43629_SUMRELL, JOE_20051205

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I= C411VIA / C 1 DREDGE & FILL
GENERAL PERMIT Previous i
permit #
_JNew i- 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
D Rules attached.
Applicant Name _ _ ` ` Project Location: County
1
Address s t '
City State Ak ZIP
Phone # ( ) -( . — %` "Fax # O
Authorized Agent
Affected ElCW ElEW f� JrrA ErES ❑ PTS
AEC(s): ElOEA ElHHF ❑ (H ElUBA ElN/A
❑ PWS: ❑ FQ
ORW: yes / no PNA yes / no i Crit. Hab. yes / no
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
cuDic yaras _
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
Shoreline Length
SAM not sure yes 00
Sandbags: 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)
Subdivision
City
Phone # (_)__
Adj. Wtr. Body
Closest Maj. Wtr. Body
ZIP
River Basin
gnat Lman /unkn�
(Scale: )
See note on back regarding River Basin rules.
Agent or Applicant Printed Name f' Permit Officer's Signature
Signature ** Please read compliance statement on back of permit" Issuing Date l Expiration Date
Application Fee(s) Check # 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 consistentwith the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
�JI 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
Washington District
Mailing Address:
1367 U.S. 17 South
943 Washington Square Mall
1638 Mail Service Center
Elizabeth City, NC 27909
Washington, NC 27889
Raleigh, NC 27699-1638
252-264-3901
252-946-6481
Location:
Fax: [phone]
Fax: [phone]
Parker -Lincoln Building
(Serves: Camden, Chowan, Currituck,
(Serves: Beaufort, Bertie, Hertford, Hyde,
2728 Capital Blvd.
Dare, Gates, Pasquotank and Perquimans
Tyrrell and Washington Counties)
Raleigh, NC 27604
Counties)
919-733-2293
Fax: [phone]
Morehead City District
Wilmington District
400 Commerce Ave
127 Cardinal Drive Ext.
Morehead City, NC 28557
Wilmington, NC 28405-3845
202-808-2808/ 1-888ARCOAST
910-796-7215
Fax: [phone]
Fax: [phone]
(Serves: Carteret, Craven, Onslow -above
(Serves: Brunswick, New Hanover,
New River Inlet- and Pamlico Counties)
Onslow -below New River Inlet- and
Pender Counties)
Revised 06/29/05

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