41146_BALUSS, JIM_20050405

CAMA / '- DREDGE & FILL
GENERAL PERMIT
❑New ClModification ❑Complete Reissue ❑Partial Reissue
As authorized by the State of North Carolina, Department of Environment and Natural Resources
and the Coastal Resces Commission in an area of environmental concern pursuant to 15A NCAC
Previous permit #
Date previous permit issued
Applicant Name Project Location: County
Address ' Street Address/ State Road/ Lot #(s)
City iai State ZIP
i
Phone#(1�') �'/ y Fax #( )
Authorized Agent
l�
a CW
CJtW p'PTA
Affected
AEC(s): LI OEA
❑ HHF ❑ IH
C PWS:
C FC:
ORW: yes / no
PNA yes / no
Type of Project/ Activity
❑ ES ❑ PTS
❑ USA ❑ N/A
Crit. Hab. yes / no
'E] Rules
Subdivision
City ` ZIP
Phone # ( ) River Basin
Adj. Wtr. Body (nat_/man /unkn)
Closest Maj. Wtr. Body
Pier (dock) length
Platform(s) _
.
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
r
avg distance offshore
max distance offshore
Basin, channel
--- --
cubic yards
Boat ramp
Boathouse/ Boatlift
1 j
i
Beach Bulldozing
i
i
Other
Shoreline Length
SAV: 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:
Notes/ Special Conditions
PC f/ OUP; 1•�^a
Agent or Applicant Printed Nam /
Signature"Pleasereadcompliancestatementonbackofpermit"
Application Fee(s) Check #
(Scale:
See note on back regarding River Basin rules.
Permit Officer's Signature
Issuing Date Expiration Date
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
landowners).
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:
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 (910-395-3900) for more information on how to comply with thesebuffer 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 / 1-888-4RCOAST
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
151-B Hwy. 24
Hestron Plaza II
Morehead City, NC 28557
202-808-2808
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
910-395-3900
Fax: [phone]
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)
www.nccoastalmanagement.net
Revised 10/05/01

t&"dtx',,-zL-i 1 turAA1AN JrKUMKt Y V 1 AILK 51"Ai'lblhNT
(FOR A PLER/MOORMG PIL1NGS/B0ATLZFT1B0AT80Un)
I hey certify that I own property adjacent to 's
(Name of Property Owner)
property located at
(Lat, Blod4 Road, etc.)
in (J� ��:��� , N.C.
Materhody) (Town and/or County)
He has descanibed to me, as shown below, the development he is proposing at that
location, and, I have no objections to his pMposaL I uadmstmd that a pier/mooring
mast be setback a minimum ffistmm offift= feei (M from my area
Of riparian access unless waived by me.
I do not wish to waive the setback requirement
I �o wish to waive that setback requirement
DESCRIPTION AND/OR DRAWING OF PROPOSE[) DEV LOPMIT:
(To be filled in by individual pmpos&g development)
Signature
C. GCL-
-
Print or Type N
Telephone Number
Date: %

INNERBANKS MARINE CONSTRUCTION, INC.
PH. / FAX [phone]
,� P.O. BOX 190 ORIENTAL, NC 28571
DOCKS, SEAWALLS, PERMITS, REPAIRS
PETER OVERGAARD - 252-671-6790
PRESIDENT
V~.INNERBANKS.BIZ
1 �"

t'"J,M%,r.,LN 1 iurx K i A Lv ricVYLKl I V M LK 61'Al"M H:NT
(FOR A PZERIMOORING Pff"GSBOATIJFTBOATHOUSR)
I hereby cmtify that I own property 4aeeut to .3
(Name of Property Owner)
property locatedat 397 9,,,.�� 1Z�
(Lod, BIock, Road, etc-)
an f�v rr,� �� eck is �����`�: v'S, N.C.
(Waterbody) (Town aund/ofr County)
He has desrnl)ed to me, as shown below, the development he is proposing at that
location, and, I have no objections M his proposal. I understand that a pier/mooring
muss be set back a minimum di.stanm offifte= fief (IS') from my area
of riparian access =less waived by me.
I do not wish to waive the setback repkement.
I do wish to waive that setback regwrement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVEMPMDENT:
(To be jiVed in by &&idual pmpodxg development)
�eu MOO.,, Q,VNNI
tL
a! -
4A4�1 ;
62 7 Al�
�Ar\rt\S
!eJ
j
Prim or Type Name
� 7 � 5.j6�_
Telephone Number
Date: /

INNERBANKS MARINE CONSTRUCTION, INC. 1848
P.O. BOX 190 PH. 252-249-1429
ORIENTAL, NC 28571 Nos- 66-30/531
PAY � DATE 472
TO THE I Y L 1� Q oo
ORDER OF `
DOLLARS 8
FYRST CITIZENS,72
n A 1�TiI DAL �1� FiMLih,rs B2a8nk7& Tut CwpanyOC.s51
w.firze3.cww
FOROCCi1% SAwk � o �rr��z
-- -- - --rip
n■00 1846116 1: 100 300':004 7 120 128 2 2ii'