48493_POTTER, DENARD_20070515

5-I(o CI`1 /..S/S
❑ CA14A / CT D.REDGE & FILL
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 I SA NCAC I zoo
❑ Rules a the
Applicant /Name Project Location: County
Address .lX W Street Address/ State Road/ Lot #(s) 5 ���'���
City 4"AC-" State ZIP�V%o
Phone # () Fax # ( ) Subdivision ss�� �,I
Authorized Agent City ZIP d� �.M
Affected ❑ Cw ❑ EW El PTA ❑ ES ElPTS Phone # () River Basin
AEC(s): ❑ OEA ElHHF ElIH ❑ UBA El N/A
❑ PWS: ❑ FC:
Adj. Wtr. Body (nat /man /unkn)
ORW: yes / no PNA yes / no Crit.Hab. yes / no Closest Maj. Wtr. Body
Type of Project/ Activity 0"' "`C) f
(Scale: )
Pier (dock) length 2
Platform(s) �. J ,
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 Q
SAV: of sure yes no
Sandbags: not sure /yes
Moratorium: V` yes
Photos: yes
Waiver Attached: (5 no
A building permit may be required by:
Notes/ Special Conditions
Agent or Applicant Printed Name
❑ See note on back regarding River Basin rules.
Permit Officer's Signature
Signature Please read compliance statement on back of permit
Application Fee(s)
Check #
Issuing Date
Local PlanningJurisdiction
Expiration Date
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, 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 (252-946-648 I) 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

May 09 07 08:54a BCC
252-745-4253 p.2
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Michael F. Easley, Govemor Charles 5, Jones, Director William G. Ross Jr., secretary
Date I I-o'
n
Applicant Name
Mayliug Address
I certify that I have authorized (agent) &VOA l "LIE OfA\O -44to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity)
at upcatiou)
This certk
Signature
400 Cornrnerre Avenue, Morehead City, North Carolina 28557
Phone: [phone] FAX; 252-247-3330 \ Internet www.rmoast'aimanagement.net
An Equal Opporlur'ity 1 Affimmtive Acaon Employer — 909E Recycled 110% Post Carmuner Paper

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FOR
A.M.
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(F 01? A PIERIM, OORING PILI.NGSIBOA TLIF'TIBOA MOUSE)
I hereby certify that I own property adjacent to Denard Potter
(Name of Property Owner)
property located at
on Neuse River
(Waterbody)
55 Salter Dr.
(Lot, Block, Road, etc.)
,in
Arapahoe / Pamlico Co
(Town and/or County)
I
N.C.
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 (l 5') from my area of riparian access unless
waived by me.
I do not wish to waive the setback requirement.
I do wish to waive that setback requirement.
----------
----------------------
-- ------------------ ------------------------
DESCRIPTI6N AND/OR DRAWING OF;� POSED DE LOPMENT:
(To be filled in by individual pro osing development)
Print or Type Name
2111 - s.-S -� , a '�
Telephone Number
Date: /

C7211C6TIAN ,:

ADJACENT R 1PA-Pd, Ind P-ROPERTY OWNER STATEMENT
(FOR A RIERIMOORI1NG PILIINGSIBOA TLIFTI BOA T OUSE)
I hereby certify that I own property adjacent to
property located at
on Neuse River , in
(Waterbody)
Denard Potter is
(Name of Property Owner)
55 Salter Dr.
(Lot, Block, Road, etc.)
Arapahoe / Pamlico Co
(Town and/or County)
N.C.
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
Trust be set back a minimum distance of fifteen feet (15') from my area of riparian access unless
waived by me.
I do not wish to waive the setback requirement.
I do wish to waive that setback requirement.
- -------
------------------------------------ ------------- ------------------------ --------------
DESCI2IPTI6N AND/OR DRAWINGOI+ I�IaOPOSED DEEI,OPIl�EI�1T:
(To be filled in by individual pro osing development)
T I
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✓--------��-- ---�b L ��----�--------------- -- ------ ---
--------------------------1=------------- --
Signatur
Print or Type Name
Telephone Number
Date:
- � 'D 7'

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If YES, enter delivery address below: ❑ No
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❑ Registered ❑ Return Receipt for Merchandise
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atlas. 8545
102595.01-M-2509

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xie dtt, NC 88M �

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