43500_TRIGLETH, JOSEPH_20051101

t ' ❑CAMA / 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 c) r 0 j'1 ! P Project Location: County _
Address er%L'�' �lJ� C �✓ Cjl " f / Street Address/ State Road/ Lot #(s)
City-- +"� - State Al( ZIP
Phone # ( )`� Fax # ( ) Subdivision
Authorized Agent City _ _- ZIP
J } ��
Affected CW I 1 EW [I PTA ❑ ES ElPTS Phone # (_ ) i River Basin
❑ OEA J HHF ❑ IH ❑ UBA ❑ N/A 7 f �'
AEC(s): Adj. Wtr. Body---_ t.� f��GJ�"' / Ur'y`�' (nat /man /unkn)
C PWS: ❑FC:
ORW: yes / no PNA yes / no,, Crit. Hab. yes / no Closest Maj. Wtr. Body 42 U �5 6 `'
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 Bulldozing
Other
Shoreline Length
SAM not sure yes n - - -A-
Sandbags: not sure yes no /7J I /t �-
Moratorium: n/a yes o fJ
Photos: yes o _
Waiver Attached: yes - - ---- --
A building permit may be required by: �� fi ❑ See note on back regarding River Basin rules.
Notes/ Special Conditions } (<I ' yU. f't `�'r '� l �P L
Agent or A plicant Printed ame _
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
ids ib i1 1 c► ! le 1,
Issuing Date ate
i
Local Planningf urisdiction

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, certifythatthis project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
JJ Tar - Pamlico River Basin Buffer Rules Other:
� I 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 (2S2-946-6481) 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,
Onslow -below New River Inlet- and
Pender Counties)
Revised 06/29/05

OCT-2,5-2005 10:19 AM
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DIVISION OF COASTAI, '.1
ADJACENT RIPARIA:ti PROPERTY OtiVNTFR NOTIFICATIONAVAIVER
FORM
Name of [ g r� o �
Individual npl�i��inb for permit:
Address of property:
GOt Of SOM N, street or road) /
.y ell
' (City & county) .
I hereby certify that 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 with 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 this notice. No response is considered the same as no
objection if you have been noted 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.)
wish to *aive the 15' setback requirement,
I do not wish to waive the 15' setback requirement.
Slg attire Date
r
Prig Nniae

btglas" Pc� Date
r
*riN.
2 2-
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Telepbone Number With Axes Code
Z:C1'il�e�,l: 11iA!i Cts{!:1'12 ft'�,:Y"„�)d. �•:({".:)hC`.r�� _i:i�:{''.•'"�. i•�L;,��'..;'.
OCT :2, S ?005
Morehead City DCM
P. as
OCT-24-2005 :OC33 PM
ADjACENT RIp'ARL4N PROPERTY ooR $TAnmmNT
(FOR ,A ptE)t/H00R1{V0 PlLX{VOS/80A7t jfT/80A,rH0l]S P
s-?c W ",e v,fir^ , `je— 1:: +Lm' 1�
i horsby cart!!y thet I awn propOy "Ad"t to . LaNa Inr�, C-S
�-00 0, (Name of Property Owner)

OCT-25-2005 10:22 AM
19t33 AM
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10.03
ADJACENT RwAR.LA►N PROPERTY OWNER STATE MTNT
(FOR A PIER/H00RhV0 PILINOSIROAT7,11, 180ATHOU, 0
J1oq 9-eo8r1c- - T:i)Lm11
I hereby aertdty+ that T own property adjacent to _g E. C.Gt1-4d1+�G"f" '/
'J
i � p c� (Marne of Property Owner)
property located at Lm.rd t
Amot, BlockRoad, etc.)
Etnr.A� M*Ie— vI•Tc--�
0 ate, __ , i, ... W,..,... � � t -A-- �...,..,..... ' N' C.
(Wa erbbody) (Town rind/or Couaty),
He hae dacOW in mil, u shm below, the developwt he is propostng at that location,
and, I hays no. objections to his praQosal. I undarstand that a pierlmoorint
pilings/boatliNboathouse must bt;aet back a minimum distance of Fifteen feet (IV) from my area
of riparian Access unless waived by me.
c
I dLW wteh to waive the setback requiremew.
OCT
J 1 dA wish to waive that setback requirernent, 5 Zlli`:g
.n•+w...w rr r4i.:rr r.rr. u�r
DESCRIpTJONN AN ioR DRAWLNG OF PROPOSED DEVELOPMtNT: �� Dctvi
(To bettlled in by indi►,Idaal prepardug dsvrtopmene)
.... ..- A r. Air.{�.........
■J�iY�_ Jam//_TM{�_/_.
signature \Vj
Print or Type Name
Telephone Number
Dist: 101z O

POSTAL SERVIC'Eo POSTAL MON
SF RIAL.'�NUtv1QER YEAR. MONi H,,
AM6UNT ONE HUNDR��}`\1
PAY TO
ADDRESS
C:O.D. NO. OR
USED FOR
l.,Qoo00a00 'oll
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15-800
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p\;AND CENyyT((rS
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CLERK
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