41358_CLUGSTON, LARRY_20050427

11 CAMA / !-J DREDGE & FILL
GENERAL PERMIT
❑New -]Modification ❑Complete Reissue []Partial Reissue
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_
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.1° 0 4. F58
1
Previ permit # 1�
Date revious permit issued
7 Rules attached.
Applicant Name Project Location: County
Address J,� `/ `} Street Address/ State Road/ Lot #(s)
City` ' State -
Phone # ( ) '' 6 ° t Fax # ( ). Subdivision
Authorized Agent !" 1-4 � f �i'� T ��% e .! <,; ti City j i ZIP
Affected 1-1 Cw ❑1EW C3-PTA ❑ES ❑ PTS Phone # (_ _) River Basin
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
AEC(s): Adj. Wtr. Body (nat /�an junkn)
❑ PWS: ❑FC:
ORW: yes / no PNA yes /,/ Closest Maj. Wtr. Bod y
Type of Project/ Activity
(Scale.
Pier (dock) length
Platform(s) _ j 1"
r
Finger pier(s)
Groin length
number t- --
Bulkhead/ Riprap length
avg distance offshore 1
max distance offshore
Basin, channel -y
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
Shoreline Length
SAM not sure yes
no
1
Sandbags: not sure yes
rno%
Moratorium: n/a yes
ono
Photos: yes
no
Waiver Attached: yes
no
A building permit maybe required by:
Notes/ Special Conditions
i a y.4 L
Agent or Applicant Printed Name
Signature "Please read compliance statement on back of permit **
Application Fee(s) Check #
— 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, certifythatthis project is consistentwith the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
f Tar- Pamlico River Basin Buffer Rules I_] 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 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 / 1-888ARCOAST
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

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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
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I hereby certify that I own property adjacent to
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located at Ae,QA1 e i P.O. SOX on
(Lot, Block, Road, etc.)
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in ep/,(/,6: Jet4a" N. C.
(Water Body) (Town and/or County)
He has described to me as indicated below the development
he is proposing at that location and I have no objections
to his proposal. I understand that a pier, pilings and
dredging must be set back a minumum distance of fifteen feet
(15') from my area of riparian access unless waived by me.
I do not wish to waive that setback requirement.
V I do wish to waive that setback requirement.
Description and/or drawing of proposed development:
(To be filled in by individual proposing development.)
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
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He has described to me as indicated below the development
he is proposing at that location and I have no objections
to his proposal. I understand that a pier, pilings and
dredging must be set back a minumum distance of fifteen feet
(1S') from my area of riparian access unless waived by o me_
I not wish to waive that setback requirement.
I do wish to waive that setback requirement.
Description and/or drawing of proposed development:
(To be filled in by individual proposing development-)
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MUD BUCKET DREDGING, INC. 4232
ATLANTIC BEACH CAUSEWAY NCDL 8039839
PO BOX 3355 PH(252)726-2191
ATLANTIC BEACH, NC 28512 Date ?ems 66-30/531
133
Pay to the
Order o$
Dollars 8 Z—x�',',�"
HRST CITIZENS —
][3AI� f K First-Cilizons Bank 8 Trust Company
I l� AIIaMic Beach. N.C. 20512
www.firstciti a s.com
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