32362_UPCHURCH, ROBERT_20020712

LCAMA / 1? DREDGE & FILL
GENERAL PERMIT
'
Previous #
permit
2New `Modification El Complete Reissue
CiPartial 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
Q Rules attached.
Applicant Name 7`1L� ! ,, ' r : F,
Project Location: County
Address F
Street Address/ State Road/ Lot #(s)
City / f'r d i • State AA- ZIP
Phone # ( 1) 7 Y %' 'r'"1G!S Fax # ( )
Subdivision .- : /-. i'' : , f
Authorized Agent
City `' if ; !"> , L ZIP /
Affected ❑ CW Vw LYPTA Q ES ❑ PTS
Phone # (�) River Basin
❑ OEA HHF ElIH ❑ USA El N/A AEC(s):
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 pier(s)
Groin length
number —i
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel YY '� /p A-
2. i,' 2 y rl r -11
cubic yards
Boat ramp J
Boathouse/ Boatlift
Beach Bulldozing i
Other
Shoreline Length
SAM not sure yes
no
Sandbags: not sure yes
no
Moratorium: n/a yes
no L
Photos: yes
no
Waiver Attached: yes
no
A building permit may be required
by:
Notes/ Special Conditions
1
IL.
H
I
T_,
I—r--
- r —
I
-.-._...i
—_....._
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit
Application Fee(s)
Check #
I
See note on back regarding River Basin rules.
t
i
Permit Officer's Signature
Issuing D to Expiration Date
Local Planningjurisdiction 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 [)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 (910-395-3900) 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 / 1-888ARCOAST
Fax: [phone]
Fax: [phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Morehead City District
151-13 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 10/05/01

Robert-9 Upchurch coloitel (retID)
Pk 252 247-9905 SSrN243-64-0802
3510 platitatioN )U rNGWW 23010433
Jkrelread CVy, AB 28557
DATE
66-30/531
137 2077
PAY TO TI-11 ORDER OF _
I rxrk Inc r ro Prinl 5ignahuc inc, graIf+c and lin—ork, ! "I Cilitcm MIA Ingo on hark. If no(firc%cnl. doow raslr. )OI.A S
i'iR�S7-�TT CITIZENS 137 Chart , ucSt
First -Citizens Bank Trust Company
Morehead City, N.C. 28557
FOR - -- - — -
- --
1:0 5 3 00fto01:0E3iL? 4606 59il' 0 20 7
V

�Iv PROPER c' �J I "EP S'TA`iE"'I i
A D j XCEI`+"r RIPARL
(FOR A. PIERIMOORING PILINGSIBO.ATLIFI'/BOATHOUS�j
i hereby ceMfy that I own property adiacer.t to (Name of Property Owner)
Iacated at
IN
Cs)P
grape: ry
(Lot. Block, Road, etc-)
r
in � , PST. C.
°r`�' (Town and/or County)
(Waterbody)
He has described to me, as shown below, the development he is propos:r.= a. ti",at Iocatiori,
and, I have no objec';ons to his proposal. I understand tha: a pied monrin�
pain as,'boatlirdboat house mus: be se_ back a minimum distance of fiitetn Met (If') from my area
of riaa ian access unless waived by me.
I do not wish to wa v! Lhe setback requirement.
I da wish to waiive t;,at setback requireTe^t.
DESCRIPTION AND/OR DRAWD G OF PROPOSED DEVrLOP`,'EN7:
(To be f lled in by individual proposin, developmert)
f ,pr a
i
DsZ4 flp'&Jv�
f
�,dj -3
-j--- ; ----c�_ -----------
—------------------
t���r j
�1 tis`Fie
0 5-e
�'�T�atl.irZ
P,;r,t cr T�rte �'a:r:e

.0001*
D
loop
r,
p
o
ri ``AA II
C,�. A N 1V le, 5 �—'\q

' A-DJACE'NT RLPARL-1,1'V PROPERTY OWNER STAMEENT
(FOR A PIER/MOORING PILINGSIBOATLIFTIBOATHOUSE)
I hereby certify that I own property adiacent to io4 05 �'s
(Name of Property Omer)
prope.-y located at 3
e
(Lot. Block, Road, etc.)
onrer c , in . `�
e �1 . 7' , N.C.
(Waterbody) (Town and/or County)
He has desc-ribed to me, as shown below, the development he is propos*77 at that location,
and, I have no objections to his proposal. I understand tha- a pier/ mooring
pilings/boatlif-Jboathouse must be se --back a minimum distance of fifteen fee: (i ) from my area
of ripa_-ian access unless waived by me.
I do not wish to wale- the setback requirement.
I do wish to waive t`.at setback requirement.
DESCRIPTION AND/OR DRAWr G OF PROPOSED DEVELOF�IENT:
(To befiled in by individual proposin; development)
C�-e*k
QReAcle
i
- ------------- ---
Signature
Print or Type Name
i e'.epnone Numb`r

ASijACE>-r REPARL-k.-N PROPERTY OWNER ST AT-h* ;.� N i
(FOR A PfERIMOJRJNG PILJNG5!g0A7ZIF7'�GA''1�0� ` j
a property ad;ace:,t *c S
I re; eby T
�ac . o
�tiame of Property"tr}
�mF�"'Y located at--
(� Block, Road, etc.)
on,;C.- lr L C
(Waterbody) t"Tuw and., ter County,
i�.5 deSC:iC '. rr , 2S Si.Ow'n. be ow, t e Neve:Qp!i1e"� he is Drop S:'z a: 6:saG
have no 8bjeo^ or,s to h}s prcpcsti. us,de:s;a. d t.'-a: a rre:-/moorr.g
pain s'bearliftlt�xiu`cuse rust bs se: 'pack a rmmmur-: dis:anre o= $rtce; fe:: (w�'} l':om my stet
of riparian access unless via.;.°teal by ;ne.
T -siltXyy,
1J.
w��i; t'v w:. � � E`
I ;L V ish to w3;vZ t�-.a_ Setback -e "�ire^ent.
DESCRIPTION A`MI OR D?,A WZ;G OF PROPOSED DEVELOP"�? N :
(70 oe,,Flled ir. Cy individacl propoin, deve:cpmenr) )i_- e,
�Rs r P �
' �0C-ATwbrJ
c
ot2t
S12712MIr- l�
Pm,mz o: ; ype Name
Tom;: h0.1d N ur!De-

v ADjACE,.N-r W'AF LAI PROPERTY 01'k NER STAT�.ti:.�jti
(FOR A PCERiMOGRIN'G PILINCS/BWLIFTIOATHOC'S)
P0, 5'. Tr
I hereby cet fy that I own property adjacent to 5
(Marne of Property caner)
propeny located at LoT
(Lot, Block, Road, etc.)
an ���r`��,� r' , in , N.C.
(Waterbody) (Town andlor County)
He has dewnbed to me, as s;lowr. Meow-, Lhe o'eveloprnvt he is proposin j a: that location,
and, I have no objections to his Froposmi. 1 understand Ll m: a rien'rnocring
piiir I&UaW1VbaathOuse must be se: �acic a rniairrurn distance or Hm--- fm (:;') front my area
of riparian access unless wa; •{ed by rne.
I do not wish to wage the setrZack re u:rtmerIL.
_..._.�_
I da wish to wave t~a: setback -e�lire ne^t.
DESCRIPTION AND,,OR DRAWING OF PROPOSED DEVELOPNrENT;
(To be filled ir by individual proposing development) Pr-�
EAs r 9-1. T�11�A 6
--- �w
a a
�fo rhmik.' NeAA, Le
f
Siinature
1
°nrzt or, T ype Nacre
Teltphone Nunbe-

m
0
r '
A4-
Voc C-A,
ReA eA % e- e- V\,
—� W\��
3° I
z N\ V11
5G's
o-C
y P R 015
c k A lu A -Ile \5 z m Lu')
1r / R