30583_RUDOLPH, STEVE_20021105

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GENERAL PERMIT
Previous permit #
LKNew ❑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 I SA NCAC
n ❑ Rules.attached.
Applicant Name J
Project Location: County
Address / ; / ;r n, �/�
Street Address/ State Road/ Lot #(s)
City S,�,y. r�. �� , State V ZIP
. �, r F/ �, •;
Phone # ( ) ;' 1 ? ( y Fax # ( }
Subdivision �' ; �V I r, ra��
Authorized Agent -dr << ,�?
'
City r E '� : G ZIP
Affected � CW O EW PTA ❑ ES r � PTS
Phone # (_ ) River Basin
❑ OEA ❑ HHF ❑ IH ❑ UBA C N/A
AEC(s):
J
Adj. Wtr. Body 1)1t rVPI
(nat /man)unkn)
❑ PWS: ❑FC:
ORW: yes P ro i PNA yes /h=/ Crit. Hab. yes / n�
n
Closest Maj. Wtr. Body L"�
�, %S
Type of Project/ Activity rr, �4111
(Scale: )
Pier (dock) length
Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshores
max distance offshore
--
Basin, channel _ T•„�i -•---_ 7
r
cubic yards
- -
Boat ramp • --.-- � -�
G
Boathouse/ Boatlift
Beach Bulldozing
Other -�•t tom: , /
Shoreline Length
SAM not sure yes no _
Sandbags: 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
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit"
Application Fee(s) Check #
�zc
❑ See note on back regarding River Basin rules.
I ! ,
Permit Officer's Signature
z, .3
Issuing Date Expiration 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 I) 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 (910-395-3900) for more information on how to comply with thesebuffer rules.
Division of Coastal Management Offices
Central Office Elizabeth City District
Mailing Address: 1367 U.S. 17 South
1638 Mail Service Center Elizabeth City, NC 27909
Raleigh, NC 27699-1638 252-264-3901
Location: Fax: [phone]
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293 / 1-888ARCOAST
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)
Revised 10/C

ANTINORI CONSTRUCTION
896 HWY. 210
HOLLY RIDGE, NC 28445
[phone]
TOHE / V r_
ORDER OF
latre- � vim. �ilc e� jly��G� cJL
MEMO C•� 36t—C
BANK OF AMERICA
66-19/530
11.00 3 5 1 311' 1:0 5 3000 196I: 0006 50 5 2 199011'
3513
ro
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AUTHORIZED SIGNATURE

FROM RUDOLPH FRX NO. '310 327 0103 Oct. 30 2002 08:28RM P2
6:';tM : RljDCLPH 910 24 ZM2 34;JGF-r,
1(1�' NOW
U&MV Of Individ;;&I Apylvirg F.,)r Par
Address -.f s'roperry: C�✓w,ryi `j '` �Y�
n �'.�..r�f �'r .r :1� _ Z O �'� CS
(Lot 0!7 St:e**t, If county)
c r
burelpy car t i Lv • tni IL z own prQ�*m�^%, K to the ak)o*:a
roferanced property, 14"he his permit hzs
described to rt IS on th-e., "Ile
thay Zro FrCPQQlnq. de., =Crilpt
hou 5 id bp z 'prvided with 'S
Vneerotand that Pdar, :d=X1 'mo'41' b,at
0USe, l'it ;Z san�bzgs nuat L% Aislice of 151
lkoe7 R ";u W, 5�
j Waive the. s6tback' M. .
v
dt% wisr'. to wai"m tho
'15wm-
jo�' r"
a int Na&e
I zq
--dw -- L
Te.;ePmono Rulebel f W. - I ... 1
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. F4ROM : RUDCLPH
FRX NO. : 910 327 0103 Oct. 30 2002 08:27RM P1
Name Of Individual R 1'
PP Yin9 for Permit:c%�►-�
Address of Property
(Lot or Street ,' Stx$ vCi, City & Caunty)
1 hereby certify that 1 own property..` adja"r%t to the above -
reference' property. The individual. aVPt,Y, , tsar this permit has
described to me as shown, on the attached` tf±esw rir the deve-lupment
they are proposing. A descripticr, or,: with dimensions,
should be provided with tilis letter.
I have no objections to this
WAIVER _ $ECG
I understand that a pier, dock, moor.i.ng p� .xs�gs.., breakwater, boat
house, lift or sandtaas must be set back -a n,I., itm distarce of 15'
from my area of riparian acce_s unless wa%ved':';by'tne. (If you wis
to waive the setback, you must i.r,itfiax >`t;`r .:a, ropriate blan;c
below.)
t'
I do wish to waive the I5.'.setba�k;.requirement.
I do rQ't wis : tc waive.the' .iS, b'g�Ck requirr.t.
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