53616_SIMPSON, HAZEL_20090416

DCAMA I E:1 DREDGE & FILL
GENORAL PERMIT Previous permit #
ENew- ::]Modification LIComplete Reissue ElPartial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Reso ces
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC
R'61es attached.
Applicant Name Y
Address
City —State ZIP
Phone # Fax #
T
Authorized Agent `_'i t,
Affected 11 Cw F-1 EW D PTA El ES ❑ PTS
AEC(s): Cl OEA Ll HHF F__ lH El UBA Ll N/A
L PWS: El FC:
ORW: yes / no PNA yes / no Crit.Hab. yes / no
Agent or App[J'ant Printed Name
Ut
Signature Pleasecread compliance statement on back of permit"
ifix _;?_J
Application Fee(s) Check#
Project Location: County
Street Address/ State Road/ Lot #(s)__
t
Subdivision
City— ZIP
Phone # River Basin
Adj. Wtr. Body (nat /man /unkn)
Closest Maj. Wtr. Body t`_'t
PermitOfficer's Signature
J
Issuing Date 1
Expiration bate
Local Planningjurisdiction
Rover Pile Narn&_

4
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.
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

North Carolina Department of Environment and datural Resources
Division of Coastal Managemukrit William G. Ross Jr., Secretary
Michael F. Easley, Governor Charles S. Jones, Director
Date
Applicant Name
Mailing Address
rb
SaIVED
AYR 1 6.2009
a �head City OCM
Q�a� k)C
jto act on my
`C .
I certify that I have authorized (agent)
behalf, for the purpose of applying for and obtaining all C AMA rmits necessary to
k k
install or construct (activity) q
at (location)
This certification is valid thru (date) JL2 4��"'
Signature f
400 Commerce Avenue, Morehead City, W,,rth Carolina 28557
Phone: [phone] FAX: [phone] Internet: NWW, nccoastal management. net
An Equal Opportunity \ Affirmative Action Employer — 504/6 Recy:!ed \ 10% Post Consumer Paper

or
Adjacent Riparian Property Owner Statement
(FOR A PIER/MOORING PILINGS/BOATLIF U BOATHOUSE)
I hereby certifythat I own property adjacent to lia C= ( 0 / " 's
(— Namevf P") . 0%yned
property located at
Lot, block, rood, etc. ?
I a �'�
on � l� �`' � in C�a v � �� � NC
Waftrbody Town ami Vor (%Imty
He has described to me, as shown below, the development he is prop( sing at that location and I ha
no objections to his proposal. x
6
I do not wish to waive the setback requirement.
A?R 1 6 -
I do wish to waive the setback requirement.
�nt,relhead City [)C"
Description and/or Drawing of Proposed Development
(To be filled,in by the individual proposing development)
Signature L/
Print or type name
Telephone number
0
Pv IT gut o i Sc'ara f
�e � i�C wcf� u N y

Adjacent Riparian Property Owne, r Statement
(FOR A PIER/MOORWG PIUINGS/BOATLI M I'MWILTHOUSE)
'
I hereby certify that I own propertY adjacent to Na.� �44me
(s
property located
--r in Pa 1,C) %� I L.2NC
on _ Gt WAY" Tmm ar far l�Y
below, the development he is prop; s,injil at that location and I have
He has described to me, as shown
no objections to his proposal•
I do not wish to waive the setback requirem
ent.
140 wish to waive the setback requiren'ent_
pPR � � ?_009
CIO
DelcrWWu and/or Dr$Wiug of Propomd Devek""t
(To be filed in by the individual proposing development)
--C ' a�
s C�ee
=
Telephone number
Date
Y j ►3Joq
►� f k U a

f sf
R.r FOIV
APR 1 6 2009
Morehead City CI►/�
rul i
f ) �j 1, /)
4c"
u
CIA g(JIO(z�e�
ke�

INTRACOASTAL MARINE CONSTRUCTION
1512 SCOTTS LANDING
MOREHEAD CITY, NC 28557�/ I Ca
Pay to the
Date^
2137
66-112/531
d'o
Doflals
mBRANCH BANKING AND TRUST COMPANY
1-800-BANK BBT BBT.00.
FORDil
.
11.0000 2137110 1:053 LO L L 2 11:0005 L9834994311