49893_D + P RENTALS_20070822

❑ CAMA PD DREDGE & FILL
GENERAL PERMIT �� Previous permit#
ONew ❑Modification El 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.
9
Applicant Name '� `"' 1 Project Location: County`
Address ; y! 1 I I I Street Address/ State Road/ Lot #(s) ! r s
City p�f' ' State ZIP
Phone # ( ) Fax # ( ) Subdivision A.6
City "' ?', }_; " ZIP -
Authorized Agent =�r � ty / r? r,
❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Phone # ( ) River Basin
Affected ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
AEC(s): Adj. Wtr. Body �( i
❑ PWs: ❑FC: nat .m n unkn j
I 3
Closest Maj. Wtr. Body
ORW: yes / no PNA yes / no Crit.Hab. yes / no f
.i
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 '
Othern{�
_
Shoreline Length
SAV: not sure yes
Sandbags: not sure yes nog
o) Moratorium: n/a yes n
Photos: yes i no
Waiver Attached: {yes no —
t_.
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 #
(Scale:#
❑ See note on back regarding River Basin rules.
Permit Officer's Signature
Issuing Date ' 'EillpirariopFbate
Local PlanningJurisdiction l�o er a IVa�me

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
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

JUL-31-2007 02:59P FROM:
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Comments
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JUL-31-2007 03:00P FROM: TO:12522473330 P.2
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(FOR A PIERlMOORING PILINGS/BOA IFTIBOATHOUSE)
I hereby certify that I own property adjacent to
property located at -�t t 15
0
(Street Address, Lot, Block, Road,
on Tf/ir- Pom) ,in Ar44AP?,
(Waterbody) (Town
He/she has described to me, as shown below, the de
location and I have no objections to this proposal.
pilings/boatliff/boathouse must be set back a minimum distar
riparian access unless waived by me. I have indicated my int
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I do not agree to waive the 15' setback
I do agree to waive the 15' setback mqi
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dame of Property Owner)
DESCRIPTION AND/OR DRAWING OF PROI
(To be f ma in by individual pmpomw,
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id/or County)
opment he/she is proposing at that
understand that a pier/mooring
of fifteen feet (l 5D from my area of
ions by initialing below:
ISED DEVELOPMENT:
development)
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t or ype Name
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JUL-31-2007 03:00P FROM: TO:12522973330 P•3
07/29/20eP U 1;JU
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,A►DJACENT RVARIAN PROPERTY
(F'+ORA m'R!lfmQrRf1m?ffjN w&0,
I hereby certify that I own p mpwty adj=mt in
property locatad at
(Street Addrm, Lot, 8104y Roar
on , in _ A &AZ
(WatorbDO) (TO"
He/she has •deson'bed to me, as shown below, the c
location and I have no objection$ to this proPOW,
,Ijkg&&WjbU0►o.=mmustbem!jbackaminimum.disc
riparian Marrs wdc4s waived by m I hove indieatvd my 1
t 4ULsl agree to waive the 15' satbedc req
nB I do epee to waive dC I5' 06M& fequ'M
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DESCRiP "ON ANDMR DRAWWG OF PRO
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moat W'-JhV is propogn at the
uffidwtanA that a pierMooring
off keenatt (151 ftom ray area of
ions by lxidfi ixg below:
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PRITCHARD CONSTRUCTION, INC.
GENERAL CONTRACTOR
2436 NORTHMONT DRIVE
ASHEBORO, NC 27203
PAY
TO E _Z,?f)
ORDER U. 41A
r-om
DATE
5681
66-1157/531
wm
Randolph Bank NP
RANDLEMAN. NC 27317
FOR
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