32822_WILLIAMS, GREG_20020912

* ^ 7CAMA / ❑ DREDGE & FILL 32822 ,
GENERAL PERMIT ``1
Previous permit #
!!New EModification ICom fete Reissue 'Partial Reissue
P 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
❑ Rules attached.
Applicant Name Project Location: County
Address Ut 0 r. Street Address/ State Road/ Lot #(s)
City_ r,,`j ��- State �t ZIP <y
Phone # ('F_ --') ; ,
' ;r, - i �! . Fax # O
Subdivision_
Authorized Agent f r-,
i i ,, ; ; r '
City___ - _ _ ----- —__-- ZIP_-—
❑ Cw
❑ EW
Q-PTA ❑ ES J PTS
Phone # (_—_) River Basin
Affected
_ _ _
AEC(s): OEA
C HHF
❑ IH ❑ USA J N/A
Adj. Wtr. Body (nat /man /unkn)
❑ PWS:
—j FC:
ORW: yes / no
PNA
yes / no Crit. Hab. yes / no
Closest Maj. Wtr. Body
I
Iy e of Project/ Activity
.
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Signature
Application Fee(s)
rAI/ i
statement on back of permit **
Check #
Issuing Date Expiration Date
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 title 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: Fax: [phone]
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293 / 1-888-4RCOAST
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)
www.nccoastaimanagement.net
Revised 10/05/01

UNITEDSTATES POSTAL MONEY ORDL`
POSTAL SERVICES
90796 D4068
pOST OFFICE U.S. DOLLARS AND CENTS
SERIAL NUMBER
YEAR. MONTH, DAY
CHECKWRITER
IMPRINT AREA
PAY TO J
FRO �
ADDRESS l ADDRE�ysj
C.O.D. NO. ORj- 32��2 Z W /Gcr�
USED FOR C3
SEF
1:00000800 21:
NEGOTIABLE ONLY IN
9079G3040G131"
u.. AND
IONS

Se.it By: =URCUE PHALIACE�TICALS °.; 252 243 2533 ; Sep-12-02 7:04AV; ?age 212
OW Jl AMY 06: 40 2527263018 ; ARRY G ARNOL D PAGE 02
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
T
OR A PP - FNCOIVERED BOAT LIFT)
r
I hereby certify that I own property adjacent to
{'Na a o(Pt'rTptCiyOwner)
property located at. -
(Lot, to Ros d, etc.)
aft
in . rdtr.
g W rbady) (Town and/o County)
IIe has described to me, as shown below, the devetvpment he is proposing at than location,
and I love no, .objections to his proposal. I understand that a plea•/uncovered boat licit most bt e`iet
back set a minimum of fifteen (151) from my area of riparian access unless waived by slat.
Ida trot wish to wtifve the setbuk requirement,
i At wish to waive that setUck requiremarst
DESCRIPTIONAN", R. D W G F PRO POSa �VLOPMEMF'
(To be filled in rn o sing development)
G x� +
Sig prim« or Type Name -- -
I el®pFa ne ?v'camber Bare
_. ----

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
FOR A PIE NCOVERED BOAT LIFT)
I hereby certify that I own property adjacent to
property located at
U
fit
(Nie of Property Owner)
's
(Lot, Block, Ptoad, etc.) v
on in 1P, NC.
( aterbody) (Town and/or,' ounty)
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 at a minimum of fifteen (15') from my area of riparian access unless waived by me.
I do not wish to waive the setback requirement.
1y� I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
C +Y
elephone Number
l �-
Print or Type Name
Date
I t