40798_DILLER, BILL AND SHANNON_20050201

•i -- CAMA / I J DREDGE & FILL YVl
GENERAL PERMIT
i. New !Modification-JComplete Reissue -1Partial 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
J
Applicant Name /'� %�� u G t J�� �/� i Project Location: County_____-_
Address - ____ __ "' (!' i� Street Address/ State Road/ Lot #(s)
City r �< � 4-, f" State ZIP
IV
-I-lWevious permit #
Date previous permit issued_
1-1 Rules
Phone # ( ) ` ' / 7 Fax # (} Subdivision -
Authorized Agent �� 1 ' fit: G'� City _ ZIP_
�� ._ ? ;.CW ❑ EW ❑PTA ❑ ES ❑ PTS Phone # (_ ) _ '16
. River Basin
Affected ' 0 OEA ❑ HHF ❑ IH ❑ USA ❑ N/A
AEC(s): Adj. Wtr. Body______
❑ PWS: ❑ FC:
ORW: yes / no PNA yes / no Crit. Hab. yes / no
Closest Maj. Wtr. Body
Type of Project/ Activity
Pier (dock) length
Platform(s)_ x: l� i is.1 /ln
Finger pier(s)
Groin length 1 ;?
number
Bulkhead/ Riprap length-
avg distance offshore___ _
max distance offshore
Basin, channel
cubic yards_ _
Boat ramp
BoathouseABoatlift i
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: yes no
A building permit may be required by:
Notes/ Special Conditions
Agent or Applicant Printed Name
at /man lunkk )
(Scale: '� )
.� t•i �P
r;
{ Z
See note on back regarding River Basin rules.
Permit Officer's Signature
Signature ** Please read compliance statement on back of permit
Application Fee(s)
Check #
Issuing Date
Local Planning Jurisdiction
Expiration Date
14
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 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 / 1-888-4RCOAST
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.nccoastaimanagement.net
Revised 10/05/01

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JAN-22-2005 03:56 AM
P. 02
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERI.'IIOORING PILINGSBOATLIFTIBOATHOGSE)
I hereby certify that I own property adjacent to .�; S dr h pry �� 11p {- ,s
property �� fineos•Property Owner)
located at � � r I �
(Lot, Block, Road, etc.) U)
on e Gt) %��"� or'�� ' 1" , in �3(f f s� ^'i~ ,NC.
(Wat rbody) (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 o ' avian access unless waived by me.
I do not wish to waive the setback requirement.
I do wish to waive that setback requirement.
---- -------------------------------
DESCRIPTION AIND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
4c, ( �c I
it S- C is
All
-_-___---------------------- - __�______
Signature
Print or Type `flame
Ter- "ILj7 7
/ Telephone Number
Date. / , cx� J

01,,25%2005 08:44 FAX [phone]
IRS GOV ENT
9 001
L.E_ Kaweeki
Tax Law Speciali-at
1D No. 50.03853
1jx0 Tax Exeioath Planning
going,
1 i`J� Dutrcach Planning Rc Rwiew
kwnw RW*WW 5ervke I i 11 Consurution Avenue, N.W.
Ann: TE/GE:TE$:0, 5th Floor
��ashington. U.C. 20224
Office: M-2N3-9792 FAX: [phone]
£niaih Lynrj,E.Kawecki@ivs,gov
To:
Fy�� rq•ra.rtrt—.�
Fax zs2 • 7 A k -19 pwies: �
Phase Date:
Re- CC:
❑ Urgent Q For Review U Mase Consent ❑ Please Reply 0 Please Recycle
This a rimwiic ition is intended for the sole uae of the indMdL" to whom it is addressed and may contain
information that is privitgged, confidential and exempt from dseJosrxp under appbcatyte law. if the rreaJer of this
communication is not the inWmed redpient W the employee or agent for delivering the oornmuracation to the
intanded recipent, you are hereby notified that any &swwation, distribution, or cupytng of this co,•ntrxnication
may be stri=r prohibited. if you have received this oorrmunication in error, please softly the sender inxnedetety by
tLiephone, aria return the communicaWri to the above addrszs via the US Postal Service
• Comments-

NOE CONSTRUCTION & SERVICES
972 HIGHWAY 101
BEAUFORT, NC 28516
[phone]
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' 1 2 1
WACHOVIA BANK
BEAUFORT, NC 28516
6&21/530
111100 1? S Col 1:0S 3000 2 191: 2054600044?S31im
17561,
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