54685_RAGAN, RANDY C_20091014

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❑ CAMA / ❑ DREDGE & FILL io
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GENERAL PERMIT WY Previous permit#
❑New �Moekation ❑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 A i Project Location: County
Address. Street Address/ State Road/ Lot #(s)
City
State
ZIP_—_'
Phone #
rr'
O .�f , .,
Fax # (:)
Subdivision
Authorized Agent I City ZIP
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Phone # O ` River Basin
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A 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
Platf
(Scale;' /- )
orm(s)
er pier(s)
n length
number
channel
cubic yards
house/ Boatlift
h Bulldozing
er
eline Length
yes no
bags: not sure yes no
er Attached:
i
( I
head/ Riprap length
avg distance offshore
max distance offshore
y
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I
I �
it
- _ {
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El
atorium: n/a yes no
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Agent or Applicant Printed
Signature ** Please read compliance statement on back of permit*
Application Fee(s) Check #
�t
Permit Officer's Signature
Issuing Date ExpiratyonlDate
Local Planningfurisdiction RoverFieN `
Agent or Applicant Printed
Signature ** Please read compliance statement on back of permit*
Application Fee(s) Check #
�t
Permit Officer's Signature
Issuing Date ExpiratyonlDate
Local Planningfurisdiction RoverFieN `

Is
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 [)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 consistentwith 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/ 1-888ARCOAST
Fax: [phone]
Location:
2728 Capital Blvd.
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico Counties)
Raleigh, NC 27604
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

....*A
MCDII�
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Mich9et F. I=aslr�y, tacvernvr Charles S. Jones, Director
WIMam G. Ross Jr.. Wretaq
Date
Applicant Name 4,
Mailing Address M-e
I certi6, that X have authorized (went)
to act oil uiy
behalf, for the purpose of applying for and obtaining all CANIA Permits necessary to
install or construct (activity) ,e—
�!
at QoC ation)
This certification is Val, bru (date) �� f! Z — I p
Signature
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: [phone] FAX: [phone] Intemet; www.nccoastalmanagement.net
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGS/BOA TLIFT/BOATHODUS'E)
I hereby certify that I own property adjacent to AV441L/-C� ✓�� ��'s
(Name of Property Owner or Applicant) n
Mailing address if different from location address / V®
(town, state and zip) /" 9v 2,& S�C�
phone numbers you can be reached at Z�5-2- — 3�! — 2 D S
property located at
�� // (Lot- Block, Road, etc.)
on M4iAIIU44 - �/ , in /w o �/e 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.
I do not wish\to waive the setback requirement.
initials
I do wish to waive that setback requirement.
initials
-------------------------------------------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
To be filled in by individual proposing development)
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Telephone Number

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGS/BOATLIFTIBOATHOUSE)
I hereby certify that I own property adjacent to /` °�' ��''J IS
(Name of Property Owner or Applicant)
Mailing address if different from location address 'Ielo
(town, state and zip) Ae w o 26 S 7 0
phone numbers you can be reached at ZS'2—
property located at _ !S� &4,zz en
(Lot; Block, Road, etc.) �
on h� �Ii'rz � �/G�-t" , in /t�+/�✓o� �Gi �' �✓ , 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.
I do not wish\to waive the setback requirement.
initials
I do wish to waive that setback requirement.
initials
-------------------------------------------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development) l
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Signatu t.
Print dir Type Name j
Telephone Number

1529
STEPHEN D SADLER 142 JUNIUS DR /�` v / 66-30/531
NEWPORT, N.C.28570 Date/� 342
Pay to the
Order of
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