32051_THORNBURG, SCOTT AND CYNDI_20020628

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]EIYERAL PERMIT APrevious permit #
New b Modification 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 15A NCAC
0 Rules attached.
Applicant Name to Project Location: County
Address -4 l k yt� T - Street Address/ State Road/ Lot #(s)
City N�a `'�'� v� State A- ZIP i ; rE �' +�� �,.I .
Phone # (_ _) -'� 11 l2 C Fax #
Authorized Agent flu, : f k,a�
Affected ❑ CW ❑ EW i�] PTA O� ES PTS
AEC(s): ❑ OEA HHF ❑ IH ❑ UBA N/A
❑ PWS: ❑FC:
ORW: yes /' no PNA yes / no Crit. Hab. yes / no
Subdivision
City c LA4(, �' ZIP
Phone # O River Basin
Adj. Wtr. Body feu l�' �., 40�at /man /unkn)
Closest Maj. Wtr. Body
Type of Project/ Activity - I f,
1),41E ^ (Scale: 14A.f )
Pier (dock) length
Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length '?,c
avg distance offshore
max distance offshore CI
Basin, channel
?'✓ ''P�'If` III(<. __
cubic yards
Boat ramp
' - r -------- - -- ---- ---- -------..�_------ ---�
Boathouse/ Boatlift i
L.. n
Beach Bulldozing
Other f'- �c k F '< C t 1
t
Shoreline Length
SAV: not sure
yes
no
Sandbags: not sure
yes
no. L
,
Moratorium: n/a
yes
(-no
Photos:
yes
no
A'
Waiver Attached: yes no —IA—
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 #
cvUiof �
See note on back regarding River Basin rules.
t
Permit Officer's Signature
t <_
Issuing Date Expiration Date
Local Planning Jurisdiction Rover File Name

♦ aw—
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 (910-395-3900) for more information on how to comply with thesebuffer rules.
Division of Coastal Management Offices
Central Office Elizabeth City District
Mailing Address: 1367 U.S. 17 South
1638 Mail Service Center Elizabeth City, NC 27909
Raleigh, NC 27699-1638 252-264-3901
Location:
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293 / I-888-4RCOAST
Fax:[phone]
Fax:[phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Morehead City District
151-B Hwy. 24
Hestron Plaza II
Morehead City, NC 28557
202-808-2808
Fax: [phone]
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico 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
910-395-3900
Fax:[phone]
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)
Revised IOJ05/0I

e
COASTAL MARINECON CONTRACTORS INC
H252-638-6407
PO BOX 12729
NEW BERN, NC 28561-2729 DATE—
PAY
TO THE
ORDER OF
6503
66-1111531
01901 ;.
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ADJACENT RIPARIAN PROPERTY OWNER STATE AM, NT
(FOR A PIERIMOORING PILINGS/B0A7ZIFT/B0ATI10USE)
I hereby certify that I own property adjacent to ���`��" C%Aor?4JvY'C S
(Nameof Property Owner)
property located at
on �Jool� k, Vt° r
(Waterbody)
3004 Rlve-�r Dc . .
(Lot, Block, Road, etc.)
in C19teT���� 00. N.C.
(Town and/or County)
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 beset 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 AINWOR DRANVD G OF PROPOSED DEVELOP.MENU:
(To be filled in by indiiidnal proposing development)
-1
M
sue, C�"�J/
Print or Type Name /
(71-LJ Z z ,?
Telephone Number

ADJACENT RIPARIAN PROPERTY OWNER STATEn'"NIT
(FOR A PIER/MOORING PILINGS/BOA?ZIFT/BOATIIOUSE)
I hereby certify that I own property adjacent to ,5c64 a 42 xl!q/• %�p,-��vr Is
(Name dr Property Owner)
property Iocated at Dr-.
(Lot, Block, Road, etc.)
on ouA 41vle,r in�.9.2�tr� �o
(Waterbody) ,. N.C.
(Town and/or County)
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/boatlifUboathouse 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 DRAINT�;G OF PROPOSED DEVELOMNIFEW:
(To be filled in by individual proposing development)
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Print or Type Name
Telephone Number

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