41705_DOCKSIDE MARINA_20050511

JCAM, A/ `DREDGE & FILL 16� � Al
GENERAL PERMIT Previous permit#
nNew ❑Modification ❑Complete Reissue C'Partial 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
❑ Rules attached.
Applicant Name Project Location: County
Address
City 1'
Phone # ( )
Authorized Agent _
Affected ❑ CW
AEC(s): LJ OEA
❑ PWS:_
ORW: yes / no
( State .",J ZIP
Fax # ( )
❑fW ❑ PTA ❑ ES ❑ PTS
❑ HHF ❑ IH -1 UBA C N/A
❑ FC:
PNA yes / no Crit. Hab. yes / no
Type of Project/ Activity
Pier (dock) length
Platform(s)
Finger pier(s)
Groin length
Bul ead/ Ripraplength
avg distance offshore
max distance offshore_ _
Basin, channel
cubic yards
\Boat ramp
ZBoathouse/ Boatlift /
Beach
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
Signature Please read compliance statement on back of permit
Street Address/ State Road/ Lot #(s)
Subdivision
City- i ►.� r , , -- ZIP r. }
Phone # O River Basin
Adj. Wtr. Body -atl/man /unkn)
Closest Maj. Wtr. Body _ ` / c `"
i
(Scale: iv '? / )
See note on back regarding River Basin rules.
Permit Officer's Signature
Issuing Date Expiration Date
Application Fee(s)
Check# Local PlanningJurisdiction
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:
n Tar- Pamlico River Basin Buffer Rules L] Other:
j 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 11
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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03-may-2005 01:08pm From -TOWN OF FOREHEAD
T-672 P.002/003 F-846
4.1211,311 u. - L 1 : r
DIVISION OF COASTAL N.' kNAGVvM.NT
ADJACENT RIPARIAN PROPERTY OMER . iOTMCATION/WA YER FORM
Name of Individual applying for Permit_ ��� %fie✓ 'alb ��,
Address of Property-
(Lot or Street R, Sim : or Road, City & County)
I hereby testy that I own prcpery adjacent to the ab ve refe.-enced prope:ry. The individuLl
applyinz for this permit has described to me as shown c i the attached drawing the deve:opmerc
ley are proposing. A description or drawing, with d tensions, should be provided vita this
Ie:per.
vl�l have no objections to this proaoq-c.'!.
If you have objections to what is being proposzd, Tease ware the Division of Coastal
Management, Hestron Pl= II, 151-8, Hwy. 24, More-7 ad Ciry, NC, 28557 or cal! (251) 808-
1808 whin 10 days of recent of this notice. NO responss is considered the same as rco obrc_rion
if you have been notijzed by Cerrijied Mail.
WArVER SECTIC r
I understand that a pier, dock, mooring pilings, brralrxa_e boar house. li* or sandbags rr,,4 ' be
se: back a minimum distance of 15' from my area of rra,-a ;access unless waived by me. (I= you
wish to waive the setback, you must inirial tha aopropriz:; blank be!ow,}
I do wish to waive the IS- setback require
I do not wish to waive the 15' setbac;t rc; :ire.'nam,
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05/03/2005 09:17 2522474451 BAKER CDNSTRUCTIDN PAGE 02
r;,3 1.)5 0 8 : 0 0 a TD Eure 252-728-4192 �
DIVISION OF COASTAL NUNAGE,IEST
4DJACE�T RIPARIAN PROPERTY OWNER VOTMCATION/WAIVE; 'r`O R"V(
Name of Individual applying for Permit D�4z%'?
address of Pro t A32L perty:
(Lot or Sam, a, Sur' or Road, City dt County)
1 he.eby c_-airy that I own prope.,7 adjace.-it to the above propF.-,J. T=;:,
ap-plying for this permit has described to me as shown on the a?-Mci l drwin tli�
7.ey are proposing. A descripdon or drawing, whit anensions, Should be pro»iu:::
h',7L .
(X� I have no objections to this proposa_
If you have objections to what is being proposed, please wr.1e the Dfvr,nfj ri;,"
hfana;pmenr, Hesbvn Plasma 17, 157-8, .Nwy. 24, M017Read Cuv NC, 28.157
2.508 whin ,10 days of rL-ceipt of this no*e. IVO response is contide7d the seine as :.c r ,,
if you have been aotifLed by Certified Mail.
WAI TR 5EC IO"
1-.ider;taod that a pie:, dock, mooring piiings, brea -va:er, boat house. lift or
see back a minimum distance of 15' ;Eom my area of ;;ta,:a- access unies; waived
.�h to waive the setback, you must initial the approp;;ate biank be!ow,)
I do wish to waive the 15' se}.back require -eat,
QD 1110 not wish to waive the 15' setback re=,irement.
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Pant Nane
Te'.eahone Number With Area Code
--�0,J
MAY 0 5 2005
feb.ead...G fty-1) U-'

T D EURE CONSTRUCTION CO., INC.
PH. [phone]
P O BOX 650
MOREHEAD CITY, NC 28557
PAY TO THE 0 N
ORDER OF
BRANCH BANKING AND TRUST COMPANY 39451
MORC_Hf AI) C11 Y. r40111 I'CAROLINA
u, 117!531
f 117:SIII
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DOLLARS
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