51190_MAXWELL, ANN_20080619

Jz 7-o S /6� -1❑ CAMA / E' DREDGE & FILL
GENERAL PERMIT Previous permit #
flew ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
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
LDRules attached.
Applicant Name Project Location: County
Address
City
Phone # O_
Authorized Agent_
Affected ❑ Cw
AEC(s): ❑ OEA
❑ PWS:
ORW: yes / no
State - _ZIP `,I '
Fax # ( )
,t
O EW ❑-PTA DES ❑ PTS
❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ FC:
PNA yes / no Crit.Hab. yes / no
Street Address/ State Road/ Lot #(s)
I
Subdivision
City 1. ZIP
Phone # O River Basin
Adj. Wtr. Body i JI, Lj j l j (pat /man /unkn)
Closest Maj. Wtr. Body
Type of Project/ Activity
Pier (dock) length
Platform(s)
Finger pier(s)
(Scale:
✓
f
Groin length
number _
Bulkhead/ Riprap length ; i iJ
avg distance offshore
max distance offshore f l
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
I
Shoreline Length _ I ' ! (, .l '
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 by: 1 1
Notes/ Special Conditions
❑ See note on back regarding River Basin rules.
I
V
Agent or Applicant Printed Name
--.:1®Xp
Signature ** Please read compliance statement on back of permit ** % r
Permit Officer's Signature
1
C/O 1 �
Issuing Da a 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 (910-796-7215) 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

17-Jun-2068 10:31am From -TOWN OF MOREHEAD
t '
' 417' (o 33a
T-175 YP.001/001 F-935
fro° ��-�Irra
i , i�..'J 4'
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIF.RAVOORING PII.INGS/B0A77lFrIROA7710USE) � 2008
hcrvby certify that 1 own property adjacent to
(NAute of Property Owner)
pro flirty 1pcV'_'ri at
WS-
(Lat Block, Road, etc-)
on
I'�ra�
to N.C,
(Watcrbo�>Y) (Town and/or County)
fIc tas described to me, as shown below, the development he is ,proposing at that location,
and, I have sio objections to his proposal. I understand that a pierlmooring
pit inns/boatlift brxxthouse must beset Nick- a minimum distance of fifteen feet (l5') from my area
of riparian access unless waived by me.
tT m ► wish to waive the setback requirement.
11-0 Wish to e that setback requirement.
DRSCRIPTION AND/OR DRAWING OF PROI'OSrD DEVELOPMENT;
(To be filled in by individual proposing development)
Signature
Print or Type Name
oasa . 7a (, - s clB
Telephone Number -

J-
t
RIPARIAN PROPER ,a y
(FOR A PIER1,jf00pjjVG PI%IIVGSlBOA7ZlATnaus
I hereby certify that I ownprope
rty adjacent tot
(Nstrle of Pro"Y (honer) is
Prof-=rty iocak-"d at
tI t, Biork, Road, etc_)
on
��
C in f� _
ty aterbody) � ��
Cl'awn and/or County} ' N.C.
HL has dscribcd to
and i mc, as shOwn Wow. �
7ind have no objections to his , doi�mettt he is proposing at that loCatiaPn
Is .,s/[x�atlifttbo�uho; must 3�e s a minim m distar understand that a ' of riparian S ice of fiftaan fttt IS' Picr/mooring
un&*as waive by me. ) from my area
wisil to w:1ive the Setback requiremenr_
I Ito wish to waive that se (back requirement.
1)pSjCttI!''Ti0X AtYI)/OR DRAWING--
!7'o be filled iij by f lr/ F T'ROPpgr1) nR{rU,0
propnsiRg developrneucl} W:
signature
Print or LA
YPc me01 1�v r y cJe 5
S s 3 3 a�
relePhone Number
Date: 15- ,3 - 1� 5

FIRST CITIZENS BANK
www.flrstcitizens.com
OUTER BANKS MARINE CONSTRUCTION, INC 3071
1501 FIRST AVE 66-30/F?t
MOREHEAD CITY, NC 28557
[phone] 6d 3/9Q_ 0R
PAY TO THE
ORDER OF
MEMO
D.C.N.R. DOLLARS
11'00 30 7 1118 I:0 5 3 100 3001:00 13 1 2 18 2 1 2
ror

OUTER BANKS MARINE CONSTRUCTION, INC
1501 FIRST AVE
MOREHEAD CITY, NC 28557
[phone]
PAY TO THE
ORDER OF
D.E.N.R.
MEMO I I J C
FIRST CITIZENS BANK
www. tirstc itiz en s. co m
3106
66-30/531
137
6/27/2008
$ **200.00
DOLLARS
III NP
0 0 3 10 6 II' •
0 5 3 10 0 3 0 01:0 0 13 1 2 18 2 i 2?' -- -_ ----- --