40734_BATEMORE, BILL_20041215

CQMA / Cl DREDGE &FILL
GENERAL PERMIT "`'1�
Previous permit #
l New ❑Modification L'-�Complete Reissue ❑Partial 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
❑ Rules attached.
Applicant Name""('' r"`�''� Project Location: County----_____---___ —
Address_ +1, a'' Street Address/ State Road/ Lot #(s)_
City . ,�_-!�. —s State ZIP --- —� —
Phone # O ' " '" Fax # ( ) Subdivision
Authorized Agent ' Ag City--_-- --- ZIP
Affected CW aEW EYPTA ES PTS Phone # (_ ) _ _ River Basin _
❑ OEA ❑ HHF ❑ IH UBA N/A
AEC(s): Adj. Wtr. Body_ — — (nat /man /unkn
PWS: O FC:
ORW: yes / no PNA yes / no) Crit. Hab. yes / no Closest Maj. Wtr. Body_--- — —_
I Type of Project/ Activity
Pier (dock) length
Platforms �.
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
Shoreline Length
SAM not sure yes no
Sandbags: not sure yes no
Moratorium: n/a yes no
Photos: yes no
Waiver Attached: es' no . - — --
A building permit may be required by: !
Notes/ Special Conditions
�b i t V.fr�r
Agent or Applicant Printed Name
Signature * Please read compliance statement on back of permit
Application Fee(s) Check#
(Scale:
i
See note on back regarding River Basin rules.
Permit Officer's Signature
Issuing Date
Local PlanningJurisdiction
Expiration Date
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
Neuse River Basin Buffer Rules
L ] Other:
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:
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293 / I-888-4RCOAST
Fax: [phone]
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

VARNER BROS. CONSTRUCTION, INC. SOUNDBANK 13921
GENERAL CONTRACTOR MOREHEAD CITY, NC 28557
P O BOX 1652 66-1246/531
MOREHEAD CITY, NC 28557
[phone]
PAY TO THE
ORDER OF s
DOLLARS
MEMO ZC'hlpr_qJ G
nm
1160139 2 L1ll 1:053 L 1 24ED: 000 1 2 1881i'

Nov 17 04 06:01p Lee Broughtor, 252-837-2050 p.1
I1/15/2004 16:04 252-726-4804 VARNER BROS CONSV PAGE 02
ADJACENT 1 WAR AN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING MUNGSIBOATilf'1'%BGATHOUSE)
I hereby certify that I own property adjacent to 4-6&gs. STD` g e�16,117pAJ
(Name of Property {Owner)
property lrx:ated at � �G' ?E—LA 4A6# Ali ti,a�� l�tAC
(Lot, Bloch, Road, etc.)
on ',��kmov �rin ►hl�T /' "� , N.C.
(Waterbody) (Town and/or County)
Tie 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 pierlmooring
pilings/"boatlifY/boarhouse must be set hack a minimum distance of fifteen feet (15') from my area
of riparian access unless waived by me.
I do-nM wish to waive the setback requirement.
_ I dg wish to waive that setback requirement.
IDESC,RIMON AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be flUed in by individual pmposing development)
kikk
el I-e
l � ` M- p'cr-
Signature
-s- t--e, 4 Fo,
Print or Type Name
Telephone Number
Date:

11/29/2004 12:29 '522474309 GRADY FULCHER MGT PAGE 02
11/15/2004 16:10 252-72E-4804 VARNER BFW (NST PAGE 02
FOR A PIFRaii'OORING PHINGSIMA77IF'dIBOATfll7(% R)
I hereby certify that i own property amijac4xtt to
( alive tit Property Owner)
(i.a " ftvk, Road, eu,)
on _� t*at" _ _.> in .._ _ '► _ __ ..v.D I.C.
(Waterbody) 1"Tawta andtot County)
He has de=ibod to me, as shown tx*jw, the development he is proposing at that location,
and, A have no olajectians to his ptvpoW. 1 undwsta ..d tdiut a pier/moorit►g
pifingsAmadif athouse +heist be set back a minbnum distance of +tom feet (151) d°tvm my am
Of APariann acceass unless waived by me.
Agwi Ai to sue the wthack re quiremev.
.� .� .�.. I Ada wish to waiwe 0tat setbwk requirement.
-------
DESCRIMOfq AINDIOIt DRAWING OF PROPOSED DEVELOPME.�'�T'g':
CFA he,%xtkd fps by MYividual pmv.rr'ag developmeW)
p
E
Signature
.Print or Type Name
Telephone N-Umiser