34567_VENTERS, JEROME_20030718

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QCAMA / 7 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
N�/ P;
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC 1 r 4 � Ld li i
}Rules attached.
Applicant Name Project Location: County
Address
Street Address/ State Road/ Lot
# s
City{, _ State ZIP ~4�/
Phone # (1")� Fax # O
Authorized Agent `. ; 4 '
Affected ❑ CW 0 EW p PTA ❑ ES ❑ PTS
AEC(s): ElOEA G HHF ❑ IH ElUSA [IN/A
❑ PWS: ❑ FC:
ORW: yes / no PNA yes / no Crit. Hab. yes / no
Type of Project/ Activity
Pier (dock) length
Platform(s) _
Finger pier(s)
Groin length
number
Bulkhead/ Riprap I
avg distance
max distance
Basin, channel
cubic yards_
Boat ramp
Boathouse/ Boatiif
Beach Bulldozing_
Other
Shoreline Length _
SAV: not su
Sandbags: not su
Moratorium: r
Photos:
Waiver Attached:
A building permit may be required by: I
Notes/ Special Conditions f v
_�
Agent,or Applicant Printed Name
Sig jnature Please read compliance statement on backofpermit
Af plication Fee(s) Check #
Subdivision
City__
-
ZIP
Phone # ( 1 River Basin
Adj. Wtr. Body (nat /man /unkn)
Closest Maj. Wtr. Body I
(Scale: P i S )
C See note on back regarding River Basin rules.
Issuing Da> a EkpiratiogDate
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 consistentwith the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
El Tar - Pamlico River Basin Buffer Rules ❑ Other:
[l 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)
www.nccoastalmanagement.net
Revised 10/05/01

PAY
TO THE
ORDER OF
C*—
SHORELINE MARINE CONST
ASHLEY BROOKS NCDL-7666496
PH (252)-646-3212
99 CENTURY CT
SWANSBORO, NC 28584
Ar T-)F--Pj P,—
-WAC--H-Ovu
Wachovia Bank, N.A.
I,i K �J[Sho— NC211,57 6,PC,-34,57Zp7
FOR" -;t:70?Atl� - 02130101, Elio
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28010486
66-152/531
DATE
DOLLARS
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JUN-16-03 15:29 UENTERS INS IEL:91U-324- 711 P:U2
ADjAcLNT jUVAItj.%N 1'izorI,wrY OVVN at serA,1- it "NLY
(FOR A PIE. K/A400RING PILINGSIUOATLIT-TIROAT1101,U)
- JUL 0 3 2003
I hereby certify that I uwn property adjacent to
(Nance of Property Owner)
property located) at_ - — — ,.:
(Lot, Itlt)ck, Road, etc.)
(i U S,1UvC. 111_ l e�, �Li.1!" f �rl -/ .N.L
on i, �._._._..
(Wateritody) (Towit audlor County)
He has dmtibed to me, as shown below, the development he is proposing dt that iucadoll,
and, I have no Objections to his proposal. I understand that a pier/mooring
pilin&sftadMuathouse must be set back a minimum distaPLU Of fifteen feet (15') frorn my area
of riparian access unless waived by me.
I do no Wish to wai%u [lie setback regiiiremenr.
..IC:f' I dR wish to waive ti:at setback requirement.
DESCRY YION AN-DIOR DRAWING OF PROPOSED DEVELOPMEYT:
(To bP filled in by indiv(dual proposing development)
Id
Vr.
/ A
s' natL1T
4--
PHnt or Type Name -
Telephone Number
Date: 6'--1 � -C' 3

ADJACENT RIPARL-kN PROPERT'Y OWNER STATEMENT
(FOR A PIER/MOORING PILINGSIBOATLIFT/BOATHOUSE)
,''J' 0 3 2003
I hereby certify that I own property adjacent to �e1'�i''� 2 Ve'ltfk5 m'i_'s
(Name of Property Owner)
property located at %V-,o k .So u/vc� A% /' k t
(Lot, Block, Road, etc.)
on Bo 9 U-�. souMC� _,in -7154i CALftj•cf Co„ 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 se: 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.
I d-u wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPNIE`T:
(To be filled in by individual proposing development)
pgAov
--------------------- —--------- ——--------------------
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SAr► e S G, �eLf6N
Print or Type Name
Telephone Number
Date:—/ (.- 0 3

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MONITORING & COMPLETION REPORT
[CAMA Major Development & State Dredge & Fill Permits]
PERMITTEE' S NAME: PERMIT #
LOCATION:
FIELD REP.
G 1
PHONE: �j ✓ -- �� I DATE REPORTEDLY COMPLETE:
DATE OF INSPECTION
1) Do thphpsured dimensions of the development differ from those indicated in the permit and workplat?
YES/ O [circle one].
2)
COMMENT:
disturbed areas? YES/NO Jcircle one]
COMMENT:
Has Permittee seeded, grassed, or otherwise stabilized all
3) FUTURE MO RING &ENFORCEMENT ACTION: Is further investigation or enforcement action
needed? YES/ O [circle one].
COMMENT: