44714_WARNER, D L_20060314 (2)

1 CAMA / DREDGE & FILL
GENERAL` PERMIT
❑ _New ❑Modification [ ]Complete Reissue El Partial Reissue
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
PrevioGs permit #
Date previous permit is!
Applicant Name ` Project Location: County
Address %✓ n� �� /� 'F'c"?,/ Street Address/ State Road/ Lot #(s)
City.. :'. '.. jx- - Al State AAA ZIP 2—
Phone # Fax # ( )
Subdivision
Authorized Agent
,): I'v' +� !
City ':
' �✓ ZIP
Affected CW
❑ PTA A�ES ❑ PTS
Phone # (
) River Basin
^! OEA
AEC(s):
❑ HHF ❑ IH ❑ UBA ❑ N/A
Adj. Wtr. Body
ti _ J ,
' ' c' 4 1! /
/
iat./man /unkn)
PWS:
❑ F
y T
ORW: es no
PIMA es no Crit. Hab. es / no
y y
Closest Maj. Wtr. Body
Type of Project/ Activity
Pier (dock) length
Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length 1
avg distance offshore_ _
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
Shoreline Length �!
SAM not sure yes n
Sandbags: not sure yes t/ad
Moratorium: n/a yes KW -
Photos: yes 4�4
Waiver Attached: yes n
A building permit may be required by:
Notes/ Special Conditions
-.— Yi .
(Scale:
[ See note on back regarding River Basin rules.
Agent or' leant Printed Name pR Permit Officer's Signature
Signature-"*" Please read compliarfce statement on back of �iy� {. Issuing Date Expiration Date
-- 1031 q 13,1
Application Fee(s) Check # 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 consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
Tar- Pamlico River Basin Buffer Rules EJ Other:
EI 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

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(Bulkhead/rip rap)
I hereby certify that I own property adjacent to -D, � - W 61? M J'r2 's
(Name of Property Owner)
property located at 1 30 G U2+CA( r" ZQ'�
(Lot, Block, Road, etc.)
on 29,c(L C rW9 k in A/rEc J (� 94oi C'�B�FJ , N.C.
(Water body) (Town and/or County)
He has described to me as shown below, the development he is proposing at the
location, and, I have no objections to his proposal.
�N
w ;
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(to be filled in by individual proposing development) 30
Foley & Foley Contractors, Inc.
Phone#: [phone]
Fax# [phone]
a,il I
101.9- "
tj
ignature
Print or Type Name
Telephone Number
3 ,-D
Date
ela9;dk
row

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(Bulkhead/rip rap)
I hereby certify that I own property adjacent to -D, � - W 4 n N IFW- is
(Name of Property Owner)
property located at 130 GQ; �A t c" a, ,
(Lot, Block, Road, etc.)
on Rart (Z C►WO—, in A/F..) (3 e" C49u19J , N.C.
(Water body) (Town and/or County)
He has described to me as shown below, the development he is proposing at the
location, and, I have no objections to his proposal.
�N
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(to be filled in by individual proposing development) 3 _ A*#;d K
Foley & Foley Contractors, Inc.
Phone#: [phone]
Fax# [phone]
Flili�oop
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12,04
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Signature V
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Print or Type ame
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Telephone Number
�a z"Date

FOLEY & FOLEY2CONTRACTORS INC.
10 OLD AIRPORT RD.
N1EW BERN. NC 2&%2
PAY
TO THE
ORDER OF
2770
66-112/531
22 t �j BRANCH 01901
DOTE
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FOR 5 3 LO L 12 L':000 5 2 900 5 L 40"
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