32973_WASHBURN, MACK_20021216

,❑ CAMA / ❑ DREDGE & FILL
` GENERAL PERMIT
❑New CModification --]Complete Reissue ❑Partial Reissue
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
Applicant Name
Address
City State ZIP
Phone # ()( Fax # ()
1'
Authorized Agent
Affected L1 CW ❑ EW D,PTA ❑ ES ❑ PTS
AEC(s): C OEA ❑ HHF ❑ IH ❑ UBA G N/A
PWS: ❑ FC:
ORW: yes / no PNA yes / no Crit. Hab. yes / no
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Previous permit #
Date previous permit issued
❑ Rules attached.
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision
City_ ZIP
Phone # ( ) River Basin
Adj. Wtr. Body (nat /man /unkn)
Closest Maj. Wtr. Body
Type of Project/ Activity
Pier (dock) length
(Scale: (i ;
Platform(s)
)
Finger piersiwwol
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Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp -----------
Boathouse/ Boatlift
Beach Bulldozing
Other
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Shoreline Len h ._._..-- --- -- -
SAM not sure yes no
Sandbags: not sure yes no77
--
Moratorium: n/a yes no 1^ a I
Photos: yes no 4+
Waiver Attached: yes no
A building permit may be required by:
Notes/ Special Conditions
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L See note on back regarding River Basin rules.
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit
App ication Fee(s) Check
Permit Officer's Signature
• 0
Issuing Date 1 Expir4tion 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:
❑ 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:
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293 / 1-888ARCOAST
Fax: [phone]
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

ALTON D JOYNER NCDL 5741679
ANN W JOYNER NCDL 5927142
270 SEASHORE DR PH 252-225-8621
ATLANTIC, NC 28511
PAY TO
ORDER
v
_WACHOVIA
Wac6ovia Bank N.A.
Sea I xvd, NC 285 7
FORM Ly /J1 W4s ,, a! 3Z9�3 --
I:0531015291: 5461 L84
1546
/: � / 66 152/531
D 2
DATE
ILLARS
-- NP
Lill L 546

ADJACENT RIPARLAN PROPER (ER STATEMENT
fFOR A PIER/MOORING PILINGS(BOATLIFTI OATHOUSE)
I hereby certify.that I own property adjacent to j# ltlq5- bc4 's
(Name of Property Owner)
property located at / Z U d "i
(Lo(, Blo , Road, etc.)
AlL ,
on.) , /U lZ �� e e , in Z ivy
N.C.
(W erbody) (Tow and/or County)
He has described to me, as shown below, the development he is proposi.. a: that location,
and, I have no objections to his proposal. I understand that a pier/mooring
piling- a ' oathouse must be se: back a minimum distance of fifteen m from area
() y
of riparian access unless waived by me.
I do not wish to waiv-- the setback requirement.
I da wish to waive that setback requirement.
T) SCRIPTION Av'D/OR DRAWrNG OF PROPOSED DEVELOPMENT:

ADJACENT RIPARLAN PROPERTY 0 R STATEMENT
(FOR A PIER/MOORING PILING(BOATLM7 OATHOCSE)
I hereby certify that I own property adjacent to �gr�&e/Z•-,,/ ,s
(Name of Property Owner)
Property located at / 2 6 �a An fez ? IGGz A_,-, C--
(Lo. B14, Road, etc.)
on i/� l C , in 5� Z/r��— , N.C.
Wa ody) (To and/or County)
He has described to me, as shown below, the development he is proposir.` a: that location,
and, I have no objections to his proposal. I understand tha= 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 dR wish to waive that setback requirement.
TWSCRIPTION AND/OR DRAWrNG OF PROPOSED DEVELOP`IE'\T:
ak
Print or Type Name
- -L r - 7 74�b
Telephone Number
Date: -L/ / � - p

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