49843_KILBY, ANDREW_20070822

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❑CAMA / ❑ DREDGE & FILL
GENERAL PERMIT
6
Previous permit #
❑New ❑Modification ❑Complete Reissue
El Partial Reissue
Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources
�'� �'L V
and the Coastal Resources Commission in an area of environmental
concern pursuant to 15A NCAC
❑ Rules attached.
Applicant Name -'` " 'k ; ; y:
Project Location:
County
Address :,;;rc `CC:Street
Address/ State Road/ Lot #(s)
City, `, 4 f..- ; , State ZIP
Phone # (�) Fax # (�)
Subdivision
Authorized Bent
City
ZIP
❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS
Phone # O
River Basin ;: r
Affected
❑ OEA ❑ HHF ❑ IH [IUBA [I N/A
AEC(s):
Adj. Wtr. Body
F� _
rwd Inanat jman /unkn)
❑ PWS: ❑ FC:
-
ORW: yes / no PNA yes / no Crit.Hab.
yes / no Closest Maj. Wtr.
Body i
Type of Project/ Activity
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/ Boat iftZ
Beach Bulldozing
Other
e
Shoreline Length
l
'
SAV: 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
t
(Scale:
1
}, tY
i .i. f
I
Signature Please read compliance statement on back of permit
xw• a
Application Fee(s) Check #
w
'ice 4� GA.
❑ See note on back regarding River Basin rules.
PermitOfficer's Signature
Issuing Date Expiration Date
a3Z z I> A
Local Planning,lurisdiction Rover File Name

�i
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, certifythat 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
Morehead City Headquarters
Mailing Address:
400 Commerce Ave
1638 Mail Service Center
Morehead City, NC 28557
Raleigh, NC 27699-1638
252-808-2808/ 1-888ARCOAST
Location:
Fax: [phone]
2728 Capital Blvd.
(Serves: Carteret, Craven, Onslow -above
Raleigh, NC 27604
New River Inlet- and Pamlico Counties)
919-733-2293
Fax:[phone]
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

2;. 2007" 2:13P0 - `REN, i,. Trca ;Tl +l 7 761 o. 23-13 P. 12
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Division of CouW Mann~
W11391 F. Easley, Governor LEI #s S. Jones, L1,1 wor Mllam G. Rasa Jr., Seomtaq
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aau, jor tot jpw7m of applying for and obtaining itH C,AMA Fog --wits neccanary w
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06-E5-2007 00:47 DENNIS SONS CONSTRUCTION 2527287613 PHGE1

ya g_ 613
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSBOATLIFTIBOATHOUSE)
I hereby certify that I own property adjacent to is
(Name of Property O ner)
property located at �-PC' � CCAv -1 i - � �
(Lot, Block, Road, etc.)
on Q l). , inCQJ &U\�g N.C.
(Waterbody) (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. (If you wish to waive the setback, you must initial the appropriate blank
below.)
I do not wish to waive
I do wish to waive that setback requirement.
-----------------------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
cagy all
Signature
Print or Type Name
oZS -72 4�r- 6 � ��V
Telephone umber
Date: 0

Jul, 10 2007 4:25PM RENFRO No, 2442GE2 P. 3
06-28-2007 19:49 DEIINZJ SO'IS C(3`4T7iCIJC7ION 2527287613
ADJACENT xlP�pnp*�r ��oAr�oE STATEMENT
(FOR A Pl1'.R/M
I hereby certify that I own property adjacent to
sane ai Property Utvue )
property located at
(Lot. Black. Aord, ete.)
lrl
N<C.
on �aterug (Town and/or County)
I le has described to me. as shown below, the development he is proposing at tttai locatlon, and.1
have no objections to his proposal. i understand that a pier/mooring pilings / boatlitt I boathouse
must be set back a minimum distance of fifteca foot (15') From my area of riparian access unless
waived by me. (It' you wlsb to waive the setbadk, you must initial the appropriate blank.
below
1 d2jo Wish to waive
l wish to waive that setback requirement-
DESCRIMON.AI D,OR DRAWING Off' PROPOSED DzVE OPWNT,
(To ba jilted is by and hQaal proposing
11M &C,-� i
�r'�NQAI q �A
5itgature
Print oar -'ype Nwnc
3yt.,- 7 Y 7 r
Telephone Number
07-10-2007 02:58 DENNIS SONS CONSTRUCTION 2527287613 PAGES

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