49060_MYERS, SAM_20070626

1:1 CAMA 0 DREDGE & FILL
GENERAL PERMIT
EINew LIModification ElComplete Reissue El Partial Reissue,
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 I SA NO
Applicant Name
Address—.-,
State ate ZIP
Phone #
'Fax #
Authorized Agent
Affected 0 Cw
U EW
El PTA DES D PTS
AEC(s): El OEA
EJ HHF
DIH [I UBA 0 N/A
El PWS:
D FC:
ORW: yes / no
PNA
yes / no Crit.Hab. yes no
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
Previous permit #
Date previous permit issued
attached.
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision
CityZIP
------
Phone # River Basin
f
Adj. Wtr. Body_ - (n t 1man-lunkn)
Closest Maj. Wtr. Body
cubic yards
V
Boat ramp
Boathouse/ Boatlift I
Beach Bulldozing
Other
Shoreline Length
SAV: not sure
3ye
no
Sandbags: not sure
yes
'no)
Moratorium: n/a
yes
no
Photos:
yes-
no
Waiver Attached:
A building permit may be required by:
Notes/ Special Conditions
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
(Scale: _J
See note on back regarding River Basin rules.
PermitOfficer's Signature
IssuingDateExpiration Date
f
J
Local PlanningJuriscliction Roveff He ►Name

o
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
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/ 1-888ARCOAST
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

t�v���,r.t*11 �x� K ! A +� rKVY�Kl Y V 1MPii�KK , t A►i"1�Y1.�N1'
(FOR A PMR(MOORING Pffllk?'GSBOATUMBOATTIOL M
I hereby certify that I awn property 4acent to 'f-;A 0
(Name of Property Owner)
pmpeTtylocateaat L TP,¢ L�gf5V-' Of-iFoTPt 066�;1
{Lot; Block, Road, etc-)
N.C.
(Waierbody) (Town andlor COUQty)
s - 1 . / :� «/ !•:./ 1• It - 1 I • ' 1 1 - • " 11 1 • • t ff off i II f Ell f • 11 .
• ✓.If •it .It 1 IK ' 1r• 1'1 :.Mf,/ { If 1t 11 f'1 f�� IIL/ wf:`Y.II.t tlra 1 :+ 1l�• •//l/
fI 111 -6:1176ill 11 I Idlil./'tlr•• flll o1T• -; 111111!11!1 ifits 1 '1 Y.1I.Y' 1 111f f t� 1 • 11 is, .1
I do not wish to waive fire setback
I do wish to waive that setback requirement.
DESCRIPTION ANDIOR DRAWING OF PROPOSED DEVELOPMENT:
(To be,ied in by &&1&dPmP0dng development)
A -b-P N G-tJ
r60A7r 1.1 F= T r v FVV1 i' i N G 1>o G�e w ►TN 4 ,>,,a �T
51701 i
G
Print or Type Name J
Telephone Number
Date: �Aaa, 107

I t(irft► rc A► _ N rJ&VYMK1 Y V W M S IA.lkMENT
(FOR A PZERIMOORING Pff"GSBOATU BOATH019SE)
I hereby cff fifY that I awn PrQpesty 4aceot to _ GA 0 tA h S is
++ Na}me of Property Owner)
prWertylocatedat t`i i t�1= Cjzr r V—'rYTc1l 1 �� L
(fs Bloc etr—)
an (r�i, L� % �tL , in �"-A t-k , N.C.
f W'aterbodp) ('Town andlofr County)
:'- r. t:.Isrtat t! Ir 11• I 17 1 ••' II 1" \tna/t 1 /�\:l�It• 11.
! rl7 oil re ' ti IJ !'1 t{� Ili 1 :il:'Y,tt.t f1Y.t I Ur tilt 11■ t •
tl 111 �: t \�!1 II t \ :itl,1'//:-' Itti '• t•" `!w /�. IIIIIt111Ii111 11 '1N.I1.Y' 1 llf�t:: t I Oil It • .I✓.
I do not wish to waive fhe setback requires
I .- wish to waive that setback
Tequmement-
DESCIUPTION AND/OR DRAWING OF PROPOSED DEV MOMEW:
(To be filled in by individual proposing r evdopment)
A .) P N e ►v
5 1 N G L r PU1,.V5
-41
C U 1-11A A
Signature
Pnnt or Type Name
3o 3 .rya - 7i 7
Telephme Number
Date: 61 ) 0)60 7

m�
:.y
-_ r-,l -__ ty-=rh ed.
iNNERBANKS MARINE CON
StTRUCTION INC ,%
P.O. BOX'190' PH#'('L52) 249-1429\N�`
ORIENTAL, NC 2857166-30/531
472
DATF
60
T �uf2 #Vi"bogp',— DOLLARS fAti-11ST CITIZENS B \r r,
www firstei ' e .Com
s�Ap
FOR':. s
11200 2 50 7n■ 1:0 5 3 i00 3001:004 7"1 20 L 28 2 211■,,,''
PAY
TO.THE
ORDER. OF