34022_PERRY, RICHARD_20030605

7 CAMA /-7 DREDGE & FILL
GENERAL PERMIT
Previous permit
'New L: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 1 p
Address h1 <
City 1.j • 1 jr ► < <� y � State AJI ZIP 2 7
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Phone#( ) a j1G Faac#("Ij ) 33C Gtf�
Authorized Agent
Affected CW O EW ❑ PTA [IES ❑ PTS
AEC(s): F OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
-] PWS: ❑FC:
ORW: yes / nqo PNA yes / no Crit. Hab. yes / no
Project Location: County /,, r -I r, < t
Street Address/ State Road/ Lot #(s)
?[. ! r.N , �L ) f 4 rf -f
Subdivision
City 114 10, f,< ZIP � S /l
Phone # ( ) _ River Basin i✓N �� va k-
Adj. Wtr. Body /iq,,n r, asu (nat AQan; /unkn)
Closest Maj. Wtr. Body.
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Agent or Applicant Printed Name
y�
Signature ** Please read compliance statement on back of permit
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Application Fee(s) Check #
Permit Officer's Signature
Issuing Date /} Expiration Date
Local Planningjurisdiction 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 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 (910-395-3900) for more information on how to comply with thesebuffer rules.
Division of Coastal Management Offices
Central Office
Mailing Address:
1638 Mail Service Center
Raleigh, NC 27699-1638
Location:
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293 / 1-888-4RCOAST
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)
Morehead City District
151-B Hwy. 24
Hestron Plaza II
Morehead City, NC 28557
202-808-2808
Fax: [phone]
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico 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
910-395-3900
Fax: [phone]
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)
www.nccoastalmanagement.net
Revised 10/05/01

RICHARD D. PERRY NCDL 23556
NC 23556 PH 919-563-2600
2914 WAGON CT
EFLAND, NC 27243
Pay to dhc
Ordcr of /
�F ,6Ju,�v�iLEd� s,
1003
G66-49t531
Datc Y 7 d�
Dollars
W,M'I- 11"I in
Wachovia Bank N.A.
Nrl.ur. SC 279U'
1:053 IDOL, 941: 144E 44 257 Lil' 1003
CLASSIC
O HARLAND

Jun-04-03 06:56P PERRYS CONSTRUCTION CORP 919-732-3420 P_01
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Jun-04-03 06:57P PERRYS CONSTRUCTION CORP 919-732-3420 P.02
' Avg- 11-03 1.81P P.06
♦ twn .tie itb� tC•C:1 fit �1b wit ut �vriJtttL INIMII rnn NJ. 9 r•. UO
ADJACENT RWARLAN PROPERTY OW?%IR STATEMEIN-r
(FOR A PIER/MOORING PILmGVBOATUFTIBOATHOL'SI!)
I bexby cerory that I owr. pcaperty ad xart toJ -- c.)�) s
(Name of Property OVAC.)
(Lat. A104k, Road, e(tr)
N.C.
(Watarbody) (Town and/or Coun()
Fe W des` 39d to me, zs 5-.O-r: be,'ow, the &vvIopmc he is pro*,', a. emt Ix%!gq,
2-n4, I hpve ra obie~nons t_ h-s Froposzr. I e-4'e s�!Q ctr t pie-lm0or'n=
Oil; .g�bo? i�./bcl@ Ouse must bt se: back a n:.Zimem dismlce of f.-Z_ (;-;") Fain my t'da
of ri.s im access unless waived by, me.
1110 ant Wish CO way, 0e s::_o:ck' re;uirer++:-,,
Ids ��isi; ce ui+ve .�,c sr ba;'; re:hjre-;ear.
4 DESC;X-W TO\ ,�\'D/OR DRAIATNG Of PROPOSED DI:VtLrjP?SE.\T:
(re be/fUrd i.: by indi iducl`.oaosittj Ctraapr..tat)
........... `...__.._
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MESSAGE
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SIGNED
Reorder No. 01325
URGENT!
TELEPHONED
CAME TO SEE YOU
TURNED YOUR CALL
WANTS TO SEE YOU
PLEASE CALL
RUSH
WILL CALL AGAIN

Apr-17-03 01:52P
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P. 07
f XT' 1 6 2003
DIVISION Of COASTAL MANAGEMENT
A,DJACF,IvI Rl
Name of Individual
Address of
I hereby certify that I own property adjiccnt to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing, A description or drawing, with dimensions, should be provided with this
letter.
I have no obiections to this proposal.
/f you have objections to what is being proposed, please write the Division of Coastal
Almurgerrtent, Hestron plaza 11, 1S1-B, llwy. 24, Morehead City, NC, 285-0 or caU (252) 808-
2,W$ within 10 days of receipt of this notice. No response is considered the some as no objection
i1 you have kera notffi*0 by Certifled Mail.
WAIVER SECTION
I understand that a pier, dock. mooring pilings, breakwater, boat houst:, Vitt or sandbags must be
set back s minimuta distance of 15' front my area of riparian access unless waived by me. Wyou
wish to waive the setback, you must initial she appropriate blank below_)
I do wish to waive, the 15' setback requirement.
XI do fiat wish to waive the IS' setback requirement.
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["A'r' 1 6 2003

sA
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSIBOATLIFT/BOATHOUSE) - '. LOGS
I hereby certify that I own property adjacent to t C' 0I — ' 'S
(Name of Property Owner)
property located at �� V4 / S:
(Lot, Block, Road, etc.) /
on , in 14�Ll a --AY l� , 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/boadift/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.
I dQ wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
---------------------------------------------------------- ------------
Signatu
Print or Type Name
Telephone Number
Date: r 10 03

•-4.pr-'21-03 03:16P PERRYS CONSTRUCTION CORP 919-732-3420 P.02
Ul� 1 G 2003

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