47158_GLENNON, ANN_20070111

1
❑ CAMA / ❑DREDGE &FILL.+ �-
GENERAL PERMIT
Previous permit # d
❑New ❑Modification El Complete Reissue ❑Partial Reissue Date previous permit issued {
As authorized by the State of North Carolina, Department of Environment and Natural Resource
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC " H
QR'u es attached. i
Applicant Name_ Project Location: County +
Address
City
Phone # O_
Authorized Agent
Affected ❑ CW
AEC(s): ❑ OEA
❑ PWS:
ORW: yes / no
State
Fax # ( )
❑ EW ❑ PTA
❑ HHF ❑ IH
❑ FC:
PNA yes / no
Type of Project/ Activity
Pier (dock) length
Platforms)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length_
avg distance offshore_
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift X
Beach Bulldozing
Other
Shoreline Length
$AV: not sure yes noSandbags: not 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
Street Address/ State Road/ Lot #(s)
ZIP "t ,
❑ ES ❑ PTS
❑ UBA ❑ N/A
Agent or Applicant Printed Name
Crit. Hab. yes / no
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
Subdivision
CityZIP 7
n
Phone # ( ) River Basin
Adj. Wtr. Body (gnat dn�ani/unkn)
a
Closest Maj. Wtr. Body
I
�T
(Scale: )
.cam ;
❑ See note on back regarding River Basin rules.
Permit Officer-sSignature
h'
Issuing Date �^ E ira on Date
F% �
Local Planningjurisdiction 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:
[J 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
Central Office
Mailing Address:
1638 Mail Service Center
Raleigh, NC 27699-1638
Location:
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
Fax:[phone]
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)
Morehead City District
400 Commerce Ave
Morehead City, NC 28557
202-808-2808/ 1-888ARCOAST
Fax: [phone]
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico 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 06/29/05

'-'A. 111..1 A I I IA. 3 JL U 1 A LL 1,(„yJl � j
(FOR A PIER/MOORING PILINGSIBOATLIFT/BOATHOUSE)
i I hereby certify that I ow;t property adjacent to _ Amtq L.1r utiim) Is
(Name of Property Owner)
property located at 4-0 15� CN A N W-t, qDRP't I ✓--,
(Lot, Block, Road, etc.)
on , in rMr- K 1aU--) 1 SLk !, 7 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
pilings/boaffiMoathouse must be set back a minimum distance of fiA o lra
of riparian access unless waived by me.
L"i
I do not wish to ,.give the setback requirement. NOV 2 0 006
I da wish to v a:ve that setback requirement.
M!arghgtO Oity gQ
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
20-L 13' 24' 1 Q �; I I
CALL R05x-r
25-2 - 2q!S 6260
vnnt or Type Name "
Telephone Number
Date:

(FOR A PIERIMOORING PILINGSIB OA TLIFTIB OA THO USE)
S
4
I hereby certify that I own property adjacent to AMR ) 's
(Name of Property Owner)
Property located at CN A N i C-E- >- `fit V
(Lot, Block, Road, etc.)
on , in�,*S.�S�LI; 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
pilings/boadiftfboathouse must be set back a minimum distance of fift t 15 from my area
of riparian access unless waived by me. '
I do not wish to waive the setback requirement. NOV 2 % 70
06
I da wish to waive that setback requirement. Nq
100
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOP:1rF-I T:
(To be filled in by individual proposing development)
20 d 13' 241 IF 4 3 '
"FT
Print or Type Name
fe—lephonW Number
Date: 11-26 — (Z)

(FOR A PIERIMOORING PILINGSIBOA TLIFTIBOA THOUSE)
I hereby certify that I own property adjacent to Amu 's
(Name of Property Owner)
property located at 40 15� ifN A N Kr.--L, ` Ki V�_
(Lot, Block, Road, etc.)
on , in !`�F KA.t i� 1,5L , , 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
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 dot wish to waive the setback requirement.
I da wish to waive that setback requirement_
DESCRIPTION AND/OR DRAWS' G OF PROPOSED DEVELOP.MEIN7:
(To be filled in by individual proposing development)
L 1, ) 31 1-_ 241 t_ 143
AJ
„`T" F 1
2
Signature
Print or Type Name
Telephone Number
Date:

MPORTAVT MESSAGE`
FOR
DATE ` TIME
Mj
OF
PHONE �` — `` T=
AREA CODE NUMBER EXTENSION
❑ FAX
❑ MOBILE
AREA CODE NUMBER TIME TO CALL
TELEPHONED PLEASE CALL
CAME TO SEE YOU d UViLLALh ASAtf�l
WANTS TO SEE YOU PUSH
RETURNED YOUR CALL SPECIAL ATTENTION
ME SAGE
1
SIGNED
VFWFORM 3002P
MADE IN U.S.A.

ME
R
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Michael F. Easley, Governor Charles S. Jones, Director William G. Ross Jr., Secretary
Date
Applicant Name
Mailing Address
7F-cY�9;
w�
I certify that I have authorized (agent to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) �l'c- 16 ,
at (location) /-/O ' C L1►1J Al) E/ /7 r ,
This certification is valid thru (date)
Signature
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