52673_PINE KNOLL ASSOC INC_20081204

❑ CAMA / r � DREDGE & FILL �J�/ /Z �y-C1Y 1S,6
GENERAL PERMIT Previous permit#
❑New,, ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State" ' North Carolina, Department of Environment and Natural Resources
and the Coastal Resources N:nmission in an area of environmental concern pursuant to 15A NCAC
❑ Rules attached.
Applicant Namer ; Project Location: County_
Address '`� _ _ Street Address/ State Road/ Lot #(s)
City t-0 c; i State ZIP
Phone # ( } Fax # ( Subdivision
Authorized Agent - City ZIP
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Phone # O River Basin
ElOEA ❑ HHF ElIH ElUBA El 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
(Scale: / v j )
Pier (dock) len
Platform(s)_
Finger pier(s)_
Groin length _
number_
Bulkhead/ Ripr
avg distar
max dicta
Basin, channel
cubic yan
Boat ramp _
Boathouse/ Bo
Beach Bulldozi
Other
Shoreline Leng
SAV: no
Sandbags: no
Moratorium:
Photos:
Waiver Attach,
A building permit may be required by: /" ❑See note on back regarding River Basin rules.
Notes/ Special Conditions
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
PermitOfficer's Signature
Issuing Date r , Expiration Date
Local Planning) urisdiction Rover File Name

Statement of Compliance and Consistency t
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 ❑ 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 Citv 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

ACE ,ff R&ARUN PEtOPEP'TY OWNER STATEMENT
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I k.az�by
property kwvrd at
!.MVAV.l
F;e has dos;
and, I have no objw
must be get back A;
rv3iv0d by me.
mt I own property sdiace ut to le
r.., (Name of ptoperty Owner)
(i,ot, Blom, Road, c°tr-)
kis'
NC
y, (gam audler Comfy)
*.0 dr shown below, to development he is proposiM at that k)mtion,
x� °c�iosai. I tarscicas��d t�'ssi apicrfmo€ari� pz"tin�wpt]iositbousc
in ; ;r=- cm of ffftccra flirt (IY) Born my area, of ri!A6an #AG. 5 mkss
Tkds 6o; ve the setbarl, rN immmit_
�Y
h to VVal4llmt 8L- mquitL'trYm.
kn/OR DRAWING G OF PROPOSED DE'VFJA)pmxn-.
(Tobe f ad in by Wiv#dud prapo d ap+ } '� e , } � -� � � 1Q � Z
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGSBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to SI�Ci�TJT12 's
(Name of Property Owner)
property located at
(Lot, Block, Road, etc.)
on r5 �`C�J-/���/i , in/�11�-,�ili? l�l�i%C� , , 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 to7is-proposal. I understand that a pier/mooring pilings/boatlift/boathouse
must be set back a minimum.,, stance of fifteen feet (15') from my area of riparian access unless
waived by me.
`i
0-41.r 1
I do not wish to waive the setback requirement.
I do wish to waiv4.that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMWNT:
(To be filled in by individual proposing development) b `
S b:
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(Applicant Information)
Mailing Address
City/State/Zip
�-52-.IVD-/7/`7
Telephone Nu ber
a 6v '
Date
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(Rimanan Property Owner Information)
Signature
Tl
Print or Type Name 1
0 �- -:�- -DU��U
Telephone Number,
Date

C T U 10:!f.9 AN S R HOMES 840 7499 F.01
ADJACENT RKPARI.AN PROPERTY OWNER STAT,EMNT
A PIETdWCIQRMGplZr.NGNIB0ATI.
1 hereby certify th4t T O'Nu ro
P irtY adjacent to's
(Nate of Property Owner)
property located
(Lot, ftck-, Roadetc,)
in .�L •y, L,f �� i� A
(W�tprlrodY) (Town seodlc�r County)
Re has described to''rti, as sho.�a balow, the davelopznent he is proposing at that location,
arid, l have no objections to posat. 1'Lldexstand that a pier/rnaaring pilingsUwlifr/boathouse
jlaust be set back a miuimu jstan`e of fi n Feet (15) fratrt my area of riparian access unless
warred by me.
1 q2.30t wish t ''waive the setback requirement.
._.. _ 1 d,- 0 wish to wai that setback requirement.
D "CIMPTION Ai l)/() T RAWihdG OF PROPOSED DEVEftA0Pl4-Y�------ - --
t"lo be filled uK by ir:divi+daaal pr posing dez�el�pmenl) �' WN
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1.€ allirtg rf B1 s --
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City�Stata/Gip
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Telepltprte !t'zs
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Dcsie '
(Wparfan Property Owner Information)
Signature �`'---
,FrW or T,c pj 1Vf^e
7/g 535 6)�-/7'7
I'elrphone Numbfr —"
J 03
Date --- — —

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGSBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to �'V l�.�t�!i )4 JS
(Name of Property Owner)
property located at KIWIS 06' M/�9/—
(Lot, Block, Road, etc.)
on )VIA)6 `5 %d, M-7,-- �i Z - , in / tc k))011 Jl ;S (V,N.C.
(Waterbody) (Town and/or Coun )
He has described to me, as shown below, the development he is proposing at that location,
and, I have no objections to'hs-proposal. I understand that a pier/mooring pilings/boatlift/boathouse
must be set back a minimur distance of fifteen feet (15') from my area of riparian access unless
waived by me.
`i
07-1� i
I do not wish to waive the setback requirement.
I do wish to waive,that setback requirement.
;CRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMT T:
(To be filled in by individual proposing development) b
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30
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6 �i 26
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3
(Applicant Information)
zn3gn
Ma�zhnjAddress /t y R -7
VTIC
City/State/Zip
Tel ph e Nuptber
iY�I� � /
(Riparian Property Ow r Information)
SignaTu7e
Print or Type Name
Telephone Number
I1,lv via (ir
Date I ' Date

0
PINE KNOLL ASSOCIATION INC
P 0 BOX 905
ATLANTIC BEACH, NC 28512-0905
DATE II!21-08
5478
66-112/531
BRANCH 02302
TO THE ORDER OF CA . l L WC b (Y�
BRANCH BANKING COMPANY
1-800-BANK BBT BBT.co
FOR
II'0000 5L.�i:0 5 3 LO L L 2 L':000 5 L 98 3 50a I'