58320_MITCHELL, KRIS_20110825

` OCAMA / O DREDGE & FILL
GENERAL PERMIT
ONew OModification OComplete Reissue OPartial 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
Applicant Name
Address
City State ZIP
Phone # O Fax # O
Authorized Agent
❑ CW ❑ EW ❑ PTA
Affected
❑ 0EA ❑ HHF ❑ IH
AEC(s):
❑ PWS: ❑ FC:
ORW:
yes / no PNA yes / no
❑ ES ❑ PTS
❑ UBA ❑ N/A
Crit.Hab. yes / no
Previous permit #
Date previous permit issued
Rules attached.
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision
City ZIP
Phone # O River Basin
Adj. Wtr. Body j ' (nat /man /unkn)
Closest Maj. Wtr. Body
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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 Plan ningJurisdiction
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
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

Bogue Banks Marine Construction, Inc.
111 D Turner's Dairy Rd
Morehead City, NC 28557
[phone]
PAY TO THE
OR OF
WACHOVIA BANK, NA
66-21/530
112008010113 I:053000219i:200002483L402110

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37-26-11;03.24PM; # 2/
u r i RQ/ L.V.L.L .Lu: 4o PAA 10002.
ADJACENT JUPA,RIAN PROPERTY OWNER STATE N,i,;t,.c' T—
(TOR A ,i' 1fi-R1M00R1NG P1r11VtGAS'/)3pATL1TT1B0A7jj0L1S',F.)
I hereby certify that I own property adjacent #o �J,
Nawc o;fProperty Ownc=)
property located at ., 0 %,...�. �P,�, `.f-r'
(Lot, Block, Road, etc.)
Oil 09.
(Waterbody) (Towel and/or County
Applicant's phone #:. i-'—�� —7 %4 71Q]irxg Addrau: �7��- �je✓.�� ��:
He has described to me, as shown below, the development ho is proposing at that location, and, I
have no objections to his proposal,1 understand that a pier/mooring pilings / boatlift / boatlhoust:
uhhist be set back a minimuni dWaace of fifteen feet (I S') -liana my area of dparian bccc;ss unless
waived by me. (If you w;s)h to waive the setbuc 1c, you rnujit Initlat tlhe appropriate blank
below.)
I do not wi`!f to waive
� I ,4la wish to waivc that 4etbaek requirement.
DESCRIPTION AND/Old PRAW.ING OF PROPOSED DEVELOPMENT:
(To beft"lled in by individattl pi-opo imff development)
- ----------------------
(Information for Property Owner Applying Ripari roperty Owner InJrornh Lion)
foi- Perhnit) (�
11�ai�ilhlw Aciclresss Signawre
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TcIeplaone Nitmber
Print ar 'f, YPe 11fair,4•
Telephone Number

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F'O` L � ti..;may-�s�"'4�+��:.Sy`•'.et��t`a. Ste: � - - c n.���� ° •'" � ,
UNITED STATES FOSTAL 6EMACE
..�::• :-�..��- �; � � _._ _._...,per 1�1a„4�'"1✓9�,
• Sender: Please print your name, address, and ZIP+4 in this box •
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■ 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:
JO, rK 84l
a� 0�
A. Si ature�✓�'�
❑Agent
X
❑ Addressee
B. eceived by (Printed Nme) C. Date of Delivery
P - / 0-//
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 ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
Article Number
(Transfer from service label) 7 011 0110 0001 0426 2688
PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540