52659_SAMMARTINO, MARK_20081001

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GENERAL PERMIT r Previous permit#
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As authorized by4he
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
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❑ Rules
Project Location: County
attached:
_
Address
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Street Address/ State Road/ Lot #(s)' '
+-- 17
City
^ I:, ' F State JNAC' ZIP
Phone #
Fax # (� "'
Subdivision
Authorized Agent
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City `f 9? ; �t i' Iz�/�/
ZIP jP
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❑ EW ❑ PTA [j ES ❑ PTS
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Phone # ( ) ✓' ,River Basin f 11t� j'.1 ' -
Affected
❑ OEA
AEC(s):
HHF ❑ IH ❑ UBA ❑ N/A
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Adj. Wtr. Body-11,f ; ;':
`, (na /man /unkn)
❑ Pws:
El Fc:
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ORW: yes / no
PNA yes / no Crit.Hab. yes / no
Closest Maj. Wtr. Body t .P
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Shoreline Length'M6
,
SAV: not sure yes
no
Sandbags: not sure yes
no {
Moratorium: n/a yes
no
Photos: yes
n
Waiver Attached: yes
o
A building permit may be required by
Notes/ Special Conditions
Application Fee(s) Check #
,'�j See note on back regarding River Basin rules.
Permtt�cer's Suture
/0
Issuing Da r_ } Expiration Date
.61 /'wI 31 i1
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 consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
X-Pamlico River Basin Buffer Rules El Other:
Ta
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 o the Wilmington
Regional Office (910-796-7215) for more information on how to comply with these buffer ru es.
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
252-264-3901
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

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UNITED STATES POSTAL � First -Class Mail
1116 — Postage & Fees Paid
I �I �� I LISPS
Permit No. G-10
• Sender: Please print your name, address, and ZIP+4 in this box •
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Restricted Delivery Fee
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PS Form :r0 August 2006 See Reverse for Instructions
■ Complete items 1, 2, and 3. Also complete
Item 4 if Restricted Delivery Is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
92-
A. Signature
❑ Agent
X �� Addressee
B. Received (P nted Name) /�C. Date of Delivery
D. Is delivery address different frcw5 ert� ❑ Yes
if YES, enter delivery addrebelow: o
3. segoce Type
ifled Mail ❑ Express Mail
Reglstered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number ?00 3��0 ppp�, 9681 3603
(Transfer from service lab
PS Form 381 , February 2004 Domestic Return Receipt 102595-02-M-1540

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CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Individual applying for Permit: %V A,ek S,4"Ikk 4l--o
Address of Property:
N
(Lot or Street #, Street or Road, City & County)
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions, should be provided with this letter.
I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coastal
Management, 400 Commerce Avenue, Morehead City, NC, 28557 orcall [phone] within
10 days of receipt of this notice. No response is considered the same as no objection if you
have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, boatlift or sandbags must
be set back a minimum distance of 15' from my area of riparian access unless waived by me. (If
you wish to waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Applicant Information)
Mailing Address
City/State2ip
-31Gl - 7-
Telephone Number
�
Date
(Riparian Property Owner Information)
Signature
Print or Type Name
Telephone Number
Date

46
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to m,44/z �q�zvn�T � lr d 's
(Name of Property Owner)
property located at b f / % l-3
(Lot, Block, Road, etc.)
on %%lc Sz k� ✓�e y- , in -eG �r , N.C.
(Waterbody) (Town and/or County)
Applicant's phone #: 31y 4 d 7- 75 7/ Mailing Address: % ,S<
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 pMerty owner proposing development)
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(Information for Property Owner Applying
for Permit)
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Signature
Date
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(Riparian Property Owner Information)
Signature
Print or Type Name
Telephone Number
Date

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1:3 Restricted D liver Fee $0.00
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PS Fc.m 3800. ALIgust 2006 See Reverse for InstrUCtions

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Individual applying for Permit:A��
Address of Property: < � f -41 Z 7 //
(Lot or Street #, Street or Road, City & County)
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions, should be provided with this letter.
I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coastal
Management, 400 Commerce Avenue, Morehead City, NC, 28557 or call [phone] within
90 days of receipt of this notice. No response is considered the same as no objection if you
have been notified by Certified Mail.
WAIVER SECTION
understand that a pier, dock, mooring pilings, breakwater, boathouse, boatlift or sandbags must
be set back a minimum distance of 15' from my area of riparian access unless waived by me. (If
you wish to waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Applicant Information) (Riparian Property Owner Information)
Mailing Address
City/State/Zip
31�/ - 7- 75-7/
Telephone Number
Date
Signature
Print or Type Name
Telephone Number
Date

Je'
'ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGSBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent toy&, ,6,- Sq*t1-A gr4-1� 0 's
(Name of Property Owner)
property located at / 0 f / % /--Z
(Lot, Block, Road, etc.)
on �%%zG� Sz k1 t/e r , in 6-eA'a--�0,4 , N.C.
(Waterbody) (Town and/or County)
Applicant's phone #: NY407- 7S 71 Mailing Address:.
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 prEerty owner proposing development)
4C—w _
N x k- 4GAD
(Information for Property Owner Applying
for Permit)
Mailing Address
(Riparian Property Owner Information)
98
Signature
Print or Type Name
Telephone Number
Date

TJ DAVIS JR
GENERAL CONTRACTING INC
4068 D ARENDELL ST
MOREHEAD CITY, NC 28557
PH. 252-240-0330
PAY TO THE A
ORDER OF_ C
BB&T
BRANCH BANKING AND TRUST COMPANY
1-800-BANK BBT BBT.com
66-112/531
14660
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053 10 11 2 11:0005 29768655 2u
THIS DOCUMENT MUST HAVE A COLORED BACKGROUND,ULTRAVIOLET FIBERS AND AN ARTIFICIAL WATERMARK ON THE BACK - VERIFY FOR AUTHENTICITY.'

> ­ObWG'L`�6i(�'
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Coleen H. Sullins, Director
Chuck Wakild, Deputy Director
BUFFER AUTHORIZATION CERTIFICATE FOR PIER ACCESS
A riparian buffer authorization is required for an approved access way through the Tar -Pamlico
& Neuse River Riparian buffer per Division of Water Quality (DWQ) regulations 15A NCAC
02B.0233 & .0259.
Activities covered by your Coastal Area Management Act (CAMA) permit are deemed to have
a Buffer Authorization from the DWQ as long as the project can meet ALL of the conditions
listed below. If ALL of the avoidance and minimization guidelines listed below cannot be met, a
separate buffer authorization request must be submitted using a Pre -Construction Notification
(PCN) application to DWQ at the address below.
A PCN application may be obtained on the DWQ site http://h2o.enr.state.nc.us/wetlands.htm1.
Any questions regarding this process should be directed to the wetland/buffer staff of the DWQ
in the Washington Regional Office at 252-946-6481, or the 401 Oversight Unit in the Raleigh
Central Office at 919-733-6893.
A written authorization from DWQ MUST be received prior to any construction activities in the
riparian buffer, including land clearing. Failure to secure a Buffer Authorization prior to
construction Wor land clearing shall subject the property owner & the party (contractor)
performing the construction &/or land clearing to a civil penalty of up to $25,000 per day per
violation.
❑ Pier access must cross the riparian buffer perpendicularly (which is defined as between
75 and 105 degrees). The alignment should also be located to minimize the removal of
woody vegetation to the greatest extent practicable.
❑ Walkway/access shall be made of pervious materials like open -slatted wood, mulch, or
grass. The use of impervious materials like concrete, pavers, or gravel will require a
PCN review and a separate Buffer Authorization. A request for an impervious walkway
shall include a justification of need.
❑ The width of the access is limited to six (6) feet or less. A width of greater than 6 feet
wide shall require a PCN review and a separate Buffer Authorization. A request for an
access greater than 6 feet shall include a justification of need.
❑ Please submit a project map of your property indicating the location of the pier and any
requested walkway/access.
North Carolina Division of Water Quality Internet: aww.ncwatergpalitv.org One
943 Washington Square Mall Phone: [phone] NorthCarolina
Washington, NC 27889 FAX [phone] Naturally
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Page 2
This Buffer Authorization is not considered approved until the DWQ has received both
this signed form AND the project map.
Submit the requested information to:
Division of Water Quality
Attn: Surface Water/Buffer Program
943 Washington Square Mall
Washington, NC 27889
By your signature below you agree to be held responsible for meeting ALL of the above listed
conditions and verify that all information is complete and accurate. Please be aware, violations
of the above -listed conditions are subject to civil penalty assessment of up to twenty-five
thousand dollars ($25,000.00) per violation per day.
t/AZCnYs Signature
CAMA General Permit Number:
5�41-9-1
_ (9 _L-) C
North Carolina Division of Water Quality Intemet: www ncwaterquality.ora
943 Washington Square Mall Phone: [phone]
Washington, NC 27889 FAX [phone]
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Date
Nne
orthCarolina
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