32988_SIMMONS, ROBERT_20021115

CAMA / F- DREDGE & FILL
GENERAL PERMIT 'D
Previous permit #
❑New E-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 :>
Address i& i jet ; l
City
State ZIP
Phone # ( )
Fax # (` )
Authorized Agent
Affected ❑ CW ❑ EW
❑ PTA ❑ ES ❑ PTS
AEC(s): ❑ OEA ❑ HHF
❑ IH ❑ UBA ❑ N/A
❑ PWS:
❑FC:
ORW: yes / no PNA
yes / no Crit. Hab. yes / no
Project Location: County
Street Address/ State Road/ Lot #(s)
_ ZIP_
Phone # ( ) _ River Basin
Adj. Wtr. Body ; , i ; ( r ri r (nat /man /unkn)
Closest Maj. Wtr. Body -
Subdivision
City_ -
mp
Zli
q 634-417—
I L0 `i
pier(s)
/I t " r/ � Al a
Agent or Applicant Printed Name
r -f
` r —
Signature Plre read compliance statement on back of permit"
Fee(s) I Check #
t
Permit Officer's Signature
� J
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 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, 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:
i_- euse 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

UNITED STATES
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1:00000800 21:
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..... .......

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/UNCOVERED BOAT LIFT)
hereby certify that I own property adjacent to dkQ-109- is
(Name of Property Owner)
property located at �4 O'
(Lot, Block, Rn4' etc.)
Oil Bin , NC.
(Waterbody) (Town and/or unty)
He has described to me, as shown below, the development he is proposing at that location,
and 1 have no objections to his proposal. I understand that a pier/uncovered boat lift must be set
back at a minimum of fifteen (15') from my area of riparian access unless waived by me.
I do not wish to waive the setback requirement.
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposl development)
-41�--.
Signature
Q!� Q - iYY-- ` -25 7
Telephone Number
�ID to
Print or Typ , Name
�D 3
Date

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/UNCOVERED BOAT LIFT)
I hereby certify that I own property adjacent to 9W ��✓ 's
(Name of Property Owner)
property located at�
(Lot, Block, Road
Oil AuA in , NC.
(Waterbody) (Town and/oV 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/uncovered boat lift must be set
back at a minimum of fifteen (15') from my area of riparian access unless waived by me.
I do not wish to waive the setback requirement.
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
0
lin at e
70- / 1a ,I -
Telephone Number
Vi
x�/,al��c
O 1
� a �
Print O Type Name
Date
O

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/UNCOVERED BOAT LIFT)
I hereby certify that I own property adjacent to �0 6 Sln"°_""S ,s
(Name of Property Owner)
property located at IC Q v 4 rL tl 5til- r
(Lot, Block, Road, etc.)
on i3 LL Clttr j�- in ('4e'i Lc c o
NC.
(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/uncovered boat lift must be set
back at a minimum of fifteen (15') from my area of riparian access unless waived by me.
I do not wish to waive the setback requirement.
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING. OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
LL
Signature Print or Type Name
Telephone Number
Date
Ullo3

ADJACENT RIPARL-�-N PROPERTY OWINER STATEN ENTT
(FOR A PIER/MOORING PILINGSIBOATLIFTIBOATHOUSE)
c%+-���T"a�J
I hereby certify that I own property adiacent to s
(Name of Property Owner)
Po
prope.-y located at (�Ij .41 C f\j
(Lot, Block, Road, etc.)
on -���r in �� , N.C.
(Waterbody) (Town and/or Co tv)
He has described to me, as shiown below, the development he is proposi-_ a: that location,
and, I have no oblectlons to his proposal. I uners:and ti,,27 a p:e "Moor�nQ
piii;,�s, i,oa Iift/boathouse must be s,.: back a minimum distance 0. filLeen fom my area
of r'paran access unless waived by me.
I dn rint wish to wa:vC the setback requirement.
I fin. wish to waive t�.at setback re uirement.
DESCRIPTION A.'N-D/OR DRAWLNG OF PROPOSED DEVELOP`IEti7:
(To be filled it: by individual propose; development)
0
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Iry
h jQCA"T I ;Fr
N d.
1-9-
SiEnature
Print or Type Name
—7,iA,-- 775-7
Telephone Dumber
Date: AR b 3 /"��

Page 1 of 1
Subj: Dock
Date: 12/17/2002 8:12:26 AM Eastern Standard Time
From: mbw _,pocketmail.com
To: becky318 -aol.com
CC: kirsch0pamlicomet
Sent from the Intemet Detailsl
Hi Bob
I called Bill Kirsch to look at your lift & the position of the outer poles with respect to your curent dock
configeration. The outer poles were the big concern to me & it was a memory test I requested Bill to look at.
The 8 ft extension you requested is not a problem & I told Bill to sign off on the request on my behalf.
I just could't understand the problem but trust that the extension will resolve your problem.
Bill Kirsch will sign my name to get your CAMA approval & I hope that will do the trick for you.
Bill & Mary
Bill White
4�1
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Thursday, December 19, 2002 America Online: BECKY318