41109_CHAPMAN, JANET_20050322

❑CAMA,/ I_ I DREDGE & FILL
GENERAL PERMIT ZPrevious permit#
i New CModification ElComplete Reissue EPartial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources j
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC F
F1 Rules attached.
Applicant Name
Address
C c_,
C
1 l
City /
State
Phone # ( )
r
Fax # ( )
Authorized Agent
)�CW
E9,M
aPTA CI ES
_I PTS
Affected
AEC(s): ❑ OEA
❑ HHF
❑ IH ❑ UBA
❑ N/A
❑ PWS:
❑ FC:
ORW: yes / no
PNA
yes h no Crit. Hab. yes / no
Type of Project/ Activity
Pier (dock) length
Platform(s) _
Finger pier(s)
Groin length
number
Bulkhead/ Ripraplength
avg distance offshore_ _
max distance offshore
Basin, channel
cubic yards
Boat ramp _
Boathouse/ Boatlift ,
Beach Bulldozing
Other
Shoreline Length
W5441 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
Agent or Applicant Printed Name 1
Signature' "Please read compliance statement on back of permit"
Project Location: County
Street Address/ State Road/ Lot #(s) ( r�
Subdivision
i
City ZIP
Phone # ( ) River Basin '' ,—
Adj. Wtr. Body C. hat man .unkn)
Closest Maj. Wtr. Body 1 '
(Scale: )
See note on back regarding River Basin rules.
Permit Officer's Signature
Issuing Date Exp/iratio7n D>a,� i
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, 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 -1i 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 / 1-888ARCOAST
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 zx%,=,4 x x%xrt'►xi n rtcvr JK1 Y V WNILK 61'A1'JUV1VIN'1'
(FOR A MMUMOORING PLUlNGSBOATLIFI'BOAMOUSE)
OCTM
I hereby certify that I own property adjacent to
Name of Property Owner)
property located at l
(Lot, BIodk� Road, etc.)
on PL F Fr- F G2cE�. , in , N.C.
(Waierbody) I (Town and/oir County)
He has described to me, as shown below, the development he is proposing at that
Location, and, I have no ejections to his proposal. I mWerstand that a pier/mooring
pfiings/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 requirement.
I sLo wish to waive that setback requirement
DES CRI MON AND/OR DRAWING OF PROPOSED DEVELOPIMUgT.
(To beTitled in by individual proposing development) .
t c 5 LJVACA rrt . ,
S -lUi2t1 hE I
0
Signatare
Pant or Type Name
Telephone Number
Date:

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1838
INNERBANKS MARINE CONSTRUCTION, INC.
P.O. BOX 190 PH. 252-249-1429
ORIENTAL, NC 28571 O� 66-30/531
472
nI DATE
TO THE N D E /Y is
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ORDER OF .�
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FIRST CITIZENS 472
BANKhire -Citizen. Benk & Tru I Compeny
Orf-W.N.C. 28571
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