30687_WELTON, RICK AND KRISTI_20020222

"❑CAMA / ❑ DREDGE & FILL
GENERAL PERMIT
[]New ❑Modification ❑Complete Reissue ❑Partial Reissue
j As authorized by the State of North Carolina, Department of Environment and Natural Resources
Previous permit #
Date previous permit issued
_ l
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC ! ' )C�
1
Applicant Name
Address
, c ; U,-Cf i VU ;
City j
State f' ZIP
Phone # ( ) "
,`�/�_ - 5W
, Fax # ( )
Authorized Agent
Affected El CW
El EW
aPTA El ES ❑ PTS
AEC(s): ElOEA
ElHHF
1-1IH C UBA El N/A
� PWS:
r. FC:
ORW: yes / no
PNA
yes / no Crit. Hab, yes / no
Type of Project/ Activity
rtl„ We
Pier (dock) length
Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length �—
avg distance offshore
max distance offshore
Basin, channel
cubic yards_
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other Z1�
Shoreline Length 3r;
SAV: not sure
yes tib
Sandbags: not sure
yes Ko .
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
t -
Application Fee(s) Check #
❑ Rules attached.
Project Location: County Pl- nl�it�
Street Address/ State Road/ Lot #(s) ; , ,�{ .s�' 1.3JR4
Subdivision
City i r r,Tr ZIP
Phone # ( ) River Basin ev G.
Adj. Wtr. Body ' 4 a iC C t &k. (nat %man /unkn
Closest Maj. Wtr. Body !Cos ;R,ie%
/I - rL rg0-Y VI
Y41-' (Scale: )
See note on back regarding River Basin rules.
G Permit Officer's Si�nattire
a .) rr
IssuingDate xpiration Date
r,7,t i /� t1
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:
E Tar- Pamlico River Basin Buffer Rules U Other:
l__ 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 howto complywith thesebuffer rules.
Division of Coastal Management Offices
Central Office
Mailing Address:
1638 Mail Service Center
Raleigh, NC 27699-1638
Location:
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293 / 1-888-4RCOAST
Fax:[phone]
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)
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

BROAD CREEK CONST INC.
11 Cree iew o3
11 Creekview Court
Merritt, NC 28556
PAY FC)
T1IF0 DER OF
2
WA010"A
unrr
7853
66-152/531
s.e.nlF
ILl,1 Dsl.11. on
B.cF.
Wachovia Bank, N.A.
,i @gbema NC 29515
FOR-
1:053 1015 291: 078 L 00124011, 7853

ADJACENT RIPARU�N PROPERTY OWNER STATE.NLENTI'
(FOR A PIER/MOORING PILINGSIBOATLI� BOATHOUSE)
I hereby certify that I own property adjacent to RICK t KV571 W11-7-0V 's
(Name of Property Owner)
property located at x 0-F # 61 65-1 Q 04IL 217 • . 41191 TT. At, LWT
(Lot. Block, Road, etc.)
on �i45TJ �E C'2,��K , in )94111-I Co e0VAMI , N.C.
(Waterbody) (Town and/or County)
He has described to me, as shown below, the development he is proposing a: that location,
and, I have no objections to his proposal. I understand that a pier/mooring
pilings/boatlift/boathouse must be se: back a minimum distance of fifteen feet (15') from my area
of riparian access unless waived by me.
305tJfLL AOT IN S
I do not wish to wai%-e the setback requirement. ,
I da wish to waive that setback requirement.
----------------------------------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWM OF PROPOSED DEVELOP`fE\-T:
(To be filled in by individual proposing development)
---------------------------------------------
------------
Signature
Print or Type Name
Telephone Number
Date: z�2 X'

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