59699_METTS, PATRICIA_20111220

7CAMA / -i DREDGE & FILL
1
GENERAL PERMIT
❑New ❑Modification ❑Complete Reissue
4. - -i--c id VIr e 4
,—]Partial Reissue
(L �6
Previous permit #
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 15A NCAC
f-1 Rules attached.
Applicant Name ' a tir 1a t z,, 3
Address �� ��It�t't Dr,'ve
NJCCity' ' j A State ' ZIP F 5�
Phone # (1 Or ) 3fe '_'' __-_- Fax # (--
Authorized Agent
Affected ❑ CW ❑ EW PTA Ll ES ❑ PTS
AEC(s): ❑ OEA HHF IH ❑ UBA ❑ N/A
❑ PWS: ❑FC:
ORW: yes / no PNA yes / no Crit.Hab. yes / no
Project Location: County
Street Address/ State Road/ Lot
Subdivision RQ 0,111
city +� 1 iz-, zips ac
Phone # ( ) �Z{�9' .3 �* River Basin Oa
Adj. Wtr. BodyI ^.?2 1 !: 1Jr; nat /man /unkn)
Closest Maj. Wtr. Body
■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■
■■■■■mow■■■��■��■■�u��■■■ems■■■■�■■■■■
MOORE
■■■■■
FAME
1JANW1REWRTtl■W'f[
M10
NCO
■■WBW■`il
NDIARA■
■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■
Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit
Permit Officer's Signature
Issuing Date Expiration Date
Application Fee(s) Check # 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, 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 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/ 1-888-4RCOAST
Location: Fax: [phone]
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
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

CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner:
Address of Property:
(Lot or Street #, St
Applicant phone #: 9w---3�b — 53
��
DR )l�
x Road, City & County) ��(J� `oLki
Mailing Address:
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing_the development
they are proposing. A description or drawing, with dimensions, must be provided with this letter.
I have no objections to this proposal. I have objections to this proposal.
If you have objections to what is 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.net/contact dcm.htm or by calling 1-888-4RCOAST. No
response is considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, or lift must be set back a
minimum distance of 15' from my area of riparian access unless waived by me. (If you wish to
waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Inf rmation) (Riparian Property Owner Information)
a
,Signature _ Signature
Print or Type Name
Mailing Address
CityylState2ip
Telephone Number
-"-) ^ -
Date
A C( a --K
Print or Type Name
tt 9 k,'I/C(- 0►-
Mailing Address
City/State2ip
(q10) 3 ,6 - C�475
Telephone Number
Date

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property
Address of Property: C
(Lot /or Streeeet7#, Street or"Road, City & Coun y) _ 1 l�
Applicant phone#: .� 16— C\ Mailing Address: /vr
U
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing_the development
they are proposing. A description or drawing, with dimensions, must be provided with this letter.
I
I have no objections to this proposal. I have objections to this proposal.
1.
If you have objections to what is 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.net/contact dcm.htm or by calling 1-888-4RCOAST. No
response is considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, or lift must be set back a
minimum distance of 15' from my area of riparian access unless waived by me. (If you wish to
waive ,we set you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
`' I do not wish to waive the 15' setback requirement
Owner Information) mil -Riparian Property Owner Information)
Si nature 1
C F/404
Print or Type Name
OIL,r
Mailing Address
�
City/State,2
C) 31"),16/
s3
Telephone Number
Date
Print or Type Name
Mailing Address
S--fieIIa , �C )-s
City/State2i
Telepirohe Number
Date
/ ,)L- - �Jo --- i (

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED
I hereby certify that I own property adjacent to ~ �- ' %�L 1 s
(Name1ef Property Owner)
property located a �1 LQ Ihv/
Address, Lot, Block, Road, e�t�c.)�
on tij, L in l�U N.C.
(Waterbody)
Agent's Name #:
Agent's phone #:
(City/Town and/or County)
Mailing Address:
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.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
If you have objections to what is 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.net/contact dcm.htm or by calling 1-888-4RCOAST. No
response is considered the same as no objection if you have been notified by Certified Mail.
7tperty Owner Info mation)'
t
ignature
E
Print or Type Name
ailing Address r
�N t� �� -�
�ty/State/Zip
C-1) /' -- ? .' (, - 65 Y
Telephone Number ,
Date
(Riparian Property Owner Information)
ignature
1%��Jr�v�!„ ACLas'lc
Print or Type Name
l 1 q /�"V
Mailing Address
,-3/t I ( a 1yG a`F-�
City/StatelZip
Telephone Number
1,;7,-ao-l1
Date

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED
hereby certify that I own property adjacent to 's
( e of Prope O ner)
►��.property located at Q, J
(Address, Lot, Block, Roa etc.)
on �IV�W @,(� ; in N.C.
(Waterbody) (City/Town and/or County)
Agent's Name #:
Agent's phone #:
Mailing Address:
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.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
If you have objections to what is 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.nccoastalmangementnet/contact dcm.htm or by calling 1-888-4RCOAST. No
response is considered the same as no objection if you have been notified by Certified Mail.
P? erty Owner In ormation)
6
Signature
-T +-f &C IA
Print or Type Name
g, -
Mailing Address
Cityyj/ jState2ip 2
Telephone Number
Date
(Riparian,Projy" Owner Information)
Print or Type Name `
3::Z-I IC(✓.-L
Mailing Address
�Jell�A- AiL
City/State2ip
(� (6 ) 3-2�,- --�
Telephone Nurifiber
Date