48921_MOORE, KELLEY_20070509

I-] CAMA 1:1 DREDGE & FILL
r. GENERAL PERMIT
ONew El Modification El Complete Reissue 1-1 Partial Reissue
As authorized by the State of North Carolina, Department of Environment and Natural Reso "s
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC_
Previous permit #
Date previous permit issued
Applicant Name 'r I P J Project Location: County_
Address— Street Address/ State Road/ Lot #(s)
City State;' zip 15-
Phone #(''
Fax # O
Subdivision
Authorized Agent
City 'I, ZIP
El Cw
El EW
EYPTA El ES El PTS
Phone # O River Basin
Affected
AEC(s): El OEA
1-1 HHF
El 1H 1:1 USA El N/A
Adj. Wtr. Body (nat /man /unkn
Ll PWS:
1:1 FC:
Closest Maj. Wtr. Body
ORW: yes / no
PNA
yes / no, Crit.Halb. yes no
Type of Project/ Activity
(Scale:
Pier (dock) length
Platform(s)
Finger pier(s)
7 1
Groin length
number
Bulkhead/ Riprap length_
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp
-
4
Boathouse/ Boatlift
JH:
Beach Bulldozing
Other
+IL7
Shoreline Length
SAV: not sure yes no
Sandbags: not sure yes no
Moratorium: n1a yes no
Photos: yes no
t
Waiver Attached: yes no
A building permit may be required by:
See note on back regarding River Basin rules.
Notes/ Special Conditions
i
II
II
I
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit
Application Fee(s) Check#
Permit Officer's
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 consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
❑ Tar - Pamlico River Basin Buffer Rules
❑ Neuse River Basin Buffer Rules
❑ Other:
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.
Raleigh, NC 27604
919-733-2293
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

(rult A r1r,1VtviVVntlry Afu". illIVVJL:j C i//�V —
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I hereby certify that I own property adjacent to �' 1 OCl
(iV`amc of 1'r«perty Owner) �l
property located at 3 5 _ —(-! o CCL t_ a r _—_—_ _—
(Street Address, Lot, Block, Road, etc.)
on0 u Q u hl] ,in J� o► Q1-.QA� C 1 i N.C.
aterbody) (Town and/or County)
Z52-2.L) i -"y -
He/she has described to me, as shown below, the development hele is proposing at that
location and I have no objections to this proposal. I understand that, spa ing
pilings/boatliftiboathouse must be set back a minimum distance of fifteen feet (15') from ray area of
riparian access unless waived by me. I have indicated my intentions by irt'r't'el�,,-,►
I do not agree to waive the 15' setback requirement. APR 9 2007
g q
(init s) -
I do agree to waive the 15' setback requirement. Morehead City/ DCM
(initials)
-------------------------------------------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by indiv' ' b ment)
1-3
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Signature
�slC.t►rr-`7i2.o7"TE2 ,e*3A4�`e-�/
Telephone Number
Date: '� — --)9 - o

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• ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSBOA TLIFTBOA THO USE)
4
I hereby certify that I own property adjacent to Ko ) _ p� 's
(Name of Property Owner)
property located at ,3 a rJ eOro.
(Street Address, Lot, Block, Road, etc.)
on 0 , In M O �' QL. i i �i
N.C.
OV-51terbody) (Town and/or County)
�-6LI�t
He/she has described to me, as shown below, the development Dshe is proposing at that
location and I have no objections to this 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. I have indicated my intentions by initialing below:
I do not agree to waive the 15' setback requirement.
(initials)
I do agree to waive the 15' setback requirement.
(initials)
-- --------------------------------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filler! in by individual proposing development)
ps VE ri..
APR 9 2007
Morehead City C
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7
Signature
--r rint or I ype Name
2Y7-- 5 7 �R-- �-
Telephone Number
Date: a

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KELLEY FENN MOORE
NCDL 5193404
PH. [phone] CELL [phone]
4325 CORAL POINT ROAD
MOREHEAD CITY, NO 28557
Pay to the
Order of
1837
66-112/531
BRANCH 30603
—elf Dollars
BB"
BRANCH BANKING AND TRUST COMPANY --- e\� "U-�
1-888-BANK BBT BBT.cOm
Por 1911- V� f
1:05310 11 211:000S 29 203903611'01837
® HARLAND 2005
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