34743_VERCH, BRYAN AND LYNELLE_20030828

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:.1CAMA / I DREDGE & FILL �N �'•
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 15A NCAC
❑ Rules attached.
Applicant Name _.% - _L-, t
Address
City `! i State 0 ZIP��`
Phone # O Fax # (_)
Authorized Agent
Affected p CW ❑ EW ❑ PTA ❑ ES PTS
AEC(s): ❑ OEA ❑ HHF E1IH ❑ UBA F 1: N/A
❑ PWS: ❑FC:
ORW: yes / no PNA yes / no Crit. Hab. yes / no
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision
ZIP
Phone # ( ) _ River Basin
Adj. Wtr. Body-___ (nat /man /unkn)
Closest Maj. Wtr. Body
Type of Project/ Activity
r
(Scale: 1 1 )
Pier (dock) length }•, j' i .-�
I' (
Platform(s)VC
Finger pier(s) i
Groin length
number
Bulkhead/ Riprap length
avg distance offshoreAU
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ BoatliftUAL
Beach Bulldozing _
Other
I
I_
I
j
�—
I
I
!
-- — '
Shoreline Length \
$AM not sure yes no � 1
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
—I
-
—
�
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I
+
AELA
i
'
See note
on back
regarding
River Basin
rules.
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit
062
Application Fee(s) Check#
Permit Officer's Signature
Issuing Date t Expiration Date
Local Planningf urisdiction Rover File Name
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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:
❑ 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 it
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

'UMTEDSTdTES ]NIONTEY ORDER � T
' ,POSTLI L SERVICE® P O S �l E�L 1
SERIAL NUMBER - YEAR, MONTH, DAY \•POST OFFICE U S. DOLLARS AND CENTS
0 61, 0 2? 0 6 L 8 4 2oo3-4B-27 285574
AMOUNTONE HUNDR'ED....DOLLARS,, &' 04O_ ** * *+► �+�*
PAY TO I` ;NEGOTIABLE OiJLY 1N T NE US, \AND POSSESSIONS
/ SEE REVERSE WARNING
ADDRESS �y ' CLERK
FROM. ._/ . L,,R •
/A
C.O.D. NO.
USED FOR
l:00000800 21: 06 10 2 706 1B4n' v

7
4

ADJACENT RIPARIAN PROPERTY OWNER s,rA.TEMENT
(FOR A IE ? TNCOV ERED OAT LIF.q�/.
I hereby certify that I own property adjacent to U_ c�
Arne of Proolrty Owner)
proptrty located at — J (Lot, Block, Road, etc.)
on 1 ini�C.
(Waterbody) (T n and/or County)
He has described to ont, as shown below, the development he is proposing set that location.
and I !save no objections to his proposal. I understand that a pier/+uncoverrd boat lift must be •ct
back U a minimum of fifteen (15') from my area of riparian access unless waived by me.
I do no wish to waive the setback requirement.
144 wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF IMOPOSFD DEVELOPMENT:
(To be fill d in b individual proposing development)
s+eK :
r�
IJ
o� II
A.
Si ature
B not or Type Name
xa
t) ���i4 L � �%IUChr/ 5 %O I
Telephone Number �y� ate � —�"-- --
I

ADJACENT RIPARIAN AN PROPERTY OWNER STATEMENT
(FOR A � NICOV FRIED i AT L1 ®/� y
/111 ;
i herttby certify that l own property adjacent to
ante atf E°ro rty Owner)
property bocatod at.-
dLot. Hl®c L. Road. etc.)
Matodody) (T n •ad�/,ar�ntyt—
He
has described to one, as sbown below, the development be is propasiwg at that tacstsot+.
and l haws as objectlows to Avis proposal. 1 understand that a pierfunrovered boat lilt onus% be oft
back as a aeieetweom of ilftaes (M) from my ors& of riparian access unless waived by ate.
;-•�r! 1 Jp M with to waive the setback requirement.
1 lU wish to waive that setback roquiroment.
DESCRIPT10,N AND/pit DRAWING OF PROPOSED DEVELOPMENT:
(To be fill S in by individual proposing development)
s ®' at • f'+i'z+
e ,trFr l
Signature
Telephont Number
of or Type Name