53341_PINER, J W_20090319

❑ CAMA / ❑ DREDGE & FILL Z-3-0 °l
GENERAL PERMIT Previous permit #
❑New ❑Modification ❑Complete Reissue ❑Partial eeV�; 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.
t`
Applicant Name t �,
Address3X -)) 2
City c( State \C ZIP 2,6 �2
Phone # (_) +1 }- %,?(iZ Fax # ( )
Authorized Agent
Affected ❑ CW ❑ EW n PTA ❑ ES ❑ PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS: ❑FC:
ORW: yes / no PNA yes / no Crit.Hab. yes / no
Project Location: County__ 1 - % ,
Street Address/ State Road/ Lot #(s)
Subdivision
Ciry ,_d, ZIP 2 ms
Phone # ( ) _' f)- 5 River Basin <
Adj. Wtr. Body ti= o i6/man /unkn)
Closest Maj. Wtr. Body
Agent orApplicant Printed Name Permit Officer's Signature
l m io -7
Signature Please read compliance statement on back of permit lssuinjDat4 Expiratidh Date
Application Fee(s) Check # Local Planningf urisdiction Rover File Name

Z
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 howto complywith 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/ 1-888-4RCOAST
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

%S1FIR
1Myii_1_ (LC[il J S'i�1% ILs 1 x 0V,YIiJj1 ,�S'i'Ar-1--.t
(FOR A PIERI MV C—O VERED Boll T LIM)
I hereby certify that I own propem aaiactnt to
of ProF'ertv Owner)
proper y located at
t\ ,
(L-ot, Black, Road, etc.)
on
(Waterbodv) N.C.
(Town andJori County)
He has described to me, as shown below, the developtenc he. is proposing at that
location, and, I have no obj�—_tions to his proposal. I understand Iliac a pier/uncovered boat lir
must be set back a minimum distant✓ of rice--n petit (,5') from myarea or riparian access unless
waived by me.
I do not wish to waive the setback reruirement.
I do wish to waive that setback-equLremerlt.
DESCRIPTION A_N_D/OR DRAW-ENG OF PROPOSED DE ELOP?vMNT:
(To be jWed in by individual proposing devel17pment)
i
�n -C
Signature
Print or Type ivalme
Tel?phone NumbT.r
Date:
z�ti� (off

.. r JL Cl r JL OWNT S _�'+S .L
(FOR A PIERIUL COVERED B 0j �j , LIFI)
I hereby czt-tiry that own property adiactnt tot Tt3az—
I ;
y
e of Propertv Omer)
property located at
(Lot, Block, Road, etc.) �—
on S a
N.C.
(Waterbodv) (Town andiori County)
He has described to me, as shown below. tl` e development he is proposing at that
location, and, I have no obj�--tions to his proposal. I understand ghat a pier/uncovered boat lif:
must be set back a minimum distance or nftern fe-t (15') from mylarea of riparian access unless
waived by me.
I do not wish to waive the setback recuirement.
I do wish to waive that setback req '
— .�Lre..ment.
DESCRIPTION A-ND/OR DRAW-E G OF PROPOSED; DEVELOP_'1dEN-T:
(3"a be frlled in by individr�al proposing development)
1
I �
----------------------------------------------------
� 'N, Un.
Signature
r--1�A CMG
Print or 1 hPc NaIrne
2 ~� o
Teiephone tiumbr-r
Date: 2-1 -L---sj 0 c)

•
a
ANNIE M PINER FAMILY LTD PARTNERSHIP 1021
PO BOX 2102 252-247-5262
ATLANTIC BEACH, NC 28512
66-30/531
Date 2— / 133
pLlyt�the
d1 I I
Dollars
POA14RST CITIZENS BANK
www.firstcibzens.com
r
t:0 5 3 100 300i:00 13 L 2 L90 74 Lu■ O i0 2 L
e Rmerican