30659_THULLEN, JIM AND AMY_20020201

` r❑LAMA / ❑ DREDGE & FILL
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IS306 9 ' (:�
PrevGENERAL PERMIT iotI�per
❑New ❑Modification ❑Com fete Reissue ❑PartiaI Reissu
e 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 I SA NCAC ri
Q Rules attached.
Applicant Name !01 V-k Project Location: County
Address `{'`; a ,C ;`:f' -_ Street Address/ State Road/ Lot #(s) ` ; JX -r_
city �� -c'; _ .�1�. t state_
Phone # (�) ` ,4 ` ( Fax # ( )
Authorized Agent_ f•_ r ,
Affected ❑ Cw ❑ Ew [�I PTA ❑ ES ❑ PTS
AEC(s): I— OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS: ❑ FC:
ORW: yes / no PNA yes / no Crit. Hab. yes / no
Type of Project/ Activity
Subdivision
Phone # (' ) ?' :�G c _ < % Rive Basin l
Adj. Wtr. Body nat .%man /unkn)
Closest Maj. Wtr. Body t '
Pier (dock) length 4, _ ____ f— _____-7,_
Platforms) @- A,
Fingerpier(s)
Groin length i 'CC'Cr�.
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel — -
cubic yards
Boat ramp
Boathouse/ Boatlifr +?
Beach Bulldozing
Other
Shoreline Length
SAM not sure
yes no
Sandbags: not sure
yes no
Moratorium: n/a
yes no
Photos:
yes no
Waiver Attached:
yes no
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 #
(Scale: !
, r
X'
7 See note on back regarding River Basin rules.
G- . ') ; i m
0
Issuing Date ( ExpirationDate
1, 1 'k-.
Local PlanningJurisdidion Rover File ame

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 J 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 / 1-888-4RCOAST
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 10/C

2105
-- NCDL 65047
ERIC B. ELLIS 66-30/531
JASA M. ELLIS PH (252) 726-sn5 D 133
205 NOTTINGHAM DR. Date
MOREHEAD CRY, NC 28557
Pay to the
y $ �d Q, ao
Order of G9d Dollars 8p
A,) w
QST CITIZENS "'
�NK Allat6i3.ch.Nnk C. 21512Compe�Y
li — \1 NP
For te« 5
•00 L3 L7448780n' 0 2 LO
• 3 100 30 0 1. ---fir - �16®�-� _GUAFDIANA9SAFETY BLUE ESBL
---
...... .. .......a

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIUNCOVERED BOAT LIFT)
I hereby certify 'that I own property adjacent to ( ¢ (,(,` ,s
(Naune, o Property Owner)
property located at q360
(Lot, Block, Road, etc.)
on in ! / C ©�tif/C�C ( �c
(Waterbod) , N. C.
Y (Town and/or .ol�nty)
He has described to me, as shown below, the development he is proposing at that
Iocation, and, I have no objections to his proposal. I understand that a pier/uncovered boat lift
must be t back a minimum distance of fifteen feet (15') from my area of riparian access unless
waived 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)
11
J
i
------------------------
-------------------------------
�� el7a�t,- le
Print or Type Name
o?5:;?SS 61
elephone Number
Date: ,3y pyj
I— %

ADJACENT RIPARIAN PROPERTY OWNER STATEMXNT
(FOR A PIERIUNCOVERED BOAT LIFT] Z-1VUZLBO
I hereby certify 'that I own property adjacent to �� fii1r�lJ��it 's
(Name of Property Owner)
prope;ty located at
- / (Lat, Block, Road, etc.)
on in
r 1 -/ - ��� f N. C.
(Waterbody) (Town and/or County)
4 300 S, S1Jo2,5,' c /T i/
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/uncovered boat lift
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)
---------------------------------------------------------------- ------------- --------------- - ----------------
S'gn tore
6-7
Print or Type Name
Telephone Number
Date: �-1 — /

MONITORING & COMPLETION REPORT
[CAMA Major Development & State Dredge & Fill Permits]
PERMITTEE' S NAME: r _ p qT # - l :
LOCATION: 4 FIELD REP.
PHONE: J1L--L)a,-/;
DATE OF INSPECTION l Z
1)
DATE REPORTEDLY COMPLETE: Ci
,-Boothe measured dimensions of the development differ from those indicated in the permit and workplat?
(\Y>E. fNO [circle one].
2) SEDIMENTATION & EROSION CONTROL: Has Permittee seeded, grassed, or otherwise stabilized all
disturbed areas? YES/NO [circle one]
COMMENT:
3) FUTURE MONf
IORING & ENFORCEMENT ACTION: Is further investigation or enforcement action
needed? YESt9 [circle one].
COMMENT:

T�I�FN �s
0

Eric Ellis
DOCKS *SEAWALLS • BOAT LIFTS
CONSTRUCTION & REPAIRS
TELEPHONE: [phone]
205 Nottingham Lane Morehead City, NC 28557
Capps Printing, Morehead City