49878_FLOURNOY, PEN_20070815

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❑CAF/IA / ❑ DREDGE & FILL 4�
GENERAL PERMIT Previous permit #
❑New ❑Modification El Complete Reissue El 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
O Rules attached.
Applicant Name i ' Project Location: County
Address l Street Address/ State Road/ Lot #(s)
City r" 1 JJ C StateA.%( ZlV" .)
Phone # ( ) Fax # () Subdivision
Authorized Agent ' .^ ' i City ) ZIP
Affected ❑ Cw ❑ EW ❑PTA '❑ ES ❑ PTS Phone # O River Basin
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body (nat /man /unkn)
❑ PWS: ❑ FC:
ORW: yes / no PNA yes / no Crit.Hab. yes / no Closest Maj. Wtr. Body
Type of Project/ Activity
Pier (dock) length t ( ?
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 i
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 ti
Application Fee(s) Check #
(Scale:, /
❑ See note on back regarding River Basin rules.
Permit Officer's Signature
Issuing Date Expiration Date
Local PlanningJurisdiction
Rover File Name
v�

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

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Michael F. Easley, Governor James H. Gregson, Director William G. Ross Jr., Secretary
Date d" - P - 0
Applicant Name
Mailing Address
20, r -S�zks sx
11
I certify that I have authorized (agent) C -kA=-Ly 20:) a- -�A -) to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) � � s /r ; a//f CL-)cc v ,
at (location)
This certificate-oo is valid thru (date)
Signature
"6 -/-6/
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: [phone] \ FAX: [phone] \ Internet: www.nccoastalmanagement.net
An Equal Opportunity \ Affirmative Action Employer — 50% Recycled \ 10% Post Consumer Paper

AVJ AC,:LN't- .KWARJAIN YKUFk K I Y UVViNLK �J t A L Girl1'..P! 1
(FOR A PIER/MOORING PILINGS/BOATLIFTIBOATHOUSE)
I hereby certify that I o,,va property adjacent to
(Name or Property Owner or :applicant)
y
:Mailing address if different from location address---------------.-.._---.--------.-------.. ___------.._-----_-.--,
(tov n, state and zip) ------------------- ----- + -
phone numbers you can be r-lached at =_��� -_ ------ m-m-
property located at -�
11Araie ea. �I
(Lot, Block, Road, etc.)
on 6 ��� , in N.0
(Wa rbody) (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/boatlift/boathouse
must be set back a minimum distance of fifteen feet (15) from my area of riparian access unless
waived by me.
I do not wish to waive the setback requirement.
initials
1 do wish to waive that setback requirement.
initials
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
ItVil\llllLJ
L,Q.vS Sig atu e
4Z-L 3� 30 �cutQ \�` ��eS �� w i
Print or Type Name
Telephone Number
Date, t-

A1JJAt;EN'I RIVARIAIN FRUMH 1 Y U W N 1 A t
(FOR APIER/IYIOORIiVG PIUVGS/BOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to..�h�..�_.
(Name of Property Owner or Applicant)
Mailing address if different frorn location
(town, state and zlp
phone numbers you can be reached at—,IJ��rr
property located at
(Lot, Block, Road, etc.)
in ' � , N.C. '
on ---
(Wa erbody) (Town an
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/boatlift/boathouse
must be set back a minimum distance of fifteen feet (15) from my area of riparian access unless
waived by me.
I do not wish to waive the setback requirement.
initials
"' I do wish to waive that setback requirement.
initials
------------- ------- -------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: \ff
(To be filled in by individual proposing development) 1 - Z
—111III111�
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---------------------- ------------------------------------
Signature
C' G. a y
Print or Type Name
0 �
T®I@pphone k mber
Dare:

U.S. HWY 70
C. HWY 24
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LEGEND
SIP • SET IRON PIPE
SIR - SET IRON ROD
EIP . EXISTING IRON PIPE
EIR EXISTING IRON ROD
EIS EXISTING IRON STAKE
ECM - EXISTING CONCRETE MONUMENT
RAW - RIGHT OF WAY - -
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FENCE --X-X-X-
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HWL HIGH WATER LINE
C.P. COMPUTED POINT
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REFERENCES
DEEDBOOK 975 PAGE 51
MAPBOOK 3 PAGE 137
LOT 5 BLOCK "J"
MITCHELL VILLAGE
PIN # 636613127681
NOTES:
ACEAGE 0.76 AC. BY COORDINATE METHOD
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42.s7
rn
p PROPOSED
0 HOUSE 2
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12.33
15.
75' AEC LINE
ECM
10 � p5`
ECM S I 33'
TOP OF BANK f
TOE OF BANK
APPROX.HWL
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EDGE OF MARSH - PIER
60 0 60 120
180
L —
GRAPHIC SCALE — FEET
ROGUE SOUND
MAP PREPARED FOR:
PENN FLORNOY
I, DONALD A. NELMS, A PROFESSIONAL LAND SURVEYOR, CERTIFY
ii E; OF SURIVE ;
PLAYS ! CAL
SCALE: I"
= 601
couNTY: C AR T E R E T
THAT THIS PLAT CONFORMS TO THE STANDARDS OF PRACTICE FOR
LAND SURVEYING IN NORTH CAROLINA AND THAT THE RATIO OF
PRECISION AS CALCULATED IS GREATER THAN 1:10,000 AND THAT
THE ANGULAR ERROR OF CLOSURE IS GREATER THAN 20 SECONDS
TIMES THE SQUARE ROOT OF THE NUMBW!(0"A Pg'ny),NED.
ol
.c'��OQ:• �GRR,�• /�.O'��,
DATE: 5-28-2004
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T"P: MOR E H E AD
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MAP PREPARED BY:
DONO-D A. NELMS, P
LSRPCL
a;r L-3650
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JOHN W. COLLIER & ASSOCIATES
408 ARENDELL STREET/P.O. BOX 3480
MOREHEAD CITY, N.C. 28557
OFFICE: [phone]/[phone]

(FOR A PIERII-YIOOnVG PIUVGSIBOATLIFT/BOATHOUSE)
I hereby certify that I w gin property adjacent to i;1� •�?j. - p/� �9
(.'Name of Property Owner or .applicant)
y
:Nailing address iF,liFfe:er,t from location address_—___.___-___._.__..___._.----___-
(tov; n, state and zip) ..---
phorte numbers you can be r::ached at—.-4
property located at
(Lot, Block, Road, etc.)
on t inN.C.
(w rrbody) (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/boatlift/boathouse
must be set back a minimum distance of fifteen feet (15) from my area of riparian access unless
waived by me.
I do not wish to waive the setback requirement.
initials
1 do wish to waive that setback requirement.
initials
-------------------------------------------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELMAYIENT:
(To be f fled in by individual proposing development)
1 M W--.
4 t U'S-reps
1
14
---------------------- C--------------p-�--� ---------�I---_
Signatu e
Print or Type Name
Telephone Number

MATHER BUILDERS, INC.
212 GORDON STREET
2324
BEAUFORT, NC 28516
P H . 2 52-726-621 6
66-1246/531
DATE
(j - "'y
PAY
TO THE �(' �-y�
c--Dr l `� 4
ORDER OF , v
I
o
-'
DOLLARS
Morehead City, NC 28557 �• �7
FOR
II'00232411' :0531124661:
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