51577_MATTHEWS, JOE_20071010

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❑ CAMA / El DREDGE & FILL { ~ ° —1p�-d tE J (
GENERAL PERMIT Previous permit # .1
[:]New, ❑Modification El Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Re ources
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
❑ Rules attached.
Applicant Name
Address
City State ZIP
Phone # O Fax # ( )
Authorized Agent —
❑ CW ❑ EW ❑ PTA
Affected
AEC(s):
❑ OEA ❑ HHF ❑ IH
❑ PWS: ❑ FC:
ORW:
yes / no PNA yes / no
❑ ES ❑ PTS
❑ UBA ❑ N/A
Crit.Hab. yes / no
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision
City ZIP
Phone # O River Basin
Adj. Wtr. Body (nat /man /unkn)
Closest Maj. Wtr. Body
Type of Project/ Activity
(Scale: i(7-: )
Pier (dock) length
Platform(s)
Finger pier(s) + i
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 i
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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See
note
on
back regarding
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River
Basin
rules.
Agent or Applicant Printed Name `
3
Signature "Please read compliance statement on back ofpermit" -�
Application Fee(s) Check #
PermitOfscer's Signature
�b
Issuing Date Expiration Date
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, certifythatthis 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
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

SEP-17-200 09:1 From:DCM MHG 25224733ZO To:MATTHEWS MASONRY INC P.I/I
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� ERTIFIEP MAIL , RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Individual applying for Permit: 1-4a&kea�
Address of Property; S'j "I
l T
(Lot or Strcct #, Strcct or Road, City & County')
I hereby certify that I own property adjacent to the above referenced properly. The
individual applying for this permit has described to nip, as sho.vn on the attached drawing
the development they are proposing. AA description or drawin , with tt Mould be
provided with this letter.
q
I have no objections to this proposal, OCT
If you have objections to what is being proposed, please r kk"tt-(252)oCoastal Management, 400 Commerce Avenue, Morehead City, N
808-2808 within 10 days of receipt of this notice. No response is considered the
same as no objection if you have been notified by Certified Mall.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house, lift or sandbags
must be set hack 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.
Signature e Date
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00090035-061

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