49085_HORGAN, JANICE & TOM_20070621

(9 aS-a? /'56
❑ CAWA / 0 DREDGE & FILL
GENERAL PERMIT Previous permit
❑New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous er it issued
As authorized by the State of North Carolina, Department of Environment and Natural J57A
ces
and the Coastal Resources Commission in an area of environmental concern pursuant tCAC
_ , [DRules attached.
Applicant Name k- Project Location: County `•
Address i } �:"" Street Address/ State Road/ Lot #(s)5�g]
City State ZIP
Phone # O ? �" Fax # O Subdivision r
Authorized Agent City ZIP
Affected ❑ DW ❑ EW ❑ PTA [NES ❑ PTS Phone # O River Basini•.-
❑ OEA ❑ HHF ❑ lH ❑ UBA ❑ N/A
AEC(s): Adj, Wtr. Body s r '(natyman /unkn)
❑ PWS: ❑FC:
ORW: yes / no PNA yes / no Crit.Hab. yes / no Closest Mal. Wtr. Body
Type of Project/ Activity
(Scale:
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 Bulldozin..
g - a
'C.,
Other -
Shoreline Length
SAY: 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: See note on back regarding River Basin rules.
Notes/ Special Conditions
Agent or Applicant Printed Name
Signature "Please read compliance statement on back of permit
0
Application Fee(s) Check #
�n
PermitOfficer's Signature
Issuing Date Expiration Date
`�'C vb-1-f/ G'
Local Plan ningf 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 I) 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 complywith these buffer rules.
Division of Coastal Management Offices
Raleigh Office Morehead City Headquarters
Mailing Address: 400 Commerce Ave
1638 Mail Service Center Morehead City, NC 28557
Raleigh, NC 27699-1638 252-808-2808/ 1-888ARCOAST
Location: Fax: [phone]
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
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
I hereby certify that I own property adjacent to i••e,r t �R N . ��� dC1-1111 ,
property located at S"_s,C
(lot, bl ck, road, etc)on in
---
(body of water) (town )`
North Carolina in crowel,) County. The proposal has been described to
me as shown below; the development, a vier/bulyra, and the
(circle one)
Proposed location, and I have not objection to the proposal. I under-
stand that if the development is a pier, it must be set back a minimum
distance of 15 feet from my area of riparian access unless waived by me.
I do/do not wish.to waive that setback requirement.
(circle one)
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Description and/or drawing of proposed development: (to be filled in by
individual proposing development). INDICATE THE SIZE AND LOCATION OF THE
STRUCTURE AND THE DISTANCE BETWEEN EACH PROPERTY LINE AND THE WATER.
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Name (Please int)

ADJACENT Qt0hDTAN PROPERTY nwu R STATE; i
I hereby certify that I own property adjacent to
property located at Tim .- -_
on _ (lot, block, road, a c)
e in
(body of water)
North Carolina in (town)
County. The proposal has been described to
me as shown below; the development, a bier/bt?lheadlstru
(circle one} and the
proposed location, and I have not objection to the proposal. Z under-
stand that if the development is a pier, it must be set back a minimum
distance of 15 feet from my area of riparian access unless waived by me.
I d2A2 _t wish to Waive that setback requirement.
(circle one)
Description and/or drawing of proposed developments (t. be filled in by
individual proposing development). INDICATE THE SIZE AND LDCATION OF
STRUCTURE AND THE DISTANCE BETWEEN EACH PROPERTY LINE AND THE WATER. THE
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ORDER'OF
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