43674_STANDIFER, KARL_20060112

❑LAMA / _-1 DREDGE & FILL
^� GENERAL PERMIT
Previous permit #
L7New ]Modification CComplete Reissue
D Partial Reissue Date previous permit issue
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 / �, }��% A ,'-.�/ i
Project Location: County
Address % I lytt 7A11?A) 'i'f ����%f �_ L
+titi�� Street Address/ State Road/ Lot #(s)
City_ i3e f A-J State d%<. ZIP
2 `_: 6 "� .1 �;- '' 't, c
� r�
Phone # Fax # ( )
Subdivision
Authorized Agent
City A,ra'.l+... /1tAj ZIP
:�._S!a
CW ElEW ❑ PTA DES ❑ PTS
Affected
Phone # (_ ) � ' 4"4' 3 River Basin
J, OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
AEC(s):
-1
Adj. Wtr. Body %' ` v t
nat an /unkn)
❑ PWS: 1 FC:
Closest Maj. Wtr. Body r , '`' %' t ` '
ORW: yes / no PNA yes / no Crit. Hab.
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 ke
Boathouse/ Boatlift
Beach Bulldozing
Other
Shoreline Length
SAV: not sure yes
no
Sandbags: not sure yes
no
Moratorium: n/a yes
no
Photos: yes
Yio'
Waiver Attached: yes
no `
A building permit may be required by:
Notes/ Special Conditions
Agent or Applicant Printed Name L
Signature ** Please read compliance statementon bac of permit
Application Fee(s) Check #
(Scale:
See note on back regarding River Basin rules.
Permit Officer's Signature
Issuing Date xpiratio
Y
Local PlanningJurisdiction File Na

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, certifythat this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
Tar - Pamlico River Basin Buffer Rules I i 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
Mailing Address:
1638 Mail Service Center
Raleigh, NC 27699-1638
Location:
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, INC 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, INC 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,
Onslow -below New River Inlet- and
Pender Counties)
Revised 06/29/05

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Dec 20 05 01:35p
p.3
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER /MOORING PILINGS I BOATLIFT /BOATHOUSE)
I hereby certify that I own property adjacent to k�Ar, _ sfu-
` r n (Name of Prooerty Owner)
property located at U 1, T qA 0-5) S it. � � j C1
/' (Lot, Block, Road, ect.)
on %le_J� K�i Jl-{` ,in /\,)C'(,% GAaySn cb 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 obje�-tions 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.
Ido t wish to waive the setback requirement.
IAa wish to waive that setback requirement.
DESCREMON AND / OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development`)
( See the attached drawing)
Per 5+a f -(-D, PC -a ,( Y- 16co ( t-� u l f,o jqS .
Z, 6_0�_'
Siggasture
Prfat or Type Name
�a-�033_ �Cr3
Telephone Number
-g-06
Date

Dec 20 05 01:35p P.
_, JHN-[4-Mb PIUN U1:3I FM NC DIV OF COASTAL HGKNT FAX NO, 4 F. 01
CELUM, E, D_MAIi, - REEVE LBFCEI ' REUMIED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOT11•ZCATIONIWA1VER FORM
Name of Individual aPplying for Permit:- ---
Ad(ir�ss of Property: — Lol-
(I.O[ er Strect q, Street or Road, City & Count%-)
I hereby certify that 1 own property adjacent to the above referenced property. The individual
applying for this l•;.rmit has described to me as shown on the attached drat%ing the development
they are proposin'g. A (lescriptioa or drawing, with dimensions, should be provided with this
letter.
- _ I have no objections to this proposal.
1f you lu,rc objections to whol is heing proposed, please wi*e the Di►•isiort of Coastal
Marragentent, Nestrnn Plax 11, .151-B, 11tty. 24, Alorehead City, NC, 28S57 or call (252) 808-
2S08 %-Xiin 10 days of receipt of this notice. No response is con idered the same as no objection
if you itnre been notified by Certiftcd Marl.
WAIVER SECTION
I understand that a frier, clock. moorin,; pilings, breakwater, boat house, 1111 o; sandbags atttst be
sct back a rniniMUM distance of 15' front my area of riparian access unless wa:ved by me. (Ifyou
wish to waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' sclback rcquire,nent.
I do not %vish to %vaive cite 15' setback requirerttent
1112 bl6f
Signature_. ! ate
Print -NI ante
3S9 -GIB'
Telephony Number With Area Code

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LOT 94
TOTAL AREA 4
21,997 sq. fit.
90 1 0.50 acres
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