46710_PASWLINOWSKI, GEORGE_20061006

❑CAMA / ❑ DREDGE & FILL
GENERAL PERMIT Previous permit #
❑New []Modification El Complete Reissue ❑Partial Reissue Date previous permit issue
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 attachOl
Applicant Name Project Location: County �.
Address Street Address/ State Road/ Lot #(s)
City State
Phone # ( ) Fax # O
Authorized Agent
❑CW ❑EW ❑PTA
Affected
AEC(s):
ElOEA ❑ HHF ElIH
❑ PWS: ❑FC:
ORW:
yes / no PNA 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
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
Shoreline Length
SAM 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
ZIP `e '
❑ ES ❑ PTS
❑ UBA ❑ N/A
Crit. Hab. yes / no
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit"
Application Fee(s) Check #
Subdivision
City ZIP
Phone # (,) River Basin
Adj. Wtr. Body (nat /man /unkn)
Closest Maj. Wtr. Body
(Scale: )
❑ See note on back regarding River Basin rules.
Permit Officer's Signature
Issuing Date Expiration Date
Local Planningf urisdiction 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 comply with these buffer rules.
Division of Coastal Management Offices
Central Office _Elizabeth City District
Mailing Address: 1367 U.S. 17 South
1638 Mail Service Center Elizabeth City, NC 27909
Raleigh, NC 27699-1638 252-264-3901
Location: Fax: [phone]
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
Fax: [phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Morehead City District
400 Commerce Ave
Morehead City, NC 28557
202-808-2808/ 1-888-4RCOAST
Fax: [phone]
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico 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,
Orslow -below New River Inlet- and
Pender Counties)
Revised 06/29/05

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;FOR A PIF_PJUN OVEt?—PD BOI17'IIIF7)
I herebv certify that f own property adjacent to
(ti:IIme of Property OtiTuer)
property located at_ 3 LTj 103 /7//c,y0 Y Caovr-� r
.)
. ; (Lot, Block, Road, etc-- _
on w� y in
--(To vn and; OrI Countyj.
He has desc ibed to me, as shown below, the developr;rent he is propostn; at t!,at
location, and, r have no obj(-_ctions to his proposa.I. I underst Ixd I;hat a ptirluricovered boat
must be set jack a minimum distance of rzfteAn fc t (IS') from my area -or np rian accbss unit ss
' waived by me.
I do not wish to waive .the setback requirerent.
wish to waive that setback requirement.nA-
�,.
--------------------------------------------------------------- --- --- ----------------
DESC RL�IZr�iti 3.'`D/OR DR.�,.W NG OF PRO POSEU D' E E 0P_Ae.fF.N-. --y _
(To be JUed in bt indiyufu& �rn;posirzg d�s•e1 e 94i
I -ty GOGM
D
U3�11 LI
s�
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L
�4tsf1N6'M0k
Signature
Print or
-__
Ielepfione Nerrrtli'-l�r
I
Date. a6
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.ADjACENT Ri-eA.FjAN APPROPE-1-I"I'y
O'i V NJ i- R S'. r A. -j-F, M-Ej N.
(FOR A PIERIUNCO VERED B 0/1 TIJIM
I hereby certify that T own property adjacent to I kVl- / A OX5A-
(N.-Itme or Property 0 wa—er)—
property located at,-/ ;?% 103 . -1/C 0 E Y (Lot 7—
Block, Road, etc.)
on /45N&- �✓e 4 4- 11119 7-,C- e &61,4 in h 6 5 14 OR
6� ;a g r,5,Q C r N.C.
Waterbody)
-n
(To' a a c1ior County)
He has desc;-ibed to me, as shown below, the deve-lopij
Pent he. is proposLrig at that
location, and, I have no obje--tions to his proposal. I undersund q at a . pr�tluncovetcd boat Ur--L*
must be seCback a minimum distance of PIstem feet (A5') fronmy iarea oriparian aotzss unless
waived by me. v
I do not -wish to waive,the sciback reQuIreIrne.t.
I do wish to waive that setback requirement.
- ------------------- -------- --- --- ------- — ---------------------------------
DESCR=(DN
A.N-D/OR DRAVV7PiG OF PROPOSED DE
To. be J!Uea' in kv indiY&ut-Jprrpos
r
A VAL- JUL I I Z006
Morehead City E)CM
LI
12
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------------ ------ ------------
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Signature
6;k
Prim or -I-YP,2 N.ulie
6N,J:-g
Telephone Mulb, I �r
Date:
I

c-� 45

HCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Michael F. Easley, Governor Charles S. Jones, Director William G. Ross Jr., Secretary
Date 0 - a
Applicant Name OccjsGe PP'U)t- I4w-Sef
Mailing Address
tienhi�115 P, C- aR51a.
I certify that I have authorized (agent) f93Ce 0 .15�66 to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) BL)L'V-UD + f3z�'ff —L L1 F-7_ 9
at (location) C) 3 C
This certification is valid thru (date)
�l
Signature
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: [phone] FAX: [phone] Internet: www.nccoastalmanagement.net
An Equal Opportunity 1 Affirmative Action Employer — 50% Recycled 110% Post Consumer Paper

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6337989a,111 1:0920054111:0170?1045109 21Is
■ 7HIS DOCUMENT F1A.S ;'�'� AR'il l F rJ: M,\Rk THIN I CD I i. •,( K THE FRONT OF THE DOCUMENT HAS A MICRO -PRINT SIGNATURE LINE AND BORDER. ABSENCE OF THESE FEATURES WILL INDICATE A COPY.