47846_PRATT, FRED_20070301

❑CAMA / ❑ DREDGE & FILL
GENERAL PERMIT
❑New ❑Modification ❑Complete Reissue ❑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 15A NCAC
a
47 6 1
Previous permit #
Date previous permit issued =
❑ Rules attached.
Applicant Name '. � , t
i i r.�"
Project Location: County i
Address r r ;;f .�
�- ;:� `- •1 . -.s
i
Street Address/ State Road/ Lot #(s)
City it ti3 j � -`,J State
ZIP
Phone # i Fax # O
Subdivision
Authorized Agent
c rr"� !`City
ZIP 7'4
❑ CW ❑ EW
0 PTA Q ES
El
Phone # ( ) River Basin
Affected
AEC(s): ElOEA ElHHF
❑ IH ElUBA
❑ N/A
Adj. Wtr. Body ) •tV I , . iit /man /unkn
❑ PWS:
❑ FC:
ORW: yes / no PNA
yes / no Crit.Hab. yes / no
Closest Maj. Wtr. Body
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 n.
Photos: yes no i
Waiver Attached: yes no
A building permit may be required by:
Notes/ Special Conditions
(Scale:
,1
T r
Ilk
I L
1. lr
❑ See note on back regarding River Basin rules.
Agent or Applicant Printed Name t
Signature "Please read compliance statement on back of permit"
? C,
ApplicationFee(s) Check#
Permit Officer's Signature
Issuing Date Expiration Date
Local 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, 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

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to iQ�C` � i4fif" O� '(
A- -3yJ 7 (Name of Property Owner) / 1
property located at
-e ryc.CA e� & � — . 013
(Lot, Block, Road, etc.)
on RAI -Wle, in W"Me-17'e /P1�JC_0'N.C.
(Wate body) (Town and/or Count
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 (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.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
16, /�A ') � I , , I
71
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014 Sjbtw�
Print or Type Name
Telephone Number /y
Date:%�/ �/

■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
opt,nu N. C
-2 2-
%�" �1 /� " ❑ Agent
�/+ W G ❑ Addre
B. Received by ( Printed Name) C. Date of Deli
—`)
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
3. Service Type
❑ Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ G.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number 7006 2150 0005 5859 0092
(Transfer from service label)
PS Form 3811, February 2004 Domestic Return Receipt 102ee5-02-M-1540 y

UNITED STATES POSTAL SERVICE
First -Class Mail
Postage & Fees Paid
USPS
Permit No. G-10
' Sender: Please print your name, address, and ZIP+4 in this box •
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