49758_GRAY, GENE_20070719

OC;—ftMX / ❑ DREDGE & FILL
GENERAL PERMIT Previous permit #
New ❑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
❑ Rules attached.
Applicant Name (' Irel e 6 ir n Project Location: County
Address Street Address/ State Road/ Lot #(s)
City f" State A/" ZIP,x
Phone # () Fax # () Subdivision
Authorized Agent _ / t ; City ZIP
Affected ❑ CW ❑ EW PIPTA ❑ ES ❑ PTS Phone # ( ) River Basin
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
AEC(s): Adj. Wtr. Body (rat /Fna� n :/unkn)
❑ PWS: ❑FC: r
ORW: yes / no PNA yes / no Crit.Hab, yes / no Closest Maj. Wtr. Body
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 i 1'
Beach Bulldozi
Other
Shoreline Length
SAV: not sure yes no
Sandbags: not sure yes no
Moratorium: n/a yes no
Photos: yes no
Waiver Attached: yes
A building permit may be required by:
Notes/ Special Conditions
e
Agent or Applicant Printed Name
:f <
Signature "Please read compliance statement on back of permit"
Application Fee(s) Check #
(Scale:
---- - 7---
�ww.o
❑ See note on back regarding River Basin rules.
Permit Officers Signature
Issuing Date ration 96te
Local Planningf urisdiction 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
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/ I-888-4RCOAST
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

l
NCDE I�t
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 j _ 0 1
Applicant Name
Mailing Address
k,
I certify that I have authorized (agent) - L S to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) ,
at (location)
This certification is valid thru (date) '2 3 J — D
Signature
Mor0ead City [)CM
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: [phone] \ PAX: 252-247-33301 Internet: www.nccoastalmanagement.net
An Equal Opportunity 1 Affirmative Action Employer — 50% Recycled 110% Post Consumer Paper

ADJACENT RIPARMN PROPERTY OWNER STATEWENT
(FOR A PIER/UNCOMM BOAT L1F1)
I herby c atify that I own property adjacent to a ,. ►v ti �o ✓Z- - 's
Miame of Prop6iy Owner)
ply located at /) � - � A/\,
(Lot, Bloch, Road, etc.)
CM in K ,c i L�: -I- N.C.
(Waterbndy) (Tow n and/or County)
He has dcx=beyd to me, as strewn bei wr, the davckopMMt he is prOPOS S at trial
Wcanm' and, I have no objecwm to his proposal. I understand tint a pier/unc�omed boat lift
must be set back a miaimum disw1ce of fifteen feet (15,) from my area of riparian sc= unkss
wwvod by M.
JR wish to waive the sefta regwj==t-
i j4 wish to waive that Seth l requirest=t.
DESCREMON ANVOR DRAWING OF PROPOSED DE ELOP%CENT:
(TO be jwdd in ley LO&A na3 PAW )
g
j L � rSTw� 1
,..
JUL 0 9 2007
- DCM
Print or Type Name
Telgftm Number
ram:

ADJACEM MaPARLAN I I SrATEMWa
OFOR A PJNRIVNCOVBRXD BMT IJM
e— A
I bwoy cwd& Vw I mm papaty aommso - 1,o ,_ Mka A ,%IAT.�. mr I%
pwotykmwat
ah c I.C.
(TOM SN&sr Comety)
He bay 4=Cf%W to Me. at 31 a' - bell. do
am
slim- Md. I hm 00 04096M ID bb PtOPOMI I sbiw*WW t 106t
no be ON beck A UdOimm diMOM Of 90190 fsft (15') &M my au of *1
wad by me.
wi* 0 wales do ndn& Wit.
-1 pot
wim to waive -that WON* leg c.
3
()CM
Morehead Oty
Prot or Tyr Name
Tdepbow

205 Nottingham sane
Eric Ellis
Marine Construction
DOCKS • SEAWALLS -BOAT LIFTS
DECKS & REPAIRS
Phone & Fax: [phone]
Cell: 252.342.6775
Morehead City, NC 28557

ERIC B. ELLIS
JASA M. ELLIS PH [phone]
205 NOTTINGHAM LN.
MOREHEAD CITY, NC 28557
3659
7 v 66-30/531
V 133
Date- Z
Pay to the /l ��d �' I $ Ye
Order of- _ p
o u r" Ise" ,� q��" Oud
T B K
f{ f CITIZENS AN
www.first " s. m 63 o
For ' g[
':053 L00300�:00 L3 ?44878011' 03659
GUFRUTAN&SAFM BLUE ESBL
vo'ke/lme k—