45796_BEAK, WILLIAM_20061103

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❑G�AAAA / ❑ DREDGE & FILL
GENERAL PERMIT Previous permit #
UW El New ❑Modification ❑Complete Reissue DPartial Reiss a 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 Pro•ect Location: County f'
Address v
City
State ZIP
Phone # O
Fax # O
Authorized Agent
ElCW
❑ EW El PTA El ES ElPTS
Affected
AEC(s): ElOEA
❑ HHF ElIH ❑ UBA ❑ N/A
ElPWS:
❑ FC:
ORW: yes / no
PNA yes / no Crit. Hab. yes / no
I i
Street Address/ State Road/ Lot #(s)
Subdivision
City ZIP
Phone # (J) River Basin
Adj. Wtr. Body (nat Lman /unkn)
Closest Maj. Wtr. Body
Type of Project/ Activity
(Scale:
Pier (dock) length
Platform(s)
Finger
Groi
n length
number
head/ Ri ra
channel
ramp �.
h Bulldozing
r
not sure es
not sure es
ratorium: n/a yes no
- - --- - ----- — - --
i
--
P P length � -- - -• — -- -
avg distance offshore
max distance offshore _ _
cubic yards i•. �
'� •� � / % - _ �- j i
j I
! _
Y no
i
Y no _ Ui��
yes no
,
: I
f�
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit
2
Application Fee(s) Check #
Permit Officer's Signature----------'-""`•�
Issuing Date ` i Expiration Date
Local PlanningJurisdidion Rover File Name j
f�
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit
2
Application Fee(s) Check #
Permit Officer's Signature----------'-""`•�
Issuing Date ` i Expiration Date
Local PlanningJurisdidion Rover File Name j

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:
E Tar - Pamlico River Basin Buffer Rules JI 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 (252-946-648 I) 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:
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
Fax: [phone]
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

Eric Ellis
Marine Construction
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DOCKS *SEAWALLS *BOAT LIFTS
DECKS & REPAIRS 9AU
Telephone : [phone]
205 Nottingham Lane
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Capps Printing, Morehead City

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ADJACENT RIPARIAN PROPERTY OWNER srA
TMWMT
(FOR A PAWuNCOYBjW BOAT ijm
I hereby certify that I own property adjacent to 1,;`;
(Name of Property Owner)
property locoedF-
(Lot, B1oek Road, etc.)
on Cr,
(watatwy)
in — i -i,—, �� �' �f
(Town and/or County)
He has described to an, as shown below, the
Location, and, I have no objections to his d�elopmant he is proposing at that
must be set back a minimum distance of fiftiedt few IS )�UM a/+erred boat Lift
waived by me.
( Y riparian access uttless
Ido ,
t wish to waive the setback requirement. .�, I 'J ��
C, I wish to waive that xfta mqmren=L Nov -1
2006
_'__�"""""'_'---------•— - --- - �h ran �. _
DESCRIMON AND/OR DRAWING OF PROPOSED
(To be,J1d in by i*induW ProP*dng development) M
f �
Print or Type Name
TeIt Number —`
Date:

ERIC B. ELLIS
JASA W ELLIS PH (252) 72"775
205 NOTTINGHAM LN.
MOREHEAD CITY, NC 28557
3457
66-30/531
Date 133
Pay e the % � �� Noe
Order of aV / "
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R�S�Ir CITIZiJNS 133
All-ti.5—Bank 328 1t Company
Atlanlit Boatli, N.C. 28512
firstcitizens.com
For
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