50718_MAXWELL, ANN_20080417

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❑ CAMA*' ❑ DREDGE & FILL
GENERAL PERMIT W_,;atevious permit #
❑New ❑Modification ❑Complete Reissue ❑Partial Reissue e 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 15A NCAC i
0 Rules attached.
Applicant Name
Address
( , -)
City
State ZIP
Phone # ( )
Fax1 # ( )
Authorized Agent
Affected ❑ CW
❑ EW El PTA ❑ ES ❑ PTS
AEC(s): ❑ OEA
❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
❑FC:
ORW: yes / no
PNA yes / no Crit.Hab. yes / no
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision
City ZIP
Phone # ( ) River Basin
Adj. Wtr. Body (nat /man /unkn)
Closest Maj. Wtr. Body
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Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
Permit Officer's Signature
f_
Issuing Date Expiration Date
Local Planning]urisdiction
Rover File Name

It
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 consistentwith 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
Mailing Address:
1638 Mail Service Center
Raleigh, NC 27699-1638
Location:
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
Fax:[phone]
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ 1-888-4RCOAST
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

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR it PIERIMOORING PII,INGSIBOAT!_IFTIBOATHOUSE)
1 hereby certify that I own property adjacent to �% t ' L'tl! �s
(Name of Property Owner)
pfoporty located at 4 LD� ID 1 m
(Lot, Block, Road, etc.)
ll ;�.
on _ C , in M O-� � b �O
(O aterbody) ('Town and/or County)
He has dtiscribcd to me, as shown below, the development he is proposing at that location,
and, [ have no objections to his proposal. I understand that a pier/mooring
pilirr;;s/Lioatlift/bo<•itlhousc must be set hack a minimum distance of fifteen feet (15') from my area
Of riparian -ICCeSti unlc,ss waived by me.
.......,.._ 1 wish to widve the setback requirement. � �y
__•_.._____.. I s1!2 wish to wAive that sclbtck requirement•
i L \ �✓
S________________________________________________-___________________ _______________-
DE S•CIZIM ION ANWOR DRAWING OF PROKOSED DEVELO TENT:
(To be filled in by indi►•idual prop�ng developin it)
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Signature
Print or Type Name
7 ?—(A • S'zZZ
-`I*Nq "Telephone Number

CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual applying for Permit: &,7 we-j�
Address of Property: ��� "� S zZ.,�
ZeSS 7
(Lot or Street #, Street or Road, City & County)
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing, A description or drawing, with dimensions, should be provided with this letter.
I have no objections to this proposal. n
-T— ck o h GNU,- OVoJ e cA a v\ S i v\ �4- 4,1' C �n 0 U 52 syn
if you have objections to what is being proposed, please write the Division of Coastal e
Management, 400 Commerce Avenue, Morehead City, NC, 28557 or call [phone] within
10 days of receipt of this notice. No response is considered the same as no objection if you
have been notified by Certified Mail.
WAIVER SECTION
FEB $ 6 2008
g1 -QCM
I understand that a pier, dock, mooring pilings, breakwater, boathouse, oa iht or sandbags `
must be set back a minimum distance of 15' from my area of riparian access unless waived by
me. (If you wishAo 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.
(Applicant Information)
(16 Lc��le 5�-16 01-
Mailing Address
& lJsb.fn 757.3q
City/State/Zip
(g17)77,�--S�z(
Telephone Number
j-z F/a �-
Date
(Riparian Property Owner Information)
Signature
use Oct es �2 ,
Prin4 or Typb Nam
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Telephone Number
Date

CERTIFIED MAIL.
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7007 3020 0002 3513 0661
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400 Noe
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U.S. POSTAGE
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00059530-55f
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ADJACENT RIPARIAN PROPERTY OWNER STATFMFNT.
(FOR A PIF.RAWOORING PII.INGSIBOATIIFT1BO. VS-FY "
ill
1 hereby certify that I own property adjacent to-f-v, 's
j LD�7
(Name of Property Owner)
1ror-n [-Ly loca►t'd at 1 ZA- �' l 1
(I,ot, Block, Road, etc.)
U , in MVZ�r`i.��� 6) _, N.C.
on
(a ntcrbody) ("fawn and/or County)
fie 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 pierlmooring
pit irrgs/boat I i ft/boatbouse must be set tack a minimum distance of fifteen feet (15) from my area
of ripat-ian ;recess unless waived by me.
l s1_ r 11Lt wish tv waive the setback requirement.
O
i tl(I wish to waive that setback requirement.
r -- --- - -
iw �az]M'10N ANTWOR PRAWING OF
(('o he filled in by individual pr
i
i
ISrn DEVT'L
do velopyn ott)
Signature
�V
print or Type Name
'1'elehhorte Nurnber

I

1it
itx " rE
AFf, 2008
Mbretioaci city ®CI►�
ADJACENT RIPARIAN PROPERTY OWNER STATEMMU
(FOR A PMRAVOORING PTT.INGS/ROATT.IFTIBOATIIOU,SE)
1 hereby certify that 1 own property adjacent to'�� trc>',�"t"z� � 's
� (Name of Properly Owner)
pror�.rty located at �� 1 4
(Ut, Block, Road, etc_) t
On `� c , in�i�til ( N. C.
(V aterbady) (Town and/or County)
tip: has described to me, as shown below, the development he is proposing at that location,
:lTltl, I have no objections to his proposal. I understand that a pier/mooring
pilin�;s/hoatlift/boatliousa must be set back a minimum distance of fifteen feet (15') from my area
of riparian access unless waived by me.
....T_ 1 do not wish to waive the setback requirement.
- _.- ----- I iW wish to waive that setback requirement.
,- N-------------- - 1L
1)rSCRIM ION ANWOR DRAWING or PROPOSED nl VELO IrNT.
(To fie filled let by indit-idual proposing developm
S
X p
____4
Signature
Print or Type Name
L ,r'y- ),_ 5 — cf -f 2
Telephone Number
Date: -k'%—/� � ��'

Apr .t r uo U4:44p f tm GrInIa$ [phone] p.1
APR-17-2OW 16;04 From=Dcm mHo Z52297333e To:252 247 G332 P.1'1
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North Carolina Deparnent of Environment and Natural Resources
Division of Caawat Managwnent
Mthad F, F1 SWY, Gavefw Ja11" H. Gmgson, DkeeW Wftm G� Floss jr., 5ecm y
Date
�1�giicartt�, iYlamc /� /' jC.�CGc�� ��
Hailing Addrrae �g
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x eartify that i ?same authorized (agtut) iarY} c- :t. (P '1 r to act an my
behalf, for the purpose of appJyiag for and ubtaiaing all CA MA Permits accessary to
install or construct (activity)
at (location)
This certification is valid thru (date)
Sigtnset>atc Cl�--
400 Comr',We Averue, Morehead City, Nora+, Cardona 28557
PrIonB' 252•t3 -28081 FAX: [phone]'s inlertet: www.ncccasialmanage,-nent.nat
A' EMAIkIppWt m4y 1M• :i#r alrre Ulion f.Trp(D'!W - ;off F;Kycte4 ti lot Post ?AffiL rp paper

�r, .. — *,-rpw Irnr vnmm (252) 247$332 p.1
APR-17-20W 16:@4 Fr,, l;CCH MHO 2522Q1733M To J"2 a47 6JM
AMW
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North Caroiina Department of En%kronrnent and Natural Resources
Division of Coastal Management
A�clrna! �. Faete�r, �,e„a, .►dries H, G
mpom okeck r UYdliam G. PmoJr.. Sa3c wy
part J �o Y
ApplicankName
mailing Address
P, Dtl A 1 LUUO
City MO
f certify that Y have oathoriad (agent}
to act an RY
behalf, for the purposc of apVlyWg for and obtaining tit LAMA, Peistita nereosary 10
install or coastrVcj (activity)
at (location) E�) �� G
This certification�� 6valid clay (date)
io/
Signature ( —
400 Commerce Avenue, Morehead City, Nor1t1 Cardina 28557
Phone: 252.808 W8 \ FAX: [phone] tniernet: www.mmnaVaWnapMent.ne4
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