50640_PELLITIER, JERE_20080317

❑CAMA /7 DREDGE & FILLN04 F)9640
GK-NeRAL PERMIT Previous permit #
El 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 15A NCAC
�- ❑ Rules attached.
Applicant Name ~` ` - ` Project Location: County ,y
Address Street Address/ State Road/ Lot #(s)
City State ZIP
Phone # (^) 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
Subdivision
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Agent or Applicant/P{%d N ,' Permit Officer's Signature ^.
Signature Please read compliance statement on back of permit Issuing Dat t .
Application Fee(s)
Check #
rianningjunsaiction
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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/ 1-888ARCOAST
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
I hereby certify that I own property adjacent to Y V/�"//C�'s
(Name of Property Owner)
property located at / /.� �i'��� ��
l,&4
t, Bllock, oad, etc.)
on f�lq1�5yi°Y— , N.C.
bod (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.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development)
f
MAR 3 2008
�-� MgrQhaad City L)CM
�� axrsx 3
di
(Applicant Information)
Ma .1. Address
ellAe) A4/
City/State/Zip
Telephone m r
Date
(Riparian Property,Owner Information)
7
Signature
Print or A,De Name
<25�-3I33I3-
Telephone Number
.- -/- o3
Date

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
D
I hereby certify that I own property adjacent to � �' /C j
(Name of Property Owner)
located at / lk s�
property '
(Lot, Block, Road, etc.)
o�/ 41 D � � De CL � oil , N.C.
(i�V" terbody (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.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development)
06/1 64
(Applicant Information) Mailing Add, s ��
D
City/State/Zip
Telephone Number
Date
INCE1
a�©fi x 3 MAR
(Riparian Property Owner Information)
Signature
12'
Print or T)Te Naive
5a - 4,3 7- D 7/-
.-Telephone Number
Dat--7

GenBr(}wse
Page 2 of 3
OR
State Road (e.g. SR%, SR64)
or Highway (e.g. H%,
Hwy70)
Project Site's nearest city or town
Project Site subdivision name (e.g. Ocean%)
Project Site's nearest city or town (e.g. Eliz%, Atlan%B%, Oriental)
_address Search Criteria
Run Query 11 Reset Prev. Value Clear Query
True
ID
Permit#
Type
Full Name
SourcePNo
Issue Date
Expiration Date
Expired
District
Staff
County
9158
GPC31542
Initial
JERRY PELLETIER
03/22/2002
06/22/2002
Y
Morehead City
Brad Shaver
Carteret
6255
GPC34100
Initial
JERRY & JETTIE PELLETIER
06/23/2003
09/23/2003
Y
Morehead City
Brad Shaver
Carteret
I
Records Matching Query = 2
ID SELECTED: 9158
Print Permit
Edit Initial Reissue Permit EDIT Reissue Modify Permit EDIT Modify QUICK Reissue
Applicant Info:
Applicant (Owner): JERRY PELLETIER
Addl: 153 ASH STREET
City: CEDAR POINT
State: NC
Zip:28584
Country: USA
Permit Info:
Permit No.: GPC31542
DCM District.: Morehead City
http://dcm2.enr.state.ne.us/demcdaits/general/view/GenBrowse.aspx 3/17/2008

GenBAwse
Page 3 of 3
DCM Representative: Brad Shaver
Issue Date: 03/22/2002
Expiration Date: 06/22/2002
Fee Collected: 100.00
Fee Description: CAMA Mainframe General
Objections Received: N
Project Description: P-15
Permitted Rules
Permitted Activities
Activity: Access channel(canal)
Activity Type: NW
Replacement: N
Dimensions: length_width_depth
Parameterl : 3.000
Parameter2: 10.000
Parameter3: -2.000
Parameter4:0
Site
Description:
AECS:
07H .0206 Estuarine Waters
Public Trust
Project Site:
Addl: 173 ASH STREET
City: CEDAR POINT
County: Carteret
http://dcm2.enr.state.nc.us/dcmcdaits/general/view/GenBrowse.aspx 3/17/2008

GenBrbwse
J
Username: LowanaB
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The purpose of the GenBrowse Page is to search for a General Permit and perform an
action on it. These actions include: view, print, edit intital, reissue, edit reissue, modify,
edit modify, and delete. (Depending on User access level.)
,1 pelletier
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ulliar�ae Conracor Last Name
Note: Queries using Name Data may result in a recordtset that is greater t an the # of permits.
Project Name
Select Rep Select District
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Select County
County Project Location (City)
Begin/End Issue Date Begin/End Expiration Date Expired
❑ Search by Project Site
j
Selea C�our`°°<
Project Site's County
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Project Site Address (e.g. %Coquina%, 57 Oyst%, 123 Oak Dr%)
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OR
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3/17/2008

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