48437_KIRBY, JOHN_20070427

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❑CAMA / ❑ DREDGE & FILL x5
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GENERAL PERMIT Previous permit #
❑New ❑Modification El 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
Rules attached.
Applicant Name
Address
City
Phone # ( )
Authorized Agent
_ State ZIP
Fax # ( )
❑ CW ❑ EW
❑ PTA
Affected
AEC(s): ❑ OEA ❑ HHF
❑ IH
❑ PWS:
❑ FC:
ORW: �/ no PNA
yes / n�
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/ Boatlift
Beach Bulldozing
Other
Shoreline Length
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
❑ ES ❑ PTS
❑ UBA ❑ N/A
Crit.Hab. yes / no
Signature ** Please read compliance statement on back of permit
Application Fee(s) Check #
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision
City ZIP
Phone # ( ) River Basin
Adj. Wtr. Body '(nat /man lunkn)
Closest Maj. Wtr. Body
(Scale: )
❑ See note on back regarding River Basin rules.
PermitOfficer's Signature
Issuing Date Expiration Date
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:
❑ 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 complywith 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/ 1-888-4RCOAST
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

Mar 27 07 10:15a Ann O'Malley 7328867798
2007-03-27 10:15 Staebler Homes 2bZ-.354-1/ i,1» iOt00011yo
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North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Michael F. Easley, Gavemor Charles S. Jones, Director Wiliam G. Ross Jr., Secretary
Date )- � _G1}1
t
APR z b �007
Applicant Name rf )) �l.�'.y
I C . ad city DCM
Mailing Address Lc�- I-) C Ci' S '-j _
5ck , ks o'l U ',5 - 17
I certify that I have authorized (agent) J� C to act on mY
behalf, for the purpose of applying for and obtaining aD C ermits nemsary to
install or construct (activity) a C-
at (location)
45
This certification Is valid thru (date)
Signature
Opp Commerce Avenue, Morehead City, North Car+na 2M57
Phone: [phone] FAX: [phone]M0 Internet www.nacoastaimanagernent.net
2007-03-27 10:18 7 32086 7 7 98 F'a �a 1

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to 'r `#' e° 's
(Nam of Property Owne
property located at I /U vl (-- I J I
Lot, Block, Road, etc.)
on .S out/ , in r 4 e►�i� Co . , 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�'
APR ,a `� 2 cr%
DESCRIPTION M4D/OR DRAWING OF PROPOSED filled in y Dg�gP, �
To be ib individual proposing development) W 611Y DCM
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Print or Type Name
Z5 Z 'o'2 -7o3`i
Telephone Number
Date: 4 - o 7
-29—

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to �� �b -t e` is
(Nanie of Property Ow er)
property located at 10 Jv \ -e c4 a ot 5 L- i
(Lot, Block, Road, etc.)
on aG u e So , in TG►" 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. 10f
�/ r7 er �f / d••��� �G�� try
DESCRIPTION AN-D/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development)
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SignAure
Print or Type Name
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Telephone Number
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