43549_TYLER, DARYL_20051109

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CAMA/__'DREDGE & FILL � %(N /lw"'� 14 549
GENERAL PERMIT D�revo pe it#
I-1114ew EiModification -Complete Reissue ❑Partial Reissue Date previo s ermit 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
T / Ji Rules attached.
Applicant Name /: ✓ 7r, Project Location: County
Address_ 1 /•z. , • ���� ('J !� r Street Address/ State Road/ Lot #(s)
City State A k ZIP ?'�'J � ' Z , r L % /.'Y! ✓
Phone # ( ) Fax # O Subdivision
Authorized Agent i S _ City ZIP-
.
��
Affected CW EW 2 PTA i'G°J PTS Phone # ( ) _ er in
AEC(s): — OEA HHF E IH UBA N/A Adj. Wtr. o y_- _ nat man /unkn
PWS: 7 FC:
ORW: yes / no PNA yes / no Crit. Hab. yes / no Closest Maj. 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 i
Boathouse/ Boatlift
Beach Bulldozing
Other
Shoreline Length
SAM 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
Permit Officer's Signature
Signature ** Please read compliance statement on back of permit
_ _ �% I �► l J U
Application Fee(s) Chi eck#
Issuing Date Expiration Date
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, certifythatthis project is consistentwith 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
Central Office
Mailing Address:
1638 Mail Service Center
Raleigh, NC 27699-1638
Location:
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 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, 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

AN-24-2005 MON 01:31 PM NC DIV OF COASTAL MGMNT FAX NO. 4 P. 02
YkAJAC ENT RXPARIAN PROPERTY OWNER STA'rEME4N':['
(FOR A PIEWIMOORING PILINGSIROAI H71BOATHOUSE)
r hereby ct,-rtify that I own property adjacent to 3 `tt 's
(Name of Property Owner)
property locatul at _ 3a1 , }�1aZI
(Lot, Block, Roa(l, etc.)
on lS't' 4W L-AK Y_ , in
(Waterbcdy) ('Town and/or County)
He has described to me, as shown below, the development he is proposing at that location,
and, . 1 have no objections to his proposal. 1 tinderst,ind that a pier/mooring
pilings/boitliftlboalhouse must be set back a minimum distance of fifteen feet (15') from my area
Of riparian access unless waived by me.
I &_nnt wish to waive the setback requirement.
I do wish to waive that setback requirement.
D1;SCRIPTION AND/Olt DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing devcloprneat)
---------------------------------- ----------------------------------- - - - - - - - - - - - - - - - z ------ - -------------
Sgn;tture
Print or Type Name
Telephone Number
Date:

AN-24-2005 MON 01:31 PM NC DIV OF COASTAL MGMNT FAX NO. 4 P. 02
ADJACENT RIPARIAN PROPEWry OWNER sTxrE. mLi Y '
(FOR A PIlsRIMOORING PILINGSIROATLII-TlBoATHOUSE)
hereby certify that I own property adjacent to �ar— -�u`cc 's
(Naine of Property Owner)
property located at Ja1. Qic,�a�
(Lot, BIock, Road, etc.)
Oil ISL�tn(p �rG� _ , in 1 : ec ne�� _ , N. C.
(Waterbody) (Town and/or County)
He has dcscribW to nie, as shown below, the development he is proposing at that location,
and, . i have no objections to his proposal. 1 understtnd that a pier/mooring
pilings/boatlif /boathmse must be sit back a minimum distance of fifteen feet (15') from my area
of riparian access unless waive by me.
t do.nni wish to waive the setback requirement.
1 da wish to waive that setback requirement,
- q
DX;SCRIPTION AND/Olt DRAWING OF PROPOSED D1,WELOPMENT:
(To be filled in by individual proposing devc1op►nent)
Signature
kkil e. & -l-M �-/. gt-lC'Y 1'0' d et
Print or Type Name
5 0- (�
Telephone Number
hate:

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