34041_ROTTA, LARRY_20030529

F, LAMA / 1 DREDGE & FILL
,GENERAL PERMIT
❑New DModification ❑Complete Reissue ❑Partial Reissue
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 I SA NCAC
Applicant Name
Cir�t� hi':r1CL.
Address ' ,1_ l�lVr» at-J fi
City_- i State IU ZIP
Phone # () Fax # ( )
Authorized Agent
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS
AEC(s): ❑ OEA ❑ HHF ElIH ElUBA ❑ N/A
❑ PWS: ❑FC:
ORW: yes / no PNA yes / no Crit. Hab. yes / no
L I
Previous permit #
Date previous permit issued
❑ Rules
Project Location: County
Street Address/ State Road/ Lot #(s)
.l ff
Subdivision __ _ _
City_ ZIP
Phone # ( _) _ River Basin
Adj. Wtr. Body_ (nat /man /unkn)
Closest Maj. Wtr. Body_
Type of Project/ Activity
(Scale: li`� -� )
Pier (dock) length
I
Platform(s)
Finger pier(s)
T
i
I
t
Groin length
number
Bulkhead/ Riprap length_
avg distance offshore
{
_
max distance offshore
I
r
Basin, channel
I
_ I
cubic yards
I
I
Boat ramp — I
! I —
Boathouse/ Boatlift_
I
Beach Bulldozing
Other
I
Shoreline Length
i
I I
SAV: not sure yes no
Sandbags: not sure yes no
Y
Moratorium: n/a yes no
i -- —
Photos: yes no
Waiver Attached: yes no
n
A building permit maybe required by: (tV
t C' See note on back regarding River Basin rules.
Notes/ Special Conditions
t or Iicant Print ame
Signature* Pleas re d compliance tatement on back of permit
Application Fee(s) Check #
�J
Permit Officer's Signature
Issuing Date Expirati6n Date
Local Planning jurisdiction 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, 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 (910-395-3900) for more information on how to complywith 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 / 1-888ARCOAST
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
151-13 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

II- 2358
FOLEY & FOLEY CONTRACTORS, INC.
MATERIAL ACCOUNT
' 1810 OLD AIRPORT RD. PH. 252-636-2515
P.O. BOX 3482
NEW BERN. NC 28564 DATE _ v ,� 66-65/531
ti PAYTO THE
ORDER OF
�C) c�
DOLLARS
RBC
Centura Gp#
1 ABC Centura Bank
Ne Bern, NC 28560 J
e FOR r-1Ccn� /"12pF3C�er nrHmTy nm
II'0000 2 3 4pil i:0 5 3 L006 50,:0 3 900 1 L 3 6 511'
It
.^�_..�(4^wZZ-pll/'.ra_\t@Z'V.:OII/...ra tR932C.9//l.',r��_pl@4RG0))!/_�»'1i1�e4D➢-,ram; 11t6?[!�P.i�.':��_'Rlitt�.'Jigf•_�a.-dCS,�R.RI//r=��_rtlC:�i.2^PP:-��=ti'l�w^:=Ap ��"31R.JTlII2._��-1�^����^�R^�+_IDC`. �"'SIiC'Z•�1.�_

TO: Tracey Wheeler (Cama)
Fax#= 247-3330
Date: May 5, 2003
Page# :
From: Foley & Foley (Sandy)
Phone#: [phone]
Customer Work Sheet
Customer Name: Larry Rotts Date: _Mal 5, 2003
Mailing Address: 1163 Rock Valley Dr. Rochester, Michigan 48307
Job Address: 5012 Plymouth Ct. (lot# 279 Sec: 7) Phone: [phone]
Adjacent Property Owners
Left Side: Litke Right Side: Goodmen
Job Type Description
Bulkhead
Dock/Walkway Extend Walkway 7'ft long 5'ft wide
Platform end of dock
Boathouse
Boatlift/jet ski
Piling Extend Pilin$ out with dock
Ramp/Jetty
Dredge
Rip Rap —
TO [8 YVA TZ:LO CO/50/9O

ADJACENT RIPARIAN PROPERTY OWNERS ATEMENT
(FOR A MERIMOORING PILI1VG,4V180ATI IFTIROA11101INF)
I hcrchv certify ll►al I mvii hropcoy adjaccnl lei//4 I} t
(TNamie of property owner)
properly located at Q .Z v 1(+ 29, RN
(Lot, block, road, etc.)
onAAD4L II c:&k, in ti „�'E�i•�,... N C nazi
(Water hotly) (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/m()oring
pilings/boatlill/boalhovse must he set hack a minimum distance of litieen feet (15') troni
my area of riparian access unless waived by me.
I do riot wish to ►valve the selhack requirement.
x 1 rlir wish io waive that selhack tcquiremenl.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVEI,opivm,Nn
(to be filled in by individual propttltsing development)
.SiFf bqT
Foley & Foley t owractors. Inc. _
Phoncli: (25 )) 630-2515 Signa
FaxN: (252) (06-3127 /� /
Print or�y, Pe Name
Telephone Number artd I ale
Z0 (a YVJ TZ:LO £0/9O/50

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSiBOATLIFT/BOATMOUSL')
I hereby certify that I own property adjacent tv s
(Na a of property owner)
property located at
block, road, etc.)
onApK1j h71 Crk , in iU 94) z,9iW, /U S cmufRJ _Fr-H _ N.C.
(Water body) (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.
y I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(to be filled in by individual proposing development)
SPA 6t7T
Foley & Foley Contractors, Inc.
Phone#: [phone]
Fax#-. [phone]
Signature
Flint or Type Name
13(P— /3&�
Telephone Number and Date
CO Q� YVd TZ:LO CO/5O/5O

05/05/03 07:21 FAX
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