51876_PARKER, GREG_20071127

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❑ CAMA / []DREDGE & FILL
GENERAL PERMIT Previous permit#
[]New ❑Modification ❑Complete Reissue ❑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
Applicant Name
Address
City
State ?
; ZIP r 1
Phone # O " ` i "
Fax # (
)
Authorized Agent
Affected ❑ CW ❑ EW
❑ PTA ❑ ES
❑ PTS
AEC(s): ❑ OEA ❑ HHF
❑ IH ❑ UBA ❑ N/A
❑ PWS:
❑ FC:
ORW: yes / no PNA
yes / no
Crit.Hab. yes / no
LJ Rules attached.
Project Location: County {{
Street Address/ State Road/ Lot #(s)
Subdivision�-
i
City ' ZIP
Phone # O - '{ River Basin
Adj. Wtr. Body (nat /man /unkn)
Closest Maj. Wtr. Body
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Agent or Applicant Printed Name
r
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
Permit Officer's Signature
Issuing Date ' Expiration Date
Local Planningjurisdiction !! 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

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DOCKSIDE DOCKS
1406 WHITE OAK RIVER RD [phone]
MAYSVILLE, NC 28555
1467
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11/21/2007 10:35 9199898957 QUALITY PAINTING UNL PAGE 02/02
Nov 19 07 08:52a Tony Mcneill 252:J5361.46 P•1
ADJACENTRIPARIAN PROP- RTY OWNER. STATEMEN I'
(FOR A plEAIMOORING P-ILINGSBOA?'UFTBOATHOUSE)
I berebq certifY that I owu property adjacent to
(Name of Property Owner)
property located at
(Street Address, Lot, Block, Road, etc.)
in N.0
ou (Waterbody) (Town aiadler Coeu W t `� t
He/she has descnbed to me. as shown below, the development he/she is pmposit 9 at that
location and I have no objections to this proposal- I understand tha5moorsPg
o
pikings/boatJiBJboathouse must be setback a an
minimum distance of frftees.. feet (i ') from
riparian access unless waived by me. I have indicated my intentions by initfaling below_
I do not agree to waive the 15' setback requirement.
(initisis}
I do agree to waive the 15' setback requirement.
DESCRIF" ON AND/OR DRAWING OF PROPOSED DEN ELOPMENT:
(To be filled in by individual proposing development'
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGS/B OA TLIFTIB OA THO USE)
I hereby certify that I own property adjacent to Gr r r q� >C" S— is
(Name of Property Owner)
property located at XA '1 ter•.# S cic ��
(Street Address, Lot, Block, Road, etc.)
on , in C."Q2. oLc e')c , N.C.
(Waterbody) (Town and/or County)
He/she has described to me, as shown below, the development he/she is proposing at that
location and I have no objections to this 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 have indicated my intentions by initialing below:
(initials)
(initials)
I do not agree to waive the 15' setback requirement.
I do agree to waive the 15' setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
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Print or'Cyl)t= Niume
`refeplione Ni.nnber
Date:�—

PARKER SURVEYING 724 349 2749 11/20/07 06:06pm P. 002
NL1V-1db-AVMr 10: cfr r r om: L&1'1 rJHU enee4 r.5.3-�O 1 0: e5dj1j'3b14b I✓ _ 1 / 1
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Michael F Fasley, Governor .fames H. Gregson, Director WINarn G. Ross Jr. Secretary
Datc //` c;O —07
Applicant. Name (j �4C k pis'
Mailing Address 730 C#L/ ie c'H S.T-.
/ S 7 ca /
I certify that I have authorized (agent) �o � Mi A e-' ` to act on my
behalf, for the purpose of applying for and obtaining all CAINIA PerIItits necessary to
install or construct (activity) CA— Q o
at (tucation)
This certilicatioa is valid thru (daft) a- °�' 0�
Signature G>�
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: [phone] N FAX [phone] Internet: www.nccoastalmanagement net
An Fgv* C1pr�T-;,ntly i Alfunabvo A.cuCn Emo,3yts - X"•, Pecyacd t low. Rost (:ori�,L rrE;