55086_SIMPSON, ELIZABETH_20041222

`1
❑CAMA / El DREDGE &FILL
GENERAL PERMIT
❑New li;�`lodifioation El Complete Reissue El Partial Reissue f
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 I SA NCAC_
i'Zb9/o9 11
Previous permit #
Date previous permit issued
Applicant Name 1 l-�� i ` �' ❑ _k �� 1 i, .Uy1 Project Location: County
Address Street Address/ State Road/ Lot #(s)
City �. j State_ ZIP —%
Phone # # ( ) Subdivision_
Authorized Agent i p�' j fX-t (,�''�"�( City
❑ Rules
ZIP
Affected ❑ CW ❑ EW EIPTA ❑ ES ❑ PTS Phone # ( ) River Basin
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
AEC(s): Adj. Wtr. Body -y i--( f� (nat /man /unkn)
❑ PWS: ❑FC:
ORW: yes / no PNA yes / no Crit.Hab. yes / no
Closest Maj. Wtr. Body�..f,
Type of Project/ Activity
Pier (dock) length
Platform(s)
Fingi
Groi
Bulk
Basii
Boat
Boat
Beac
Othi
Shor
SAV.
Sanc
Mor
Phot
Wain
(Scale:14
)
r pier(s)
ilength
number
r
I
lead/ Riprap length
avg distance offshore
max distance offshore
#1
,channel
I
cubic yards
ramp
—
louse/ Boatlift
I
i Bulldozing
—
--
—
-
��
r
AL
:line Length
not sure yes no
gags: not sure yes no
.torium: n/a yes no
)s: yes no
erAttached: ves no
_
❑
.I
A building permit may be required by:❑See nBarring a major shoreline change due
Notes/ Special Conditions "�,' + � rZ to a storm or other significant event,
the alignment of this structure must be
approved by a DCM Rep. within 120
days of the onset of construction.
& llpt<
rL
Agent or Applic Printed Name Permit icer(12 ' Sig re
/.�
Signature Please read compliance statement on back of permit Iss 'g Date i
C.- l
Application Fee(s) Check # Local Planning,luris ' Ro' Rover File Name

W
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/ 1-888ARCOAST
Location:
Fax: [phone]
2728 Capital Blvd.
(Serves: Carteret, Craven, Onslow -above
Raleigh, NC 27604
New River Inlet- and Pamlico Counties)
919-733-2293
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

FROM :COASTAL GENERAL CONTRACTING FAX NO. :252-728-7606
Dec. 15 2009 10:00PM P1
LIEU .l b CUUy
OF Fad 0', Dci
AD3r10ENT RIPARIAN P-ROPRIZTY OWNER STA MVWNT
!s't•.rx .. r�-c-rrsvovxrrvc: rru�vac.cao..e �i,Ir• rrvoi rrz
h Q�.��. Otr.��j •,
I hereb certify :hat I owr propezty.xdjac wt ro NL1�1
' 6D
(Mrse of'Property owner} ,.
PrcpWy located at +
MofO 8jock. Rtead, etc_)
on
(Waxerbody) (Town anrllor�oatrity)
Applicaat's phppe;�2-17 Mailing Addrey-+�11���,
He bas ciesczibed to me, as shown beiew, the devaloprners. he is proposing at that :o=stior,and, ;
have no objections tc his proposal. I u,-rderstand tha: a piar!mcorn?g pilings / boaJift! boathot--se,
must be set.bar~:c a minimum d:stanca of zfteea fe-' t (S') from. my area of tipariartt access unless
waived by me. (If you wish to "ive the setback, you must initial the appropriate blank
below.)
] do not wish :o -waive
I do -,vish to w2ive Eqpt setback requirement:
DE1,TRIPY10N A-NDlQR DRAWING of PROPOSED DEVELOP!KErNT:—
(To be f Hed in by lndhjd wr.•! prrposing dei�ef,mment)
(Information for Property Owner. Applying (Riparian Property Ohner Infararation)
for Permit)
Mailing Address Si�oatu7e
City!St -Izlp Dint or Tyne Name.
Tcicphonc Number
Sigar.:ce Date
Telepbone Number
Date
degz 6o 9l 00

DEC-09-2009 11:27 From: To:252 247 6332 P.1/1
AA
ADJACENT RXPARLAN PROPERTY OWNER STATEMENT �" ZOOg
(FOR AP1ER/MOOWNGPILf]VGSMOATUJ'TIBOA1''HOiJSE1X�
S
I hereby ce" that I own property adjacent 106_�-ls�b
rye., (Name of Property Owner)
property located at
` (Lot, Block. Road, et`)
on
i�.� (,� �ir in , N.C.
(Waterbody) (Town an or Count
Applicant's phone #: 2 S Mailing Address:
Re has described to =, as shown below, the development he is proposing at that location, and,1
have no objections to his proposal. I understand that a pier/ oring pilings / boawft/ boathouse
must be set back a minimum distance of fifteen fast (1 S') ftom tay area of riparian access unless
waived by me. (If you wiab to waive the setback, you must Inittal the appropriate blank
below_)
I d, o a of wish to waive
I do wish to waive that setback requizemettt, �w_..�_..... .......
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To ba filled in by Individual prapoaing dcreloparer>J
o5�
(Information for Property owner Applying I
for Permit)
61.4:2GcR��
Mailing Address
City/State/Zip
252, 2-4 )
Telephone Number
Signature Date
l d ZU9-LV4 (ZSZ)
Telephone Number
it a
Date
oetu!JE) Lula. BZ L:o l 60 Go Oea

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FIRST CITIZENS BANK 3833
tlrstcltizens.00m
OUTER BANKS MARINE CONSTRUCTION, INC 66.30/531
1501 FIRST AVE 137
MOREHEAD CITY, NC 28557 12/16/2009
[phone]
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ORDER OFE D.E.N.R. **400.00
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Four Hundred and 00/100***************�x*** **�x***** ***�x**** t �x***** ***************** DOLLARS 12
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