54683_PHILLIP, BILLY_20091008

11 CAMA / 171 DREDGE & FILL
GENERAL PERMIT
E N e-w ElModification ElComplete Reissue El Partial Reiss
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
Applicant Name
Address
City
State ZIP
Phone #
- J-1 —4-
ax #
Authorized Agent
[I Cw
El Ew
E:)PTA El ES Ll PTS
Affected
AEC(s): 0 OEA
❑ HHIF
D 1H D USA E3 N/A
El PWS:
L-1 FC:
ORW: yes / no
PNA
yes / no Crit.Hab. yes no
Previous permit #
Date previous permit issued_
❑ Rules attached
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision
City 7 ZIP
Phone #
20- -.,'River Basin
Adj. Wtr. Body (nat [man unkn
Closest Maj. Wtr. Body
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
Boathouse/ Boatlift
Beach Bulldozing
Other
------
N
J
I A
-T
IF
Shoreline Length
[ L
SAV: not sure yes no
Sandbags: not sure yes no
Moratorium: n/a yes no
Photos: yes no
Waiver Attached: yes o
A building permit may be req red by: fJ El See note on back regarding River Basin rules.
Notes/ Special Conditio...
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
Per 'tOfficer s Isignatur
l
Issuing Datd ExpiraAon'DA to
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, certifythatthis 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 howto complywith 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

y're,f
A-
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERlillfOORING PILINGSIBOATLIFTIBOATHOUSE)
I Hereby certify that I ow a L C n(/property adjacent .o �, �� " is
(Na ie of Property Owner)
property located at A? '4 e —�
(Lot, Block, Road, etc.)
on A, A, l d-�'�a-F�l�J ,in T 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 / 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 appropriate blank
below.)
do not wish to waive
I do wish to waive that setback requirement.
-------------------------------------------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be fillet, iri by individ..al proposing development)
(2
0 co e'
Print or Type Name
Telephone Number
Date:

RANDEL
Ei1/190"14-10-GUUb IUt UI;4!) rn NL8viV Ut' WA51AL MUnRl' FAX NO. 4 UMMIT
PAGE 01
P. 03
U, KtME CEIM- VESTED
DIVISIOiti OF COASTAL. MANAGEMI NT
AI)J',ACEWT RIPARIAN PROPERTY OWNER% NOTIRCATION"11
Nand cif Xndiv ium applyme, for rormit:
•Acldreas of 1'ro�rty:--� �.........,...,,,.`�� ..._
(I.*t or Street Strut or Rusd,
'AIVER FORM
�tl�inc
ty Ba county)
I hereby certify that I own property adjacemi to the above referenccd property. The individual
applying for this permit has described to mc. as shown on the tttaehed drawing the dcvalopme.nt
they me proposing. A description or drawing, with dimensions, should be provided with this
luttc�t'.
`/— I have no objections to this proposn],
tf yn.a have 1) jJd'[dons (n !►Trot is being pfoposeel, please wile the Di►•isiort of Coustal
41(m as"wlerrt, lle'41t01r 1'laziri 11, 151-1), lluy. 2d, 4lorchead Cite, NC, 28W or call 1252) 808-
2S03 wirlriR 10 days of r•eeciht of this rrndre. M.; jvspoirse le considercd the some es ►10 objection
if you !wive beew rrofVied by Cer7ified Mull.
NVAINTR SECTION
I understand that a pier, clock, mooring, pilings, breakwater. L•oat house, lift or smtdbass must be
Set hick a rltinimum t�istnnce tit IS' Crortt rT�y area of ripari,n access unless �rai�2d by me. (tfyott
with tt k� `'ve the se(bar_k, you must initial the appropriate blank below.)
, I dv to Waive Iftc 15' sctbuk requirement.
I CIO nal wish tq cv,tive the l 5' setback requirement
YV
TC10P11011a 1`un1ber With Arcs Cade
40, }/,-,� ,�s �� . /lam a ,� j7/o r f ' 9� ��/ r

n
Eric Ellis
Marine Construction
DOCKS • SEAWALLS •BOAT LIFTS
DECKS & REPAIRS
Phone & Fax: [phone]
Cell: 252.342.6775
205 Nottingham Lane Morehead City, NC 28557
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4065
. ERIC B. ELLIS 66-30/531
JASA M. ELLIS cy C.
/ 133
�\ %�r�/'. 205 NOTTINGHAM LN. 252-726-6775 yl Date
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MOREHEAD CITY, NC 28557 /�/
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