46741_GOTT, MICHAEL_20070104

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❑ CAMA / ❑DREDGE &FILL r/
GENERAL PERMIT Previous permit#
❑New El Modification ❑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 f`1ti Z �Q
Applicant Name : V , "_;,. cw \ fi
Address ✓\(-. CA 5 t C s-
City C c State P-i C- ZIPS YS }
Phone # ( ,)' 4.. 3 0-)" 3 M Fax # ( )
Authorized Agent i vet �_r
Affected ❑ CW ❑ EW N PTA ❑ ES ❑ PTS
AEC(s): ElOEA ❑ HHF ❑ IH ElUBA ElN/A
❑ PWS: ❑FC:
ORW: yes /. no PNA yes 7 no Crit. Hab. yes / no J
Type of Project/ Activity
Pier (dock) length
r
Platform(s) "i
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel ~'
cubic yards
Boat ramp
Boathouse/ Boatlift I X 3
Beach Bulldozing
1
Other
Shoreline Length
I
Project Location: County c �'—\ , ` L)
Street Address/ State Road/ Lot #(s) c.
Subdivision 66w-c p-r L-c" A k:,. �
Cityi'" F-c , �— ZIP S
Phone # ( ) River Basin
Adj. Wtr. Body C E' • L `-'`` '•Gnat) /man /unkn)
Closest Maj. Wtr. Body 2,
(Scale: : ter-,•, i r,.)
SAM not sure yes no I '
Sandbags: not sure yes no
Moratorium: n a yes
Photon yes
r
Waiver Attached. yes --
A building permit may be required by: ptaV'-- r L2See note on back regarding River Basin rules.
Notes/ Special Conditions c. Q C4."L, ICl�-1 E �l ^� S f" 6 -1
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit
(��
Application Fee(s) Check #
Permit Officers Signature
Issuing Date Expiration Date
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 all local
ordinances, and 2) a written statement or certified mail return receipt has been obtained from the adjacent riparian
Iandowner(s) .
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certifythatthis project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
U 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
Central Office Elizabeth City District
Mailing Address: 1367 U.S. 17 South
1638 Mail Service Center Elizabeth City, NC 27909
Raleigh, NC 27699-1638 252-264-3901
Location: Fax: [phone]
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
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/ 1-888-4RCOAST
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,
Orslow -below New River Inlet- and
Pender Counties)
Revised 06/29/05

d
T hereb3y -C=tify ghat I Crwn prOPertiY a.ij�tit
qj.rA, -Block, Read, etc.) -
in. N-c-
a dp) (TOWU and/or OMO)
He has described to me as shown below, the deveL l-ment he is proposing at that location,
(To be ftffad in by urfvL*wl prop i cg dleve—logmentt)
LIM
J
-
-,
x L _
S-ter —�7z
- Pry or .l e NI me
`e?enhone ?dumber

Creek Constmai,
)x 268
t, NC 28556
jig
IIII! Illli�l II IIIPn�Illlllllll III II!
■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
1sT NorlcE EL946(�
2ND NOTICE
A. Signature
❑ Agent
X ❑ Addressee
B. Received by ( Printed Name) C. Date of Delivery
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
3. Service Type
❑ Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number 7001-1940 0001 0025 8671
(Transfer from service label)
PS Form 3811, August 2001 Domestic Return Receipt 102595-01-M-2509

CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER
FORM
Name of individual applying for the permit: CDC
Address of property:
(Lot or street#, street of road)
22Z �
(City & County)
I hereby certify the 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 whit 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, 400 Commerce Ave., Morehead City, NC 28557 or call [phone]
within 10 days of receipt of the 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 requirements
Signature
Print Name
Telephone number with area code
Date

here&Y 6'ar fy that I awn Xgper 2,�acent to r
5
{rl,acne of Property own r)
property ioca� at Lk-,—�
Clot, mock, Road,
(Town =r#!flr
He has desaff3ed to me -.L- shown below, the de -veto
,_rneni he u PrOPaSing at the locati©rl,
and, I have no objections to his :Fr0p0&-IL
-------------
-I POSED DEVELOpMENT
a Ae JYffad'in by hzdf v&u&,prap � ,,g deve&q�--rri)
Cotes � zUC � �o�
-IS I-- a\o
�(� X ao! Phi rOc�iYl
H vL5E
priilt or -6Name
Date:
Number