34578_RUBENSTEIN, DAN AND DONNA_20030904

CAMA El DREDGE & FILL
I GENERAL PERMIT Previous' permit#
r- New ElModification F-'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 I SA NCAC
E-I Rules attached.
Applicant Name
Address
City_ 61K. C�j State
Phone# Fax #
Authorized Agent
, zip , 7gL
Affected L CW El EW 2 PTA F] ES El PTS
AEC(s): EJ OEA E HHF El 1H I-- UBA El N/A
El PWS: El FC:
ORW: yes fino PNA yes / no Crit. Hab. yes / no
Project Location: County_
Street Address/ State Road/ Lot #(s)_
Subdivision
City
Phone#
Adj. Wtr. Body —___
Closest Maj. Wtr. Body
ZIP —
River Basin
- -- (nat /man /unkn
Type of Project/ Activity
,X J:
(Scale:
Pier (dock) length__
Platform(s)
pier(s)
Finger Groin length i
number
Bulkh ead/ Riprap length
avg distance offshore 1 ---------
max distance offshore
Basin, channel
cubic yards
Boat ramp
T-7-
Boathouse/ Boatlift 1
Beach Bulldozing
Other
4-J,
Shorel 4�C-
SAine Length V
not sure yes no
Sandb ags: not sure yes no
Moratorium: n/a yes no
Photos: yes no
Waiver Attached: yes no
A building permit may be required by:
Notes/ Special Conditions
4
H-11
1. J
T
on back regarding
la.7
River
El See note
Basin
rules.
,-Permit O
cer's Signituriii`
2oo 3 .2,�7o 7
Issuing Date Expiration Date
J .10 rlo fil 6
Local
Rover File Name
Agent or Applicant Printe� Name -T
Signature Please read cornpl iance statement on back of permit
Application Fee(s) Check #
ffi
Planning Jurisdiction
Agent or Applicant Printe� Name -T
Signature Please read cornpl iance statement on back of permit
Application Fee(s) Check #
ffi
Planning Jurisdiction

Y
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:
U, 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 / 1-888-41RCOAST
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

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PRESCOTT BROTHERS INC
141 TARA TRL , ` 66-30/531
ARAPAHOE, NC 28510 7- / 471
PAY
TO THE
ORDER OF
DATE /
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/, a ,bC o. N.C. 28515
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSIBOATLIFT/BOATHOUSE) Z 0 2�ro
I hereby certify that I own property adjacent to D, t b; , V4 ??6kD0h1J7Gi-A)s
(Name of Property Owner)
property located at
(Lot, Block, Road, etc.)
on D�1:>- J effQ�� , in /CJGt, /11C a , 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.
x I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
Gv�4 k
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Prin or Type Name
kotl---7XLI 3 S 9
Telephone Number Date: j 16) J

JUL-21-2003 07:51 PM PRESCOTT BROTHERS INC. 252 249 09S7 P.01
�j i : a � V � �yY� Wi4TRAj�Cl IN CCRP bK52999593 P' 01/01
ADJAL"4.1 J �'�+w OWNER TATLIN!aIIL
(Po .P_t P.1,91
s bmr)"I orrHy that, I OW11
'NipineiT;r�er)
property loc*Lvfl at /�Id �► Cr6.
(A-at,13tock, riaed, ate.) /�t!
on r;
� � �% r.� . N.C.
t:terbody) (Town addlor County)
fie ass U'VA;1 ►hru .v .►.r, z.:hn n a„r^W/ tih,, devoioommt he is proposing at that location,
and,1 have no objections to his pi aposal. I uilderstttn(i th<Lt a ploOmooring pilingerttouuivraxu,vuw
must be sat back a miniraum dwtance of fifteen feat (15') fr)m my area of riparian access unless
wws'vay iry r�r,
.tAq.nat wish to
1 U wish to waive that Wbiok mquirament.
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DESCRIMON AND/OR DRAMING OF PROPOSED DEVELOFMIENT:
(T4 by JVW is by Lrdivide4l proposing development)
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