41711_EASON, RONNIE_20050516

CICAMA / D DREDGE & FILL
GENERAL PERMIT % Previous permit#
CIR;eW -]Modification —]Complete Reissue ❑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
C Rules attached.
Applicant Name
Address
City
State ZIP
Phone # ( ) Fax # ( )
Authorized Agent
CW
❑ EW ❑ PTA
Affected
-1
❑ OEA
❑ HHF ❑ IH
AEC(s):
11 PWS:
❑FC:
ORW:
yes / no
PNA yes / no
❑ ES ❑ PTS
UBA ❑ N/A
Crit. Hab. yes / no
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision
City C c ?� (/, a _ ZIP
Phone # ( ) River Basin
Adj. Wtr. Body__ (nat /man /unkn)
Closest Maj. Wtr. Body
Type of Project/ Activity
(Scale:
Pier (dock) length
Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore_ _
max distance offshore
Basin, channel
cubic yards
Boat ramp -
Boathouse/ Boatlift -
Beach Bulldozing
Other
1
Shoreline Length
SAM not sure yes no -!
Sandbags: not sure yes no 1
Moratorium: n/a yes no
°
Photos: yes no !i
Waiver Attached: yes no
A building permit may be required by:
Notes/ Special Conditions
i"
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.
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:
El 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
151-13 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

PARKER SURVGYTNS 724 S4S 2749 0E/ii /oS oe-ispm P. zoi
• U5/1.U;05 TUL YU;1t1 t:AA 25:3938689 Goose Creek Landing HUA �L-+.UL1
ADJACENT RIPARLAN PROPERTY OWNER STATEMXNT
(FOR A MERAV100RING PILI,'VC I'BOATLIFTi$O.4THOUSr)
I hereby certify that I own propeiiy adj t to _f�Or.rs er, C L.
('Nance of Property Owner') (�
P'opery located 3t a'' _e
'Lot, Biock, R—odd,, "etc..)
on � ��L ��t"r+ , in __CA�,�
(Waterbody) (Town and/car Cou try .
. 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
pilingstbradift1buathouse must be set back a minimum. distance of fifteen feet (15') from my a-*4x
of riparian access unless waived by me.
I do not wish to waive the setback requirement.
14-0 wish to waive that setback requirement,
-------------------------------------------------------- ----------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
fTo be filled in by individual proposing development)
Signature L/�
Psint or Type Name
Ielephort Nlmbe:
W-
Date: � S-

01'10/05 TUE ZO;21 FAX [phone] Goose Creek LandLag HOA
A]DJ CEIN7 RIPARLAN PROPERTY OWNER STAIT-N'
0FOR A FjER1M00R14VG PILL GSIBOA77.1-FTI O MOUSF)
10 002
I hereby cPrdfy that S own pioptrty ad;aa"... "t trj
kNLarne of Property Owner)
property located at
ICA
(Waterbody) (Town andlar County
AN
Behas described tome, as 4hown below, the development bg i.s proposirg at that loeat:on,
and; i have no. objections . to his pro=posat. I unders=d that a pi.erlmDoring.
pilings/boat)iftfboathouse must be setback a mininum4, distanCe of fifte-tzrl `:et (I51) from my 9aea
of riparian access unless waivcd by mc.
I wish to waive the setback requirement.
I _Q wish to waive t ;at setback-equirernenr.
DESCRIPTION AN-D/OR DRAWING OF PROPOSED DEVELO?iMENT:
(7"o be filled in by fadiwau-aZ proposing development)
S ignaturc
Print or Type Name
Te1ehone number
Date:
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NOT TO SCALE
LEGEND
E.I.P. EXISTING IRON PIPE
S.I.S. SET IRON STAKE
R/W RIGHT OF WAY
M.B.S.L. MINIMUM BUILDING SE73ACK LINE
M, B. MAP BOOK
PG. PAGE
yi S.F. SQUARE FEET
N: CENTERLINE
d E.C.P. EXISTING CONCRETE A!ONUl,,lENT
E.I.S. EXISTING IRON STAKE
b�q E.M.N. EXISTING MAG NAIL
S.M.N. SET MAG NAIL
% NOTES
b 1.) AREA a 00, ocx:> • o s, f.
R Ib 2.) CLOSURE - 1:10,000+
J.) REFERENCE : M. B. Z 9 PG. 7.0 0
i 4.) P.I.N. -& 63A-J, LB-'9/7Z
y 5.) FLOOD ZONE AIR,"
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C 6.) FINAL MAP RECORDED .Jury Z5, Z000
7) THIS PROPERTY IS SUBJECT TO ALL
EASEMENTS, AGREEMENTS, AND RIGHTS
OF WAY OF RECORD PRIOR TO THE DATE
OF THIS PLAT.
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Order
-
Personalr Money
137
66-30/531 Branch No. —
HRST CITIZENS
4806119
BANK
First -Citizens Bank & Trust Company
Date
May 16 2 0 5
Raleigh, North Carolina
Pay to the NC DRNR
$ 100.00
�
order of
NOT GOOD OVER $1,000.00 INVALID AFTER 180 DAYS
BRCFI.# l' , r.:" �i
01717R!1,
Dollars
Ronnie Eason !-
Remitter
001-,806119110 1:053 1003001:9a0799499011,