49816_BLAHS, TONY_20070914

10- 11-U-7 / O`D01
n CAIVIA / ❑DREDGE &FILL 6(w
GENERAL PERMI Previous permit#
❑New ❑Modification ❑Complete Reissue Li 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 I SA NCAC
Applicant Name Project Location: County.
Add Street Address/ State Road/ Lot #(s)
City
State ZIP
Phone # ( )
Fax # ( )
Authorized Agent
❑ CW
❑ EW ❑ PTA ❑ ES ❑ PTS
Affected
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 T Tr
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
ti lr/
Shoreline Length
SAV: not sure yes no
Date previous permit issued
[-I Rules attached.
Subdivision
City ZIP
Phone # ( ) River Basin
Adj. Wtr. Body (nat /man /unkn)
Closest Maj. Wtr. Body '.
(Scale:
y e `
Sandbags: not sure yes ` no {+ i
Mi i1 v
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
Signature Please read compliance statement on back of permit
Permit Officers Signature
Issuing Date Expiration Date
Application Fee(s) Check #
Local Planning Jurisdiction 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, certifythat this 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
Raleigh Office Morehead City Headquarters
Mailing Address: 400 Commerce Ave
1638 Mail Service Center Morehead City, NC 28557
Raleigh, NC 27699-1638 252-808-2808/ 1-888-4RCOAST
Location: Fax: [phone]
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
Fax:[phone]
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico Counties)
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)
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 08/09/06

AD.T.r CEW x EPARIA r PROPE R Ty OVVNF STATEMENT
TOR A 1'IEl?/�i�fOOJ?ING PlT.WGS/BOAT"pT/SOATHOUSP
I hereby certify that I own property adjacent to t-(rrz is
�� , (N�tute o Praperty Owner)
KOPC'ny located at �Xj i S
(I,ot, Bloc ,(R(nd, etc-)
1
on{j�t'( �� , in , N.C.(Wat rbody) Crown and/or Cotttrty)
He has &=Abed to me, as shown below, the development he is proposing at that location,
and, I have no objec dons to his propowi. I undcrstand that a picr/moodng
Pil>n atltR/bo.'ttitousa must be suet track a minimum distance of fiReen feet (IS') from my arcs
Of riparian acc= unless waived by me.
A
rltt uAt wish to waive the setback requiremew. �•a1 �''
- — T 110 wish to waive that setback requirement. �(p l 2007
DFSORIM?O,'Y AND/OR DRAWING OF PROPOSER i)EVIvi:OMr!. YT.
(To be filled in by indiridaal proposing development) ";
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A. a111a vi I YW I-4ame
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Telephone Number
Date: / � 6

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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(TOR A PIERAVj00RJjVG PIT,INGS/130AT!_IFT/BpATHDUSF_)
hereby certify that I own property adjacent to
s
t w _ _ (Naine of Pr perty Owner)
l:r0j'--2rty located at
�� � ��`� Y
([At, Bloelt Road, etc_) 1
on�� —6 , in C.Va crb dy) N
(Town and/or County)
lie has described to me, as shown below, the development he is proposing at that location,
anti, I have no objections to his proposal. I understand that a pier/mooring
piliri;;s/iioatlift/boathouse must tx; set back a minimum distance of fifteen feet (15') from my area
Of rip;nian access unless waived by me.
.......__..__. 1 JOLMA wish to waive the setback require►nent.
I sa wish to w.live that setback requirement.
- - - Moreh
Or-SCRIMO,N ANWOR DRAWING OF PROPOSrD DEVELOPMENT: �
(To he filled in by i►tdiridual proposing development)
a::�54r,- n 10o I + - Cam'
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Telephone Number
Date: k- 5 f 6

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FIRST CITIZENS BANK
MOREHEAD CITY, N C 28557
OUTER BANKS MARINE CONSTRUCTION, INC
1501 FIRST AVE
MOREHEAD CITY, NC 28557
[phone]
9/4/2007
2658 t`-I
66-30/531
137 L�
PAY TO THE
ORDER OF D E N R $**200.00
Two Hundred aDd
DOLLARS
D.E.N.R.
MEMO 41 � ��
11,00 26 Sail' l:0 S 3 100 300':00 1 3 1 2 18 2 1 2 7ii'