51157_SHIRLEY, GRAHAM_20080715

❑ CAMA / ❑ DREDGE & FILL
GENERAL PERMIT
❑New ❑Modification ❑Complete Reissue
L�Vjll
0k
El Partial Reissue
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
Applicant Name
Address (A V
City State ZIP`
Phone # O Fax #----
Authorized Agent ❑ ,=...` l k plt '
Affected ❑ CW ❑ EW ❑ PTA VaTs ❑ PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH UBA ❑ N/A
❑ PWS: ❑ FC:
ORW: yes / no PNA yes / no Crit.Hab. yes / no
Previous permit #
Date previous permit issued
D Rules attached,
Project Location: County I
Street Address/ State Road/ Lot #(s)
Subdivision
City_ ZIP
Phone # (�) �C1 1 {' River Basin y
e
Adj. Wtr. Body _ ` (nat , man unkn
Closest Maj. Wtr. Body `' I_ r "7 L'
.
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Agent or Ap icant Pri ted Na
r ,
Sig ** Please read compiia a statement on back of permit
Application Fee(s) Check #
Z' 4J
Permit Officer'srSig ur
17
Issuing D�te r.e 4 Expiration
Date
at jel (I
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 ail 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, certifythat this 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/ I-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

W. BRYAN CHEEK �..r
CHARLOTTE E. CHEEK ! 6085
1825 SNOW WIND DR. ,$—
RALEIGH, NC 27615
es-)sa as
Wachovia Dollars
Wachovia Bank & Trust Company, N.A.
Raleigh, NC 27611-7888/
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Jul 10 08 08e16p
Jul 09 2008 4t26PM
06/26/2006 11:13 W
Shirley d moams. rL-Lt� ..,.. P. 1
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AUJALT.NT RWAR1AN FROPERTY OWNER STATEMENT
(FOR A FIU MOORING PILINGS/BOA1UPIMOAMOUSE)
l hereby Certify that t own property adjarxnt to ('ata,.iia�._'._K.�^^_..�•rie�� 1s
Odme of revotrtr Uw= or AmIlcnst)
Mulling address if diffaattt frow location addresa b irJll f� rho < a r� '�
(town, state and zip)
pi"io ntlmbcrs y w caei be re:nchCd at �w b Z-Lq rL_Z
property located at .=.r—k`{L b%601- It Nap, *14KOP -
(Lot. NO&. ROA%L ew-)
on _Q.�et�_ ,ilfvJa•l` AA..Q}nt...�t3.]l..�^D! <.�._. _ _•N.l^.
(Wnitsbo�) C CrWU awfor Cum)
He hna described to me. as shown below, the dcvelopmen% be is proposing at that location.
and, I hart no ob cWons to his proposed. I undemmd that a pier/muoraigpilinga/haatliftiboad►ouse
must be set back a minimum Asttt=of fifteen feet (isi Gam day area of riparian -wtmw unleu
waived by ine.
C l dQ not wish%to waive the setback requirement.
aitia�
I do wish in waive that sttbock requirernem.
DESCRIPTION AND/OR DRAWING OFPROMSED DEVELOPMENT:
fro be fQad in by iA6Mm churl proposing development)
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1'mm or Typt Ram
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Tceepi+cai• PW�►bar

00/26/2008 11:13 FAX
Zoos
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A 111ERIM001UNG PILINGS/BOA:I'LIF %BOATHOUSE)
1 hereby certify that I own property adjacent to rj ro 4.. ' . �•M^ 3w. ��-1 s
(Nesne of Property Owner or Applicant)
Marling address if differem from location address_.._
(town, state and Lip)
phone numbers you can he machud at --
property located at!-o�
(Lot, Bloch, hood, etc.)
ou ....._..._... _.. ___ . , in N.C.
(waturbody) (Tuwu audlor Cowtty)
He luts described to tne, as shown below, the development he is proposing atthat location,
and,1 have no objections to his proposal. I understand that a pier/mooring pilinbs/hoatlift/boathouse
must be set back a minimum distance of fifteen feet (15' from my area of riparian access unless
waived by Ine.
1 do not wishNto waive the setback requirement,
I do wish to waive that se:buck requirement.
nutuds
................. ---------------------------------------------------------------------------------------- ........
DESCRIPTION AND/OR DRAWING OF PROPOSED DLVELOPMENT:
(Tv be filled in by individual proposing development)
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i'rinc or'1'yp¢ N�,mt.
Tlaaphunu Number

06/28/2008 11:13 FAX Q 004
North Carolina Department of Environment and Natural Resources
DiAllon of C01119bli 100"9etnent
WchM F. eaddy, Go+wnbr Charles S. Jones, Dlredor WDSM G. Raw it., seuewy
Applicant Flame 1 GEL-1 5V %i tee
Q Mailing Address
Ck
I certify tbat 1 have swtborii.cd (agent}�,ir�c' �Ll�s" 1�(#•'� (ice i 1 . to wrl un my
i►,:Iralf, for the purpneo of applying; for and obtaining all CAMA rcrmils neer-4sary to
install or construct (activity) V,
at (10ention) .�2. �-4y
This cen-tiflcation is valid thru (date) 11 61It)
SignaftTr
400 Coinnwce Avenue, Morehead City, Nurth Carolina 28557
Phone: [phone] FAX: [phone] Intemet: www.nccoa.qtalmanage"itt.net
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