52692_STALLINGS, ROBBIE_20081016

❑CAMA / ❑ DREDGE & FILL �'C��
-. GENERAL PERMIT C' Previous permit #/,t.���6e
❑New ❑M�dification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
1 +
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 i
1 ❑ Rules attached
Applicant Name ^'
Address_ J 7, I r
f;!
City�c'1F?�,�: i i c� .._ Statew ZIP
Phone # () Fax # ( _T—
C�: '
Authorized Agent 'o;Koo'A C-C� <— it r
Affected El CW ❑ EW D PTA J11ES ❑ PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS: ❑ FC:
ORW: yes / no PNA yes / no Crit.Hab. yes / no
Type of Project/ Activity
Pier (dock) I
Groi
Bulk
Basir
Boat
-Boat
Beac
Oth(
Shor
SAV:
Sand
More
Phot
Wain
Project Location: County ~'
Street Address/ State Road/ Lot #(s)
Subdivision
City..�t� �. t i t �' ''5 ZIP
Phone # ( ) River Basin
Adj. Wtr. Body ! ! `> A,'rn-ab /man /unkn)
Closest Maj. Wtr. Body , j''
(Scale: \ 1
r pier(s)
I
I
i length
number
lead/ Riprap length
avg distance offshore
max distance offshore
,channel
T
S'
7.
cubic yards
ramp
iou /�13oatlift
-
+r
i Bulldozing
r
--�
I
✓ ...,�
__.-
�
-
--
1``--.. {..
--
it
dine Length
not sure yes no
:)ags: not sure yes n
dorium: n/a yes no
Ds: yes no
er Attached: yes no
-
i
--
i{�_
A building permit may be required by: f .See note on back regarding River Basin rules.
Notes/ Special Conditions
A
Agent or Applicant Printed Nam
Signature Please read compliance statement on back of permit f _
Application Fee(s) Check #
PermitOffic*'s Signatur
Issuing Date Expiration Date
dr CO � �- 1U��
Local Tanning 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 I) 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 thatthis project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
❑Tar - Pamlico River Basin Buffer Rules L ] Other:
�_*'NVeuse 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 Offic 4(�64_81, 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.
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

'Jct. 0.9 08 0�3'03a BCC
252-745-4253 p.1
Broad Creek Construction, Inc.
P.O. Box 268
Merritt, NC 28556
Phone: [phone]
Fax: [phone]
Email: info(a-)-BroadCreekConstruction.com
www.BroadCreekConstruction.com
To: ` From:
Fax: l Pages:
Phone: Date: t Q
Re: cc:
❑ Urgent 0 For Review ❑ Please Comment ❑ Please Reply ❑ Please Recycle
a Comments:

Oct 09 08 08:04a BCC
252-745-4253 p.2
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOOPJNG PILIIITGSIBOATLIFTIBOATIIOUSE)
I hereby certify that I own property adjacent to"g t t f �`��, is
(Name of Property Owner)
property Iocated at
(Lot, Block, Road, etc.
on K in
(Waterbody) (Town and/or County
He has described to me, as shown below, the development he is proposing at that location,
and, I Dave no objections to his proposal. I understand that a pier/mooring pilings/boatlifr/boathouse
roust be set back a minimum distance of fifteen feet (15') from my area of riparian access unless
waived by me.
gC �
1 r�GYj Y
Pi.RT cflQ� �.x 30`
�_HCce"Z-
I do not wish to waive the setback requirement_
I do wish to waive that setback requirement.
f AND/OR DRAWING OF PROPOSED DEVELOPMENT:
be filled in by individual proposing development)
` L �sa�•�
1
Signature
t 4 /"l )--01- / I �
Print or Type Name
a�DOLS Telephone Number
l" ` Date: l "�

Oct 09 08 08:04a BCC 252-745-4253 p.3
1U11Jj/16iJ8 0/:18 843bb93by0 UAWSON INC GENERAL C PAGE 01/01
OC C3 U;i lib"l9� BCI: 252-745-4253
AA ACENT RVARFAN PROPERTY OWNER STATEAUNT
(FOR A P'IRld OOALVGPLUNC. SISOATLIIFTIZOATHOVS-9
I hereby certify that I awn property adjacent mC�
(Name of Property Owner)
party kxated at ?t om AU a
(Lot, Block, Raad, etc.
on i� z� jC� . in
(Waterb"Y) (Taw,a aiad/oc Caanty
He has des+exs'bod to me, as siwvm below, the dcvrJopmrnt he is proposing ;et first location,
and, I brit no objectiams to bis proposal. I und=tand that a pieVmoorimg cif boathome
must be set back a mini3nwm distance of fi8een feet (15) from my area of riparian access unless
waived by me.
f
;r -3o
Sr�gC r
a� m
171.2;
r r 10 $ ter
x
I dopa* wish to waive the setback r«luiremcot-
I de wish to waive that setback tequhv=t
A *WM DRAWING OF PRO"ED pEVVWPMENT:
befiiled in by itr~and pr+o mUV derempmexe)
0 r. Y c- SE A
r�r Signature
Print or Type NaQne
`�,p�S Telephone Number

Oct 09 08 08:04a BCC
252-745-4253 p.4
Nott.h Carolira
ivlichael F. Easley, Governor
Depaitment of EnvirorimenL and Natural
Division of Coastal [Ow-trygement
Charles S. Jones, Director
Applicant Name
l�%lading Address P_O- �s- �--
Resources
`:�'.ti;iam r. Rosy ar., Secretar:
i ceri-I "y Chat I have authorized (agent) t1 (��K �E�l% / I to act u-xi gay
behalf, for the purpose of applying for and obtaining all CANIA Permits necessary to
install or eoastruct {activity}
at (location) UlE
his cer ti ication, is valid thru (d-ate)
Signature
400 Commerce. Avenue, Morehead City, North Carolina 28557
Phone: [phone] FAX: [phone] Internet: www.nccoastalmanagement.net
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