40783_COLEY, WILLIAM_20050119

' J CAMA / El DREDGE & FILL
GENERAL PERMIT 1
Previous permit #
FJNew lModification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources 11;W0
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
❑Rules attached.
Applicant Name �' r.-� i Li �� Project Location: County
Address Street Address/ State Road/ Lot #(s)
City ��/�"fit State ZIP
Phone # ( Aif ) `r'�7' /,' '� Fax # ( ) Subdivision
Authorized Agent City � �' f'� f;t r� c. �� ZIP
Affected
Q CW Ej EW Ci PTA ❑ ES ❑ PTS Phone # (- ) :Z /,�' River Basin h
AEC s : ElOEA ❑ HHF [IIH ❑ UBA El N/A 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
J �
Platform(s) / f,l/,Jt�` ^s
Finger pier(s) ^ rf Z
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
i
Waiver Attached: yes no --- -- -- —-------- --
i
A building permit may be required by:
Notes/ Special Conditions
Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit"
(Scale:
L k
E See note on back regarding River Basin rules.
Permit Officer's Signature
Issuing Date
Expiration Date
L 0ll,20; 2 4
Rover File Name
Application Fee(s) Check # Local Planningjurisdiction

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:
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

15-800
G UNITEDSTAV S I'O�'I'�u, -NIONi�:Y OR ER 000
I" POST'L SE, ICE,,
SERIAL NUMBER YEAR, MONTH, DAY POST OFFICE U.S. DOLLARS AND CENTS
07359029280 �:oo5-oi -1 4 285700 N-Jl M'4p22 .�
PAY TO
ADDRESS
USED FOR Oft/; _ {^ 7 _3
ONE HUNDRED DOLLARS & 00$
AAouNr NEGOTIABLE ONLY IN THE U.S. AND POSSESSIONS
SEE REVERSE WARNING
CLERK
FROM /I r 9 A n(1 7:
A DD{/ES
1:00000800 21: 073S9029280,119,

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RIP SIVE u
JAN i 4 2005
Morehead Clry DCM
•

P1 RIVED
JAN 14 2005
Morehead City DCM
ADJACB. r RIPARIAN pit®PIE.R'TY OWNER STATEMENT
(FOR A PIER/MOORING P1L1N0S/H0T?V11 7 SIFt o �"
I hereby certify that I uwn property 40301cc y Owner)
(Nstttc Of roe
rty
ZA
properly located at •,----�--�"_
(Lot, Block, Road, etc.)
r , N.C.
on in ('Paws anor Co��nty)
( aterbo ) the development he is pro
} is has de abed to me. as shown below- that at �erlmoot nB
hat
and,
t have no Objections to nic proposal. 1 understand that a pi_
arcA
pilingslb0at1Jt1bQat1ouse must he set back a minimum distance of fifteen feet (IS') from my
of riparian access Unless waived by me.
�da_Ud wish to waive the selbaCk requirement.
X/-
10 wish to waive that seNlck regL'ire+nent.
.....-- ---- . -
DFS-CRIPTION AND/OR hR4te I dual pr�(kNG OF ROPOosing �EDoD►nc'n) OPMEti
(To be fills
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ne
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Print or Type Name
T ie ephone Nu+� S
Date: 3 �=S
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ADJACENT RIPARIAN PROPERTY OWNER t;1ATHO STATEMENT
(FORA PIER/,�fOOdRlNG PILINGSlBO /`/ l � _S 1 `-r4 7, - / 610'
���A�� _ s
I hereby certify that i own property adjacent to }"�'�•
(Name of Property Owner)
property located ate
(Lot, Block, Road, etc.)
I.C.
on , in -
aterbo y) down and/or County)
that lmatiOnw
He has described to nee, as shown below, the development
unde stand that a proposing
t pier/moo ng
and, I have no objections to his proposal.
pilings/boatlift/boathouse must be set back a minimum distance of fifteen feet (IS') from my area
of riparian access unless waived by me.
I do riot wish to waive the setback requirement.
I do wish to waive that setback requirement.
--- -- --•- -------------------------------------------------------------------
- - DESCRIPTION AND/OR hRindividual GF p OPoh ED "mc,ELOPt�,ENT:
{To be filled r )ISIVED
e- a/Irew-D°(�
a fz Pj,^ C &s
F9
h J-d a /i/e fi JAN 14 2005
r- 'e V,1V r,4 0">
Morehead City DCM
a---------------- -----
�ignatur�
Print or T Narne
e
7-2
Telephone Number
Date: �_ -