48030_JACKSON, JEREMY_20070523

❑LAMA / ❑ DREDGE & FILL Z/ 481130
r. GENERAL PERMIT Previous permit#
❑New ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
i
As authorized by the State of North Carolina, Department of Environment and Natural R ources J r/
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC ! /1 "�
ElRules attached.
Applicant Name ✓ ` i Project Location: County
Address (: j '! 'fq Street Address/ State Road/ Lot #(s)
City 4 ^i State "' ZIP
.� ? .
Phone # ( ) �'.� �' �' i Fax # O Subdivision
Authorized Agent t_.'/ Z 'n ir e-'Ie t' City f._.•' `� ZIP '
Affected ❑ CW Z'EW p ETA ❑ ES ❑ PTS Phone # ( ) River Basin
AEC(s): ❑ OEA ❑ HHF ❑ IH ElUBA El N/A Adj. Wtr. Body (' ( (nat /man /unkn)
1-1 PWS: El FC:
ORW: yes / no PNA yes / no Crit.Hab. yes / no 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 _
7
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
I
Other
1
Shoreline Length
SAV: not sure yes no
Sandbags: not sure yes no;
Moratorium: n/a yes Ino
Photos: yes no
Waiver Attached: yes no
A building permit may be required by:
❑ See note on back regarding River Basin rules.
Notes/ Special Conditions
f _ J
F rt ( G u h v r
i
Agentor Applicant Printed Name
Signature ** Please read compliance statement on back of permit e
Application Fee(s) Check #
Perris er s Signature
Issuing Date fT e%/— Expi—Date
r. '. •f .
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 [)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 (910-796-7215) for more information on how to comply with these buffer rules.
Division of Coastal Management Offices
Raleigh Office
Mailing Address:
1638 Mail Service Center
Raleigh, NC 27699-1638
Location:
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
Fax:[phone]
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ 1-888-411COAST
Fax: [phone]
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico Counties)
Elizabeth City District
1367 U.S. 17 South
Elizabeth City, NC 27909
252-264-3901
Fax: [phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
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
910-796-7215
Fax:[phone]
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)
Revised 08/09/06

'gyp r. 17. 2007 8: 24AM JACKSON COMPANIES No. 0860 P. 1
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PMWOORING PILINGS-/-BOOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to �r�_r+►T.r_rtSv, 's
(Name U Property Owner)
properly located at �_ �4 SI os &zAa fit'
(Lot, Block, Road, etc.)
on Core Gree-k- in 6kC 'JV '/ ��ere� , N.C.
('Waterbody) (Towh 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. (If you wish to waive the setback, you must initial the appropriate blank
below.)
I do not wish to waive . 'J
I do wish to waive that setback requirement. ED
_--_— __—-------------------------------T 2 3 ZQ07
DESCRUMON AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled ut by w&vWkal proposing developmm1) Moret sad City DCM
c c
I IV
X
a o
Si e
Print or TypiaName
Telephone Number
i
Date-4 7 -
-

ISLAND MARINE CONSTRUCTION, LLC N*
CUSTOM DOCKS & DECKS
` SEAWALLS, BOATLIFTS, ROCK GROINS,
WOOD, VINYL & COMPOSITES
FREE ESTIMATES
THOMAS LAWRENCE
1286 ISLAND ROAD
HARKERS ISLAND N.C.28531
OFFICE [2521728-3419
CELL {252} 725-OJ32
CELL {252}241-1394

A r.17, 2007 8:24AM JACKSON COMPANIES ND,0860 P. 2
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILING& BOATLIFTIBOATHOUSE)
I hereby certify that I own property adjacent to Se M-MS, c ksa_ti 's
(Name of Property Owner)
property located at _ 634 Sp,. Ga4 e Dr. .
(Lot, Block, Road, etc.)
on C- re L nc_e.L , in 16 R.-4eM- , N.C.
(Waterbody) (Town and/or County)
He has described to me, as shown below, the development he is proposing at that location, aTA I
have no objections to his proposal. I understand that a pier/mooring pilings I boad& / boa 9,0
must be set back a minimum distance of fifteen feet (15) from my area of riparian access unles"
waived by me. (If you wish to waive the setback, you most initial the appropriate blank
below.)
��I do not wish to waive
I do wish to waive that setback requirement. 10,
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filed is by ixi ividual proposing development)
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gap.
0v cuis��Ng
144
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Fx,,54 'rz)
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NumberPrint or Type Name
Telephorie
D. i (1

AQr.17, 2007 8:25AM JACKSON COMPANIES
CAMA —signature Authorization
634 Sea Gate Dr.
Newport, NC 29578
ND, 0860 P. 3
1, Jeremy C Jackson, hereby authorize Thomas Lawrence of Island Marine to sign and complete permit
applications for the purpose of marine construction located at 634 Sea Gate Dr, Newport, NC.
Jerem C Jackson
252-447-7122

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