40920_DAWSON, RODNEY_20050315

Lam'"LAMA
DREDGE & FILL
GENERAL PERMIT
Previous permit #
EINew ❑Modification El Complete Reissue
LIPartial 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
1 Rules attached.
Applicant Namey%�`'� ' % j /� "
Project Location: County -
Address�lc f /
Street Address/ State Road/ Lot #(s) G�
City State '/(' ZIP_.:
Phone # O - 1(. Fax # ( )
Subdivision
Authorized Agent
City_ '•, r % - c.I J _ ZIP
Affected L=6CW ❑-@W .fl'PTA LES ElPTS
Phone # ( ) River Basin !'
AEC(s): � OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
Adj. Wtr. Body / ` t ' nat man unkn
ElPWS: ElFC:
'j
ORW: yes / no , PNA yes / no Crit. Hab.
yes / no Closest Maj. Wtr. Body
Type of Project/ Activity
Pier (dock) length
Platform(s)- y
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore _
max distance offshore
Basin, channel
cubic yards
Boat ramp /
Boathouse/ Boatlift__
i
Beach Bulldozing
Other_—
Shoreline Length
SAY: not sure
yes no
Sandbags: not sure
yes no
Moratorium: n/a
yes no
Photos:
W ; A h d
yes no
0
G
(Scale: )
giver ttac a yes no --- — — -----
r/ r%
A building permit may be required by: c [ See note on back regarding River Basin rules.
Notes/ Special Conditions
Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit **
Application Fee(s) Check #
Issuing Date ion a e
Local Planning Jurisdiction Rover File Na

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: Fax: [phone]
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293 / 1-888-4RCOAST
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

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSIBOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to k v { =� I�✓ f a +J is
(Name of Property Owner)
property located at �� 2-o t l 4 �` 2 � 2� !y f ja/ a io k � 4140
(Lot, Block, Road, etc.)
on
(Waterbody)`
in , ., ; Q ✓v j /0 tv Gwti 9y , N.C.
(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/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 do wish to waive that setback requirement.
------------------------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
r^Y
------------------------------------------------------------------- ---------------------------------------------
/r���3z 11 llzl�1'2 �'k n
1 t- Roll A g7— Signature
CCi j4 / N J v� ►U y I; 7 91 J� i n1
Print or Type Name
Telephone Number
Date: Aa:�, ! Z ,�CZ'�

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSIBOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to 's
(Name of roperty Owner)
property located at
on ,' n
(Waterbody)
�za
(Lot, Block, Road, etc.)
in �1=-� , N.C.
(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/boatlift/boathouse must be set back a minimum distance of fifteen feet (15') from my area
of riparian access unless waived by me.
70-e,-,J I do not wish to waive the setback requirement.
I d4 wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
Signature
57c
Print or Type Name
/A� ; C' 6 - % ffF
Telephone Number
Date: � —I - v /

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RODNEY DAWSON
LINDA DAWSON 66;j 9
103 SHADY OAK CT. PH. 252-635-1051 39201606
201606
NEW BERN, NC 28562
PAY TO THE
u ORDER OF INCl/
- OLLAR. M„
ECB� PROSPERITY
BANKING
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1
MEMO
i:0531067991: 39 20 16060 2059