40751_BAYLISS, TOM_20050203

CAMA / ` 7 DREDGE & FILL M
GENERAL PERMIT Previous permit #
DNew liModification -]Complete Reissue ClPartial Reissue 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
0 Rules attached.
Applicant Name Project Location: County
Address _ _ / La Street Address/ State Road/ Lot #(s)
City rIV e..G _% State ZIP b Z
-------- --- -----------------
Phone # F
6
O Fax # ( ) Subdivision
'a C
Authorized Agent }6 / City ZIP
CW & EW K� PTA - ES PTS Phone # (- -) ---- -- _ River Basin
Affected ;, OEA ElHHF ❑ IH - UBA - N/A
AEC(s): - PWS: CFC: Adj. Wtr. Body __-- ----- (nat /man /unkn)
ORW: yes / no PNA yes / no Crit. Hab. yes / no Closest Maj. Wtr. Body---''�------------ — --
Type of Project/ Activity
Pier (dock) length _ --
Platform s
Finger pier(s) - - --- 4
Groin length
number
Bulkhead/ Riprap length
avg distance offshore___` I
max distance offshore i.
Basin, channel --
cubic yards_
Boat ramp
Boathouse/ Boatlift1
Beach Bulldozing
Other - -_---- -_--
Shoreline Length
" v
SAM not sure
yes (nod
Sandbags: not sure
yes o,
Moratorium: n/a
yes 1n9
Photos:
yes no
Waiver Attached:
yes ` no
A building permit may be required by:
Notes/ Special Conditions
Agent or'Appiicant Printed Name
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
(Scale: )
I
Y yiV
i
? i--
--
r
`'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
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:
Tar - Pamlico River Basin Buffer Rules Other:
—F 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 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: Fax: [phone]
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293 / 1-888ARCOAST
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.nccoastaimanagement.net
Revised 10/05/01

FOLEY & FOLEY CONTRACTORS, INC. 1122
MATERIAL ACCOUNT
[phone]
1810 OLD AIRPORT RD. _ 66-112/531
NEW BERN, NC 26562 DATE 01901
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PIiINGSIBOATLIFTIBOATHOUSE)
I hereby certify that I own property adjacent to
(Name of pr perty owner)
property located at a't I
(Lot, block, road, etc.)
on I 2LIL (�� i . in New Bern/ Craven , N.C.
(Water body) (Town and/or county)
He has described to me, as shown below, the development he is proposing at that
location, and, I have no objections to his proposal. I understand that a pier/mooring
pilings/boathfl/boathouse must be set back a minimum distance of fifteen feet (15') from
my area of riparian access unless waived by me.
I do not wish to waive the setback requirement.
I do wish to waive that setback requirement.
DESCRIPTnoN ANDioR DRAWING OF PROPOSED DEVELOPMENT-WFZ1--
(to be flUed in by individual proposing development) Vow
Flo
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Foley & Foley Contractors, Inc.
Phone#: [phone]
Fax#,. [phone]
U1r 1lfiL W Mr /
Print or ype Name
Telephone Number and Date
/ —05 --0-

AD3ACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A FIER/MOOJUNG PILINGSBOATLMTBOATHOIISE)
I hereby certify that I own property adjacent to _K"
(Name of pr perty owner)
property located at 0 a lit
_�_,._____��--
(Lot, block, road, etc.)
on1„11 _ , in New Bern/ Craven , N.C.
(Water body) (Town and/or county)
He bas described to me, as shown below, the development he is proposing at that
location, and, I have no objections to his proposal. I understand that a pier/mooring
piiings/boatlift/boathouse must be set back a minimum distance of fifteen feet (15') from
my area of riparian access unless waived by me.
I do not wish to waive the setback requiremen t-
r% I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMEN' - 6;f
(to befilled filled in by individual proposing development) mow 12'. ' /,
o
Foley & Foley COntraciors, ruc.
Phone#: [phone]
Fax#: [phone]
Signs
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Print or Type ame
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Telephone NuDate

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