51811_McMILLIAN, NANCY_20071127

❑CAMA / El DREDGE &FILL
GENERAL PERMIT
Previous permit#
❑New ❑Modification fi❑Complete Reissue
El Partial Reissue
Date previous permit issued
As authorized by the State of North Carolina, Department of Environment
and Natural Re rces
and the Coastal Resources Commission in an area of environmental
concern pursuant to 15 NCAC
❑ Rules attached.
Applicant Name
Project Location:
County
Address
Street Address/ State Road/ Lot #(s)
City State ZIP
Phone # (4) Fax # ()
Subdivision
Authorized Agent
City
ZIP
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS
Phone # ()
River Basin
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
Adj. Wtr. Body
(nat /man /unkn)
❑ PWS: ❑FC:
ORW: yes / no PNA yes / no Crit.Hab.
yes / no Closest Maj. Wtr.
Body
Type of Project/ Activity
(Scale: )
Pier (dock) length
Platform(s) _
Finger pier(s) j C"
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
Shoreline Length
SAV: not sure yes no
Sandbags: not sure yes no
Moratorium: n/a yes no
Photos: yes no
Waiver Attached: yes no
A building permit may be required
Notes/ Special Conditions
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4
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by:
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❑ See note
on
back
regarding
River
Basin
rules.
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit
Permit Officer's Signature
Issuing Date Expiration Date
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 (910-796-72 15) 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

07 05:27p INNERBANKS MARINE CONSTRU 2524472429
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NCDEHR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Michael F. Easley, Governor James K Gregson, Director Wiliam G. Rn--, Jr-, Secretary
Applicant Name AAAACI( V'
Mailing Address
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I certify that I have authorized (agent) to act on my
-7�
behalf, for the purpose of appbing for and obtaining'all O�XU'A Permits necessary to
install or construct (actf%ity) 2)l-
at (location) ),4 5! b ty"i
This certification is valid thru {bate)
Sigmalure
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400 Coffnerce Avenue, Morehead C4, North Carolina 28W
Phone: 252-808-MB FAX [phone] ti Internet. wwnctoastaIrnarogernentnet
An Equal Oppwtu*%AffkmE6weAcd" Employer— 50%R"Ied 110% Post CDnsumw Paper

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGSBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to _I Arl&V 14 C H I i-w AIJ 's
(Name of Property Owner)
property located at �Q 2. RFA
(Lot, Block, Road, etc.)
on , in TICI� L—1 GI�D 'N.C.
(Waterbody) (Town and/or County)
He has described to me, as shown below, the development he is proposing at that location,
and, I have no objections to his proposal. I understand that a pier/mooring pilings/boatliftlboathouse
must be set back a minimum distance of fifteen feet (15) from my area of riparian access unless
waived by me.
I do not wish to waive the setback requirement.
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
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Print or Type Name
Telephone Number
Date:

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INNERBANKS MARINE CONSTRUCTION, INC 2636
P.O. BOX 190 PH# [phone] �`r� i i• j� _ / 1�
ORIENTAL, NC 28571 �1>\ i J' , f` it\r� , ' J�; f T�V lV Ile
PA66-30i531
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TO THE 472
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGSBOATLIFTBOATHOU„S E)
I hereby certify that I own property adjacent to [J A �GU I _ \ C I `J� ( L-1,i A IJ 's
(Name of Property Owner)
property located at�
(Lot, Block, Road, etc.)
on in �i� ►il l Gy AC.
(Waterbody) (Town and/or County)
He has described to me, as shown below, the development he is proposing at that location,
and, I have no objections to his proposal. I understand that a pier/mooring pilings/boatlift/boathouse
must be set back a minimum distance of fifteen feet (15') from my area of riparian access unless
waived by me.
I do not wish to waive the setback requirement.
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
f
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--------------------------------------------------
Signature
Print or Type Name
Telephone Number
Date:

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MARIIM CONS
TRUON INC.
r'EN ROLLMAN
VICE PRESIDENT
Phone [phone]
252-249_-1429
2429
Cell 252-671_6785
Or/°fit � 8
0X 190
N�(icen N�285!1
se #Sg8
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Email. int @erbanks.
o�innerba ks bi2

Postage & Fees Paid
USPS
Permit No. G-10
• Sender: Please print your name, address, and ZIP+4 in this box •
■ 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:
`�U(o �NSoN
A. Signature
X ❑ Agent
❑ Addressee
B. Received by (Printed Name) C. Date of Delivery
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
3. Service Type
C!�Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
14. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number 700 0710 0000 1880 0519
(Transfer from service labs
PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540