59743_MACKOWIAK, JOHN_20120209

❑ CAMA / ❑ DREDGE & FILL
GENERAL PERMIT Previous permit#
❑New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized b , 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
❑ Rules attached.
Applicant Name �; ; `;j 1 i °-T— Project Location: County
Address [ Street Address/ State Road/ Lot #(s)
City State i ZIP
Phone # O Fax # O Subdivision
Authorized Agent City ZIP
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Phone # O River Basin
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body (nat /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 piers)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore t _�
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 no
Photos: yes no
il
Waiver Attached: yes no
i I
L-L
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 #
t
(Scale:)
❑ See note on back regarding River Basin rules.
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 I) 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 consistentwith 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 howto complywith 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

NCDENR
North Carolina Department of Environment and
Division of Coastal Management
Beverly Eaves Perdue Braxton C. Davis
Governor Director
February 9, 2012
John Mackowiak
3500 Woodmont Blvd
Nashville, TN 37215
Natural Resources
Dee Freeman
Secretary
Attached is General Permit #59743C to install rip rap and bulkheads, at 186 Bluff Road in Cedar Point, NC. In
order to validate this permit, please sign the permit as indicated. Retain the white copy for your files and
return the signed yellow and pink copies to us in the enclosed, self-addressed stamped envelope. If the
signed permit copies are not returned to this office before the initiation of development, you will be working
without authorization and will be subject to a Notice of Violation and subsequent civil penalties.
We appreciate your attention to this matter.
Sinc r ly, j
�-c
Heather M. Styron
Coastal Management Representative
Enclosures
400 Commerce Ave., Morehead City, NC 28557
Phone: [phone] FAX: [phone] Internet: www.nccoastalmanagement.net
An Equal opportunity 1 Affirmative Action Employer
NoitliCarolina
;Vatll rally

DINASION Of COASTAL MANAGEMENT
ADJACENT IPARIAN PROOERT'Y 0V0JER �,i0j1FICTiQN rUYtM
CERTIFIED MAIL - RETURN RECEIPT REQUeST'EO
I hereby f 2?':i`,r that x OW,, c-, opsfi/ .aC acert to
: 0 ii-N1�—
(Name of Prop" Owner)
I:,rr�pat'Cy
(Address, Lot, Block, Road, etc.)
or: i 3' _: lc _4i^.r y ,2 in C L �rt � T
(:aterbody)
Aaeni's phone #: _-__
(Cityffown anti/or County)
Maliiny Address:
N.C.
�iE�/SI;e t^zss desQW,)ed to me as shown below the developme�± he/she is proposingat flat location,
anti I ht@ve no 00jedions to thc. proposal.
3DESCRIPTION AI DfQR DRA.WINU OF PROPOSED DEVELOPMENT
.i propcsing development musi fii! in descripts"On 401OW 01 attacl' a site drawh-rg)
if n e-
rz �' firon'ee fi '�� Proposed The proposed S"Wline 5tabi'"fiOn '
t3rd� je,-It `�ioodan W' khead
-
10
7U-h:o
Y'
consiSZ� o: a rjp rar rfi vemerlt riot Zc exct:W
in length starting at the 50utrwes'•. corfler of
pe;Ferty at the G:1t-A(J + (,Omer of ii•:e neighbor s
vjnyl bu,'khead. The revetr ietlt -her, traMiliorts =J a
,iressure treated wooden bullhead 3t the ",,d not
to 13Arred 80' in lrumgth proteCtsru; botn portd and
river SiQes of the ea'rh5^ i3arTl, This reraiss
damlre caused 4y mane.
rf a i� ve :� Jecifans to what isbong proposed, yore must notiff tree Divlsi0, of Ceastaa management
;DC'4) in writing within 10 days of receipt of this notice.• Contact irrrorrnation for t?Ct� offices rK
avai:3bfe at wwyv.nccoastaim.QngQmvnt.nctic<YrYfact do .hfm or by ca,ftrg 1-M-4RCOAST, Mo
resa case ss oonsidere#ties some as no objection ; � been ,aarmed'gvraied mau
,.: °Pelt.Y er trt iPrn
r dni or Tye+e, Nome
•_.et ..i Q/ •1r� Q�.V S�9 4 V Y��I. kAr'J_(—.—. __� �.irL
rlAotiir�g Au .'; ass
T pie, hone Number
l/
(Riparian Prop", Owner Information)
�.; /�' i .�. � -fix.•-� �._._
Srgnafe.�re ,�"
Print or TyFs Name
Maii`ng Address
G tr ) P,-P._ P r-> ! 2--1 1 N c.
Ciryi.50"110"Z'.%
T:.lept.one Number
Date
RECEIVED
FEB ® 6 2012
DCM-MHD CITY

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED
I hereby certify that I own property adjacent to -10ffO JA-CKDc % 1p1�-. 's
property located at 186, 8 L J F1' P-��
on W A-I1'e O K I-
(Waterbody)
Agent's Name #:
Agent's phone #:
(Name of Property Owner)
(Address, Lot, Block, Road, etc.)
1?-)\J Tz. , in 6 C *i?— PCO II j
(City/Town and/or County)
Mailing Address:
N.C.
He/She has described to me as shown below the development he/she Is proposing at that location,
and I have no objections to the proposal.
-= ` --------------------------------------------------------------------------------------------------------
t;U I� DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
ro osing development must fill in description below or attach a site drawing)
L L�
Proposed ri y` Proposed
'.. prap-revetment Wooden Bulkhead
Swiberexisting
bulkhead
-o
a,6
POND
The proposed shoreline stabilization project
consists of a rip rap revetment not to exceed 200'
in length starting at the southwest comer of the
property at the outside comer of the neighbor's
vinyl bulkhead. The revetment then transitions to a
pressure treated wooden bulkhead at the pond not
to exceed 80' in length protecting both pond and
river sides of the. earthen dam. This repairs
damaga caused by Irene.
If you have objections to pwhatis being proposed, you must notify the Division of Coastal Management
(DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is
available at www.nccoastalmangement.neticontact dem.htm or by calling 1-888-4RCOAST. No
response is considered the same as no objection if you have been notified by Certified Mail.
Wope erin m
ignature
,o 1-��3 m Ae)�-
Print or Type Name
359D tk ),L)3D Mar- F 1)
Mailing Address
}JA<14V I t_LG- ' i It � ?215
City/State2ip
619-3r6
Telephone Number
/,;Z-� 12-'Z>1. L
D�p
-IJ m 6 O LZ I & IC C' tf -0-
(R!p<1an Property Owner Information)
-< Signaiure
Print or Type Name
.� cc
Mailing Address
G try A - a—, T tJ C- 285 8 f
City/Sfate/Zlp
Telepho a Number
Date RECEIVED
FEB 0 6 2012
DCM-AIHD CITY

JOHN I MACKOWIAK
LESLIE R MACKOWIAK
3500 WOODMONT BLVD
NASHVILLE TN 37215-1433
1476
66-19/530NC
Date 1100
S
to the _order /oJ
G'� �� s.�-- ,'�"1�'�wi r � � ��-'l1 �.�i . � •'�'''"y5' Dollars e
Back.
Bankof America
f
ACH R/T 053000196
Memo __ ��°� r%' 2� i° t c, — :yf� i ` _ i nm
1:053000 L961: 2370 1457a333II' L4 F.

V---- L,�,l
Ste'

A.Oplicant�.`"/�
Date:
. II
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
found in your Habitat code sheet.
TOTAL Sq. Ft.
FINAL Sq. Ft.
TOTAL Feet
FINAL Feet
(Applied for.
(Anticipated final
(Applied for.
(Anticipated final
DISTURB TYPE
Disturbance total
disturbance.
Disturbance
disturbance.
Habitat P.larrte
Choose One
includes any
Excludes any
total includes
Excludes any
anticipated
restoration
any anticipated
restoration and/or
restoration or
and/or temp
restoration or
temp impact
ternimpacts
im act amount)
ternim acts
amount
e go ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
w
.
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill❑ Both ❑ Other ❑
Dredge ❑ ' Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ . Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ . Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
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