57119_SEITTER, JOHN_20110214

❑GAMA / ❑ DREDGE & FILL
GENERAL PERMIT Previous permit #
❑New ❑Modification ❑Complete Reissue ❑Partial Reissue �27 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
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)
Subdivision
CityZIP
Phone # () River Basin
Adj. Wtr. Body (nat /man /unknj
Closest Maj. Wtr. Body
Type of Project/ Activity
Pier (dock) length
(Scale:
Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
i
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
i
+
-
-
�
I
-- j
Shoreline Length r
SAV: not sure yes no
l -
Sandbags: not sure yes no - _
Moratorium: n/a yes no
Photos: yes no # (,
Waiver Attached: yes no
A building permit may be required by: ❑ See note on back regarding River Basin rules.
Notes/ Special Conditions
Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit **
Permit Officer's Signature
tl 4
Issuing Date ,% Expiration Date
,I„
Application Fee(s) Check # 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 (910-796-7215) for more information on how to comply with 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/ 1-888-4RCOAST
Location:
Fax: [phone]
2728 Capital Blvd.
(Serves: Carteret, Craven, Onslow -above
Raleigh, NC 27604
New River Inlet- and Pamlico Counties)
919-733-2293
Fax:[phone]
Elizabeth City District
1367 U.S. 17 South
Elizabeth City, NC 27909
252-264-390I
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

-.-,2 _- —
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
found in your Habitat code sheet.
Habitat Name
DISTURB TYPE
Choose One
TOTAL Sq. Ft.
(Applied for.
Disturbance total
includes any
anticipated
restoration or
temp impacts)
FINAL Sq. Ft.
(Anticipated final
disturbance.
Excludes any
restoration
and/or temp
impact amount)
TOTAL Feet
(Applied for.
Disturbance
total includes
any anticipated
restoration or
tern p im acts
FINAL Feet
(Anticipated fii.a,
disturbance.
Excludes any
restoration and/or
temp impact
amount
redge ❑ Fill ❑ Both ❑ Other
�J
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT 10'ecrivFft
�FB 2 2011
I hereby certify that I own property adjacent to JO H N 1,6 / 17E )e 'fib'' s
(Name of Property Owner)
property located at Z 2 Z /V D < T %1 S/ i��r� i. 6 /-tozc.1-�9,oV V 'CaG 1v
(Lot, Block, Road, etc.)
on /V,)e i 1t .e1 ieK Y y m �f �y` U /? l C 1,� eV ,- e, % , N.C.
(Waterbody)� (Town an or County)
Applicant's phone #: a 5a 8 i3 - 7 77 7 Mailing Address: -20 7-& S A10112-' OR
/VC
He has described to me, as shown below, the development he is proposing at that location, and, I
have no objections to his proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by property owner proposing develo ment)
J OH,(_,s4 % TTec PeAWT7
4e
SEA
=- 29
(J O C K �
(Information for Property Owner Applying
for Permit)
-? a 410nTH
Mailing Address
,ef,#VyGa/1T- il/C
City/State/Zip
a5a- 7777
Telephone Number
Siqxfbie Date
i
13 s
(Riparian Property Owner Information)
Signature
Print or Type Name
Asa -soy- zay0
Telephone Number
Date

IFOR' `
a DATE TIM P
UOF
PHONE CEL L
ui M AG
TELEPHONED
' ( RETURNED YOUR CALL
O, ❑ PLEASE CALL
WILL CALL AGAIN
21 AME TO SEE YOU
A SIGNED WANTS To SEE YOU

ADJACENT RXPARLAXPROPERTY OWNER STATEMENT
= F B 2, 201,1
I hereby certify that I own property adjacent to J © H N 1 7E e Is
(Name of Property Owner)
propertS' loud at 0 2 2, A/ o 4 T tt Ifioz• /- ANC
(1A dock, Road, etc.)
on oerr ,rli,r r��vis-� I�E��Ifan'T C l�,c�t� eE T , N.C.
(Waferbody) (Town Umver, County)
Applicant's phone #: a Sa - 813- 7 7 7 7 Mailing Address: as a WO/e ;r& s�rAre �R
41C .?&S 16
He has described to me, as shown below, the development he is proposing at that location, and, I
3 have no objections to his proposal.
DESCR MON AND/OR DRAWING OF PROPOSED DEVELOP1l� EM: •f u� l ,��(
• (TO be frlled by property ovmrrProFosix
TTf
Gj r 2 9 L-J-
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10,PorsE�,
Day k
(Information fer Property Owner Applyutg
for Permit)
a a �2 NOeTH
Mailing Address
&C,4 uRoX 7- Mc 8 /6
City/State/Zip
(Riparian. perty Owner Iuforntation)
L-
Signature
awes
Print or Type Name
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Telepho Number Telephone Number
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