163011' l:053000 2 19i: 20000 2 17 2933911'
,t

ISLAND MARME CONSTRUCT)"
1286 ISLAND ROAD
To: HARKERS ISLAND, NC 28631
252-728-3419
From:
Re: Authorization Letter
I g oo- authorize
44,.4-5 �A-*04-ce to act as my agent for the sole purpose of
obtaining/signing permits to perform work at
e5 Aex"'
Sincerely.
Signature
Print Name
A113 QH➢V-N OG
110Z 5 9 I00
Q3AI90911

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m
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CaAlaz)"

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGS/BOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to e-_—*ANC— " I
me of Property Owner)
( P tY
property located at
ad, etc.)
on 1^e�2 , in G 0(4e *e
( aterbody) (Town an/or County)
Applicant's phone #: -73 .2-3 41-6 3CCMailing Address: /9 / o N � r
e AjJJ' 6 87J 3
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. (If you wish to waive the setback, you must initial the apprwhq& lank
below.)
I do not wish to waive O C T 2 5 2011
I do wish to waive that setback requirement. DCM-MxD CITY
-----------------------lp-3f --------------------------------------------------- -------------------------------------
�PTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
jv,N 9 — (To be filled b irylividual proposing development)
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(Information for Property Owner Applying
for Permit)
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Telephone Number
Signature Date
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parian Property Owner Information)
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Signature
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Print or Type Name
e hone Number
Date

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ConnectGIS
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1:46 feet
http://carteret.connectgis.com/MapIPrintWindow.aspx?Map=http://carteret.connectgis.comlarcgi... 10/ 14/2011