33965_RUSSELL, GROVER_20030501

❑LAMA / ❑ DREDGE & FILL
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 I SA NCAC
❑ Rules attached.
Applicant Name_
Address 1 %'v
City State ZIP
Phone # ( ) Fax # ( }_
Authorized Agent
Affected ❑ CW PEW QPTA ❑ ES ❑ PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ USA ❑ N/A
❑ PWS: ❑ FC:
ORW: yes /fno PNA yes / no Crit. Hab. yes / no
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision
City ZIP
Phone # O River Basin —I ; i
Adj. Wtr. Body i_-,r; c. i i `� : (nat /man /unkn)
Closest Maj. Wtr. Body_ t
I MOW
Si n-ature ** Please /read compliance statement on back of permit Issuing�Da e — Expiration Date
A n� r (� �t -PCt r•n � I(C?
Application Fee(s) Check# Local Planning jurisdiction Rover File Name

A
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 U 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

all
•9°1p�n�^x���°s'%=T''^`ae�T-'t'➢mm�r'acz'ru^m�s�r. r�anuum_T�(Il 5 r r u r r I v� r n L n n, r d, rl n r.0 �m r.n I. -5 r•r. �r x r. A (n r, d r 1. ,r-r 1 e. lu . - r=e'rrraRrrsr�c`��ui9-[i
PRESCOTT BROTHERS INC 2048
141 TARA TRL
ARAPAHOE, NC 28510�
DATE ss-soi4 �
PAY /�
TO THE V
ORDER OF
nRS'T CITIZENS 411
$Ba
ANK Fir bCitizons Bank & Trust Company
yboro,,N.C�28515
FO 0�
11400 20 4Bul 1:0 S 3 L00 3001:00 4 7 L 10 2 S 4 2 9ii'
DOLLARS 8 a�

gr�f3F ;: T'� £l� R CTATEMENT
ADJACENT ��
FOA A Ps G+�51'1
VitJ
op
e14.(
i hereby CC-*tafy R,y I Cxn property adj of PMPer�;y,eri
pmperty locaw at Woc,',kl R-;d, itc.)
sin vor Co ty)
.fir:-Iz at +4 •
hP ims a(O: klUB:+ t,ti ua40 .,... 1 t,+ I e' slil4l t .s �► ji:Gl;`illOt� I.2�
�.•-rt R h�+�,e: ,n,.► nk:i��cii4L'S �i''''C;'.r�_•. 1 a S:ri.:.'•.. r ..
Ei"f %+�! i7 Y: a•� i + fiiStF111G7 d flitter)
�
yl, area of
' 1 f F7,CC`-.�3:3 i:,tLlv;�$ ►� 81V'�•'� �� Ll`l$.
►Yk+w�Cii
I.Sh tw vw:ave th.E is �Il rtyu * re t.
T ,! -,is- to -alive dh.xt$':IbaGk ;*Yirri.11e 11,
DESCRIPTION ,r►%: ;,`;:, ,4. -
wn L ^_ ss�.' t + L-• i'th,�7iif!% ! )� r'-norsi�' y�;!1k l7�hm4�r"a
((fJ Uri j:;: r•. r i. .,i -
�% rl -Ed
T.

ADJACENT RIPARIAN PROP)
1"1. 1 T� V SEER QTATEMENT
(FOR A PIER/MOORD'G PfLil G&!30.4TL" ...'1B0" HOUSE)
I hereby certify that I own property ad; uc-"a
�?1amr; ai i'mex�!J
1'r ---------------
property located at-- --t.Koad, Ste
e'A
--
0.
„1;drkTt�+�y
s =,.e de,,"j.,=lment he is p_r;j,,�,;i�: at
EIP hay de��xibed t;o+�, a., showrr� -
' deY �*S end di t a r:e"; mo a)"r L �V
� ;G.:a cns tO 12:. ► �;c.al. c�
;cc:aticc a, :t:7d, s ha�r�.:�: a ram! i ,.:
,� M:U:t bo! wet back a uiuu.:uu'rizaulc C, fifteen
jx.lings/boat;'A0 -r, ,uot,,,
Ir(y area of rty:t.� ac,.-:a;v�r�
a ,�,: wish to vw ave the sei ?a r it, r(n 'at.
I do wish to ;waive that s(:tback ••--,qc;:rP,-.ent.
---
1TT.
DESCRIFTION AND/OR 'DRAWING 01 PI~:'-).? ;SPD DENN�,urm s� �:
('To be j'tlled in 5y individt+.41 F -°uPos rT
Pqq4Ve__
d/,wtToW
Qd c_-I L-
��Sh�jll/W�
IG
V
/�5
grin' �r i ype