47855_CLARK, EDWIN_20070215

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❑CAMA / ❑ DREDCE & FILL
GENERAL PERMIT
❑ New ❑ Modification ❑ Complete Reissue ❑ 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
r0
Previous permit #
Date previous permit
Applicant Name '' Project Location: County
Address
City
Phone # ()
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
ZIP
Type of Project/ Activity
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
Shoreline Length
State
Fax # ()
SAV: not sure yes
no
—
Sandbags: not sure yes
no
Moratorium: n/a yes
no
Photos: yes
no
Waiver Attached: yes
no
A building permit may be required by:
Notes/ Special Conditions
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
Street Address/ State Road/ Lot #(s)
/ Rules ahec
Subdivision
City ZIP
Phone # ( ) River Basin
Adj. Wtr. Body (nat /man /unkn)
Closest Maj. Wtr. Body
(Scale: )
1
I
{
❑ See note on back regarding River Basin rules.
PermitOfficer's Signature — -
Issuing Date Expiration Date
Local Plan ningJ u risdiction 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

t
CERTIFIED MAIL RETURN RECEIPT REQUESTED
DIVISION OF COASTAL, MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICAION / WAIVER FORM
Name of Individual Applying for Permit: C� �;,� q
� V!
Address of Property: 1 40 '` > '/:_ 1 • _� _
(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.
If you have objections to what is being proposed, please write the division of Coastal
Management, Hestron Plaza II, 151 B, Hwy. 24, Morehead City, NC 28557 or call (252) 808-
2808 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
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift or sandbags
must be set back a minimum distance of 15' from my area of riparian access unless waived by
me. (If you wish to 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.
Signature Date
Print Name
Telephone Number with Area Code
FEB o 6 ; onr
J M067�
e�ibv 96[M

6 lq jy s a. P,�
CAMA
No objection of riff raff going in front of bulkhead.
Signature
F ER 0 6 z007
IM4rohoad City DCM

I have no objection of riff raff going in front of bulkhead.
Signature
Date
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FEB-19-RO07 13:41 From:NC DIV COASTAL MGMNT 2522473330 To:2523218382 P.1/1
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North Carolina Department of t6 ironment and Natural Resources
Division of Coastal Management
Michael F. Easley, Governor Charles S. ,!ones, Director William G. Ross Jr., Secretary
Date J. — Z _a 7
Applicant Name
Mailing Address
I certify that I have authorized (agent) �&� w o ,, u 1 : tic to act on my
behalf, for the purpose of applying for and obtaining -all LAMA Pcr6its necessary to
install or construct (activity) _
at (location) L�0 3 t12 -
This certification is valid (date)
Signature
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: [phone] FAX: [phone] \ Internet: www.nccoastalmanagementmet
An Equal Opportunity l Af ;alive AcWn Employer - 50°A Recycled 110%. Post,Consumer Paper