51077_SAYKO, STEPHEN_20071029

❑CAMA / ❑ DREDGE & FILL
GENERAL PERMIT Previous permit# ~
❑New ❑Modification El Complete Reissue El Partial Reissue Date previous permit issued
As authorized bythe 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
Address
City
State ZIP.
Phone # (i)
ax # ()
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
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision
City ZIP
Phone # O River Basin
Adj. Wtr. Body - k_ (nat /man /unkn)
Closest Maj. Wtr. Body
Type of Project/ Activity
(Scale: )
Pier (dock) length
Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
I
e�
Shoreline Length
SAV: not sure yes no
Sandbags: not sure yes no
Moratorium: n/a yes no
Photos: yes no 4
Waiver Attached: yes no
A building permit may be required by: ❑ See note on back regarding River Basin rules.
Notes/ Special Conditions
Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit **
Application Fee(s) Check #
Permit Officer's Signature
9
Issuing Date Expiration Date
Local Planning Jurisdiction Rover File Name

Statement of Compliance and Consistency _J
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

--I''--'a --ram-tea as' a,��tJ'1 1t1111 V II1'--I V1111 IALl\1
(FOR A PIERAII00RING PILINGS/BOATLIFT/BOATIIOUSE)
I hereby certify that I own property adjacent to S7-(,,PNEtJ L.• sRyKo s
(Name of Property Owner)
property located at '30 J zEc'n7r tz -(zogo CLa NoeRNwcn ri C,SuRo�visrvrJ
(Lot, Block, Road, etc.)
on NCt"o rzlvE(z , in JACKSCOVI!IE(ONSLOW) N.C.
(Waterbody) (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. I understand that a pier/mooring
pdin ¢s/boatlift/boathouse must be set back a minimum distance of fifteen feet (15') from my area
of riparian access unless waived by me.
Frr'r-, TP
I do not wish to waive the setback requirement.
1% I da wish to waive that setback requirement. A(_IG 3 0 2007
--------- -------------------- ---------- --- --------------- -- .=---------------ty ®CM
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOP.NIEiNT:
(To he_illed in by individual proposing development)
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Date: 8 —.�? - 7
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(FOR A PIER/MOORING PILINGSIBOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to STGPN6t-J L. SAve�_Is
(Name of Property Owner)
LOT i, Q4oc,1� t3, SuQQlVlsia� MAP
Property located at s I T)E Tu R{� D No R,.r+4 p J
(Lot, Block, Road, etc.)
onNEW RIvC2 ,inJACJKS0riVILLB QN$L,cr,N.0
(Waterbody) (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. I understand that a pier/mooring
pilings/boadffVboathouse must be set back a minimum distance of fifteen feet (15') from my area
of riparian access unless waived by me.µ,,
I do not wish to waive the setback requirement. A(/c ,10/11
I dfl wish to waive that setback requirement.
l
------------------------------ ----- ------------- --------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
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7

PARKER
HEATING, COOLING & PLUMBING, INC.
3206 East NC 97 Hwy.
WILSON, NC 27896
[phone]
PAY ����
TO THE
ORDER OF
MEMO C/A pe,-y,t / 4 GZ)
RBC CENTURA BANK
66-85/531
1150 1G80 3110 1:0 5 3 100a 501:0 2 3 20 18 76011'
16803
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0
0
C' '� DOLLARS
8
AU ORIZED SIGNATURE