58335_SCHAEFER, JANET_20110916 (2)

❑CAMA / El/J / DREDGE & FILL 3P,3 C
GENERAL PERMIT Previous permit#
❑New ❑Modification El Complete Reissue ❑Partial Reissue Date previous permit issued !I I
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 _ u
� Rules attached.
Applicant Name ­ j . _ " �•,C, i. P e r Project Location: County � j
Address
�JZIP
Phone # ()` Fax # (_)
Authorized Agent
Affected ❑ CW EW PTA ES ❑ PTS
AEC(s): ElOEA HHF IH UBA ❑ N/A
❑ PWS: FC:
ORW: yes / no PNA yes / no Crit.Hab. yes / no
Street Address/ State Road/ Lot #(s)
1 �
Subdivision
City ✓ V')C.' S ! O ZIP
Phone # (� !ij) ��5 ' �5 `b` River Basin
Adj. Wtr. Body �tQytr.I i "� '� (nat /man /unkn�
Closest Maj. Wtr. Body `1, R `
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Agent or A, pp'
Printed Name
io ' /,SA)&-i- eo t_ t4Aefi!f-C
Signature ** Please read compliance statement on back of permit
PermitOfficer's Signature
k'
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Issuing Date ' Expiration Date
Application Fee(s)
Check #
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Local PlanningJurisdiction 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 (910-796-7215) for more information on howto complywith these buffer rules.
Division of Coastal Management Offices
Raleigh Office Morehead City Headquarters
Mailing Address: 400 Commerce Ave
1638 Mail Service Center Morehead City, NC 28557
Raleigh, NC 27699-1638 252-808-2808/ 1-888ARCOAST
Location: Fax: [phone]
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
Fax:[phone]
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico Counties)
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)
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
910-796-7215
Fax:[phone]
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)
Revised 08/09/06

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIAIOORING PILI_NGSIBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to JANET SCHAEFER 's
(Name of Property Owner)
property located at
��tt (Lot, Block, Road, etc.)
on �'fEV,EI'4.s ( R&eK in S D O L C.
(Waterbody) (Town d/or County)
Applicant's phone #: C410)3 Mailing Address: `�•� �x t 03A
51-1c has described to inc, as shown below, the development5he is proposing at that location, and, I
have no objections to NProposal. I understand that a. pier/mooring pilings / boatlift / boathouse
must be set back a minimum distance of fifteen feet (I T) from my area of riparian access unless
waived by me. (If you wish to waive the setback, you must initial the appropriate blank
below.) �_--_ izi;CEtvED
I do not wish to waive
AUG 12 2011
I do wish to waive that setback requirement. `
-------------------------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: DCM-MHD CITY
` ' n J (To be filled in by individual prop f*, g development)
(�-� Ptky1111AV
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(Information for Property Owner Applying
for Permit)
Mailing Address
u)M45800 NC. SSS
City/State/Zip
611v) 3m(0-..t88
Telephone Number
7,s ,
gnature Date
,41A�-,S�4
GinS S
(Riparian Property Owner Information)
�w Signature
�me-- ! [�
Print or Type Name
Telephone Number
Date

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERliVOORING PILINGSIBOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to
JANET SCHAEFER_ is
(Name of Property Owner)
property located at kor 37 - 2 (o f A JER REACK
(Lot, Block, Road, etc.)
on STEYE.1�►5 CREsK , in �IJAdsdoo.o �m,�ScetiJ coccnll , N.C.
(Waterbody) (Town and/or County)
Applicant's phone #:%/a 3.Z6, ..ZR8 Mailing Address: PLO. 8oX /d 38
S.i1G llas dc;SCrliieii %O iiie R S1iCiW11 bC:IGW, tiiC Cie',%E;1011riic'Ii"i.�fi;e iS prGliii�lrlg at that iCCatlCii, anCl, i
have no objections to p1-oposal. I understand that a pier/moo.ring pilings / boatlift /boathouse
must be set lack a minimum distance of fifteen feet. (I T) from my area of riparian access unless
waived by me. (If you wish to waive the setback, you must initial the appropriate blank
below.)
MENED
I do not wish to waive
AUG 12 2011
I do wish to waive that setback requirement.
- ------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELO"i .ITY
(To be filled in by individual proposing development)
AA RE H
:RA56
/►(O.5aa.i-7 b P �
(Information for Property Owner Applying
for Permit)
? 0. ,30x /0 38
Mailing Address
,,%ma5w.eo NC .2858,1
City/State/Zip
q,o 3z& -zz80
Telepho e Number
11
nature Date
AARSH
51 CRass
(Riparian Property Owner Information)
Signature
e 4 e e7 —Ali
Print or Type Name
Telephone Number
Date

JANET H.
SCHAEFER T ... PO BOX 1038 '
SWANSBORO, NC 28584_103
1314
pay to the 66-301531
Order of
Date341
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