44215_WILLIS, DONALD_20060120

i )CAMA / I I DREDGE & FILL
GENERAL PERMIT
❑New ❑Modification ❑Complete Reissue OPartial 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
Applicant Name 1� ✓ i t IS Project Location: County
Address
City .,-� i} State' ZIP-Y%"
Phone # (' f ) y - c J Fax # ( )
Authorized Agent
Affected B-CW ❑ EW P'ISTA ❑ ES ❑ PTS
AEC(s): ❑ OEA _] HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS: ❑FC:
ORW: yes / no PNA yes / no) Crit. Hab. yes / no
Type of Project/ Activity
Pier (dock) length
Platforms) l X
Finger pier(s)
Groin length
number
Bulkhead/ Ripraplength
avg distance offshore
max distance offshore
Basin, channel
cubic yards_
Boat ramp
Boathouse/ Boatlift_
Beach Bulldozing
Other
Shoreline Length
SAV: not sure yes no
Sandbags: not sure yes if no
Moratorium: n/a yes &,,o
Photos: yes
Waiver Attached: yes `
A building permit may be required by:
Notes/ Special Conditions
i
c�4-1- T7 4 t.s + S
Bent or Applicant Printed Name
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
-off is �
Previous permit #
Date previous per it
Street Address/ State Road/ Lot #(s)
Ni
ed -
ached.
Subdivision
r? a '
City vK , � `r C ZIP
Phone # (_) River Basin
Adj. Wtr. Body f(natl /man /unkn)
Closest Maj. Wtr. Body— `'1
r
C See note on back regarding River Basin rules.
Permit Officer's Signature
j t
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, certify that this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
L� Tar - Pamlico River Basin Buffer Rules [ Other:
U 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,
Orslow -below New River Inlet- and
Pender Counties)
Revised 06/29/05

01/20/2006 08:12 9197350097 SOUTHCO DISTRIBUTING PAGE 02/02
ADJACENT WARIAN - ROPFRTY OWNER STATEM:Ne JA N 2 0 2006
Morehead City DCM
I hereby certify that I own property adjacent to
(Name of Woperty Owner)
property located at Lo+ 14- K' i a L_
(Lot, Block, Road, etc.)
on �G �� ��n� , in Geocq , N.C.
aterbody) (Town and/or County)
He has described to me as Shawn below, the development he is proposing at that location,
and, I have no objections to his proposal.
DESCPJMON AND/OR DRAWAYG OF PROPOSIED,AEVELOPMEENT
(ro be f lled in by individual proposing development)
�UU i 5`
[ WPM
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I
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$ignatu e/
i7 P.�t,�i ►� P ✓r 1 n F
print or Type Name
919 '73
Telephone Number.
Date: l r �L 0 — 6
2'd IbSZ-Ot1Z12SZ] eueIa1 dtE=So 90 61 uer

p�AN PROPERTY OyNER STATEMENT'
ADJACENT R� ub
adjacent to D�� �� � V V � I 115 '"s
I hereby certify that I own property l
(i\'ame of Propert}'
M5�c_�'-
property located at � 3
(Lot, Block, toad, etc.)
N.C.
i n r TL Y r, n ( t t '
on V ' (To«•n and/or County)
sho�•n below,
He has described to'i1 z the development he is proposing at that location,
and, I have no objections to his prQpos41.
- ------ --ro -------------------------------
DESCRIPTION AN_D/OR DRANG OF PROPOSED DEVELOPti1EtiT
« I
(To be filled in byindiri(lual proposing de►elopme n1)
4
�-
-.} Wide
1 V\dis Alr. 1�e�
oaf ------
13 t- �f
---------
----------------- --------------- -
U
Signature
Print or, Typc Name,
Tel:.p`�o�e humb�r

• PROPERTY OWNER STATEMENT
ADJACENT RIPA►RIA.N
certify that I own property adjacent to �a-)CdJ 4Te-16 1Ii5's
I hereby Y (Name of Property Owner)
L - n, (leaffi �Jc
property located at
(Lot, Block, oad, etc.)
in
l brN.C.
on a�erb(Tol*Vn and/or County)
Wody') _
He has described t0-Inle a.�, shown below, the development he is proposin-g at that location,
and, I have no objections to his prpposal_
-----------------
------------
-----------------A------
DESCRIPTION AN-D/OR DRAINING licit c lO pOPOSeED DEVELOPMENT
(To be filler! in byi�i 1 PFP
os
MAxa00IT
W ; I 1 1L s `
— '
tof- 13°t y
Signature
Print or Typc Nan-,e
Tel;.phon� Numfi�r

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JOHN A. ODOM tpIM1H'YA1* Wacia 6. Willis, Jr.
and wife
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000m~ Tel&nd P. Willis
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T WILLIS CONSTRUCTION, INC.
P O BOX 222
SALTER PATH, NC 28575
PH.252-247-3850
DATE `—%O — 0
1307
66-1246/531
AY
w O THE
ORDER 0
N 'ORDER OF
a DOLLARS t �.
`, NC26584
FOR a
11100L307110 1:0531124661:
000644 10119