30668_WILLIFORD, KURT_20020226

i
` F-1CAMA / ❑ DREDGE & FILL
GENERAL PERMIT
-New ❑Modification ❑Complete Reissue Partial Reissue
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 NC/
Applicant Name
Address rj 1E�}<;'g�
i'
109
City i rmA-\ J , I le
Stated ZIPQ %
Phone #>-
t/; C�'� Fax # ( )
Authorized Agent WV,
t `r
i�C, , ! ,_ , , ,._..
Affected ❑ Cw
R EW
ETA ❑ ES ❑ PTS
AEC(s): ❑ OEA
❑ HHF
❑ IH ❑ UBA ❑ N/A
CPWS:
❑ FC:
ORW: yes / no
PNA
yes / no Crit. Hab. yes / no
Q.
Previous permit #
Date previous permit issued
❑ Rules attached.
Project Location: County ! (rk\ _'r
Street Address/ State Road/ Lot #(s)�
Subdivision
City ZIP
Phone # (_ ) River Basin ''' \cL t, :e
Adj. Wtr. Body_ rya /man /unkn)
Closest Maj. Wtr. Body -'1 W
Type of Project/ Activity
(Scale:
Pier (dock) length-
Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Nprap length
avg distance offshore_
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
Shoreline Length
SAM not sure yes no
Sandbags: not sure yes no
Moratorium: n/a yes no
Photos: yes no i
Waiver Attached: yes no
A building permit may be required by:
Notes/ Special Conditions , /
I � C 1 �.ri nfF . 1 ✓ f ��1 ,_ ", i r (,k t-[lw 14fAte tv%r;
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit
Applicatiolf
nee(s) Check #
C See note on back regarding River Basin rules.
k
Permit Officer's Signatu e
Issuing Date 9xpiration 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 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:
[ J Tar - Pamlico River Basin Buffer Rules �_I 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

9
e�
0
0
[, Security enhanced d o c u m e n t 5 e a b a c k far d e I rt i l S. ®
COASTAL MARINE CONTRACTORS INC
6367
PH. 252-638-6407
PO BOX 12729 r
NEW BERN, NC 28561-2729 - 27 _ d 2 66-112/531
DATE 01901
PAY Cl lJ
TO THE
ORDER OF $
DOLLARS
BMT
BRANCH BANKING AND TRUST COMPANY
/NEW BERN, N/qPT/ H/CAROLINA
FOR✓
00636711' ':OS3LOLL20:SLLOLL269,Bu'

Fc�b 19 02 02:19p Haroldson 252-838-8110 p.1
02/18/02 12:21. FAX [phone] SPRINT U 00]
ADJACENT RIPARUN PROIY RTy OWN]E2 STATFAMEN'I'
(FOR A PIERIMOORING PHJNGS1B0A7iIFf1B0ATH0USE)
I hereby certify that I own property adjacent to Zv r 4 's
(Name of Property Owner)
Fly located at ? 3 (r 3 07J lVQu
etc.)
on a �v T W r G r in �fZ•� r_a/
> N.C-
(Waterbody) (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 pierlmooring
Pihngs/boad ft/boathouse must be set back mupmum distance of fifteen fleet (15') from my area
of riparian access unless waived by me.
f I do not wish to waive the setback requirement.
I -do- wish to waive that setback mgairemeut
DpSCRIPTION AND/OR DRAWING OF PROPOSED DEVEZ,OPMMN'T:
(Tp be ja7led in by individual proposing development`)
1 �
1 / I
% �S
(�U
Print or Type Name
Telephone Number
Date: 7,' 14 0 2--
I
L-0