55213_RICE, BRADFORD_20100309

❑CAMA / ❑ DREDGE & FILLt�E1 q
GENERAL PERMIT � � Previous permit #
❑New ❑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 -} /� I C E' P L C
Address d't)
City - (1 State ZIP
Phone # ()nf�i�` Fax #
Authorized Agent
Affected 0 CW ❑ EW ❑ PTA ❑ ES ❑ PTS
AEC(s): OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PINS: ❑ FC:
ORIN: yes / no PNA yes / no Crit.Hab. yes / no
Type of Project/ Activity
Pier (dock len h
Platfo
Finge
Groin
Bulkh
Basin
Boat
Boa6
Beacl
Othe
Shore
SAV:
Sandi
Mora
Photc
Waive
rolect ocation: ounty
Street Address/ State Road/ Lot #(s)
Subdivision
City ZIP
Phone # ( ) River Basin
Adj. Wtr. Body (nat /man /unkn)
Closest Maj. Wtr. Body
(Scale: - irk / )
.
.■
length
iliil■■■t:■
iiJ
/C
n■?.
_�■
■
■
�i■■■■■■■■
■
NUM
§300
0
N
LENS
0
iumber
fshore—
.vg distance -nax distance ofNEEN
'.
■■■is����ri%11���n��i■■■■■■■■■■■■i
_
channel
-ubio: yards
amr
_��___
■
ruse/ Boatlift
WNi�■■��
lip,
Bulldozing
�L���ti�'�
P
/�
■■
■
■.
■i!I
■
►
!�/
�
3111l"NJ
®1■al!,►�
`
Its
■�i1��i
NOW"11
!ine Length
notsure yes no
egs: not sure yes no
orium: n/a yes no
yes no
r Attached: yes no
�r��■�tii
■m■I
i.
Nil
■■r1�ii�Yli7i
■�i■ii�hil'/■■
■■
g
A building permit may be required by: ( I \ See note on back regarding River Basin rules.
-� j
Notes/ Special Conditions +' , I - n,� `� i '' CI t 1 (P ! of
Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit
Application Fee(s) Check #
i
Permit0 "Ceirl Signature
Issuing Date Expiration Date
IC4
d / L_r17��910A
Local Planningf urisdiction 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

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Q k �-L l R n
(Name of Property Owner)
property located at 3 r1 C-ou nt Trzy C �. a 1D z • , (1�(I N N r S -T-T I°? A C.
(Lot, Block, Road, etc.)
on L 1 s T-3 2 A il C H , in T T I' nJ N Iz S oT 7 73'<- P , N.C.
(Waterbody) (Town and/or County)
Applicant's phone #: -4 `'l - O � ` Mailing Address: '� 3 �1 o u a-r2y Cw f3 lam. rL .
MNt��C-SoTT �ac.E�ct; Z$ j I O
He has described to me, as shown below, the development he is proposing at that location, and, I
have no objections to his proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by property owner proposing development)
0
yon.� f
tykC7JDw1AQ:7�
I �P, 7ou<�NGS
�ftoPosc_a 7i� To
o
APP. 2.5,
%N4, SFFP U)Rt�.
F�cis � DNS 3�a7 (Lgr•.1'
(Information for Property Owner Applying (Riparian Property Owner Information)
for Permit)
737 QJ ('Y Ck-Ja -T,:>a , A� -
Mailing Address Signature
IY11NN�s� (�Epck . Nc- Z SI 0
City/State/Zip
CZ5Z 1 2-�4J-©`T3 S
Telephone Number
l (/ 1' 21 Zo f ci
Signature Date
Loretta M. Weston
Print or Type Name
336-413-4662 cell
Telephone Number
2/25/1
Date

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to W i Lu p� M 2A o F R4 c E 's
(Name of Property Owner)
property located at Loc,ti7��( L' � )a 11r,- , (rj ,vj1-So-r-
(Lot, Block, Road, etc.)
on L � w I s i3 (L A ni C, m , in ry�l I rJ N j�- S o-7 `� _ c- , N.C.
(Waterbody) (Town and/or County)
Applicant's phone #: Mailing Address: ' 13 '-I o u r1T2y C�� f3 1�ri .
MN0fc-Zn-T k-aC-} 2,$J 1�
He has described to me, as shown below, the development he is proposing at that location, and, I
have no objections to his proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by property owner proposing development)
'tt Lv,ais 'f32aac�t Q
--------------------------------------I------------------
(Information for Property Owner Applying
for Permit)
3 i CJ,l7R
Mailing Address /� f
ryl INNCSoi-r IuFLAcE4, Nc z8s)o
City/State/Zip
C z s 2� 2`4 - c:;, S
Telephone Number
�-, s I 21 Zo I c7
Signature Date
��/toPcsF 5 1D1cl To
`
K+Si 1t4 5f A W R tom..
�CLST� -)Cq 139AZ 2Arn�
----------------------------------------------------------
(Riparian Property Owner Information)
z
Signature
Print or Type Name
2 S2- -Q i c( 2 (101
Telephone Number
i2v ram/ 4. 2v1 D
Date

are ford
and Mr Rice, Jr.
737 ouncCi2l8i
e Rice
Arapahoe rY Club Dr ss-772is37
SRC HE (252) 249- 938570
FR OF
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Branch g -
an an �1
677 Plaz d Tr
is
Boulevard ug CO.
F �" NC28570
DR �De
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11530295?Bu■ � 7 ,
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DOLLARS B.

NC Division of`Coastal Mgt. Habitat impact Computer Sheet
Applicant: Brad Rice
Date: March 9, 2010
General Permit #: 55213C
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
found in your Habitat code sheet.
Habitat Name
DISTURB TYPE
Choose One
TOTAL Sq. Ft.
(Applied for.
Disturbance total
includes any
anticipated
restoration or
temp impacts)
FINAL Sq. Ft.
(Anticipated final
disturbance.
Excludes any
restoration
and/or temp
impact amount)
TOTAL Feet
(Applied for.
Disturbance
total includes
any anticipated
restoration or
temp impacts)
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount
SB
Dredge X Fill ❑ Both ❑ Other ❑
700
700
Dredge ❑ Fill Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑