30510_ZDEP, JOHN_20011218

- LJ CAMA J ❑ DREDGE & FILL
S (� o 30510 -e
GENERAL PERMIT
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ZNew ❑Modification ❑Complete Reissue ❑Partial Reissue
Previous perm #
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 LC
® Rules attached. j
Applicant Name
Project Location: County �`� • .� 1 ; t
Address 4`3C cnu t-V-11f f- -vt
Street Address/ State Road/ Lot #(s)
City- 4,tgCJ State k,I ZIP ?85'30
Phone # '�7 `� Z r ` I "! Fax #
Subdivision - i
Authorized Agent �.c 4. P�r r (�i
City )"vow (G 4 ZIP t ;7 7+ 7
Affected El CW El EW Z PTA ❑ ES PTS
Phone # ( ) River Basin
❑ OEA ❑ HHF ❑ IH Ci UBA J N/A
AEC(s):
Adj. Wtr. Body ( e C;-: l.r` d (nat Jman Junkn)
❑ PWS: FC:
ORW: yes /(5n PNA yes / no Crit. Hab. yes / no
Closest Maj. Wtr. Body Fw,l` ° r'
Type of Project/ Activity
(Scale:
Pier (dock) length
Platform(s)
:%�.ff �iYiek
Finger pier(s)
Groin length --.
number�� J - -
_. �QV
Bulkhead/ Riprap length -'
avg distance offshore
max distance offshore
Basin, channel
cubic yards I M
3-
Boat ramp -- - -
Boathouse/ Boatlift
i
Beach Bulldozing
Other
Shoreline Length _
SAV: not sure yes no --- ----- t), 1� �_�A i
1 llyeiJ rf its
Sandbags: not sure yes no t �k
i
Moratorium: n(a yes no -- i
- - — -
Photos: yes no f 1(—
;^
Waiver Attached: yes no -
A building permit may be required by: c , i t , t i �c.Utla•! II ❑ See note on back regarding River Basin rules.
Notes/ Special Conditions �J � � i 4 f u I c i' d+i, rin 1J,
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Agent or Applicant Printed Name
Signature Please read compliance statement on backof permit
41
Application Fee(s) Check #
Permit Officer's Signature
C 1 (• � � � J l -, e�
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 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 thatthis 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
Mailing Address:
1638 Mail Service Center
Raleigh, NC 27699-1638
Location:
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293 / 1-8884RCOAST
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 10/05/01

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SERIAL NUMBER YEAR MONTH DAY POST OFFICE - I U.S. DOLLARS( AND CENTS
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ADJACENT RIPA.RL- N PROPERTY OWNER STATEMEINT
(FOR A PIER/MOORING PILINGSIBOATLIFT/BOAATHOUSE)
I hereby certify that I own property adjacent to _ 30U.4l ZC4�"l -�5-02V zN�'s
(Name of Property Owner)
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Property located at •��7` � 6� OG k� �% ! I S��D 5�.� �T y ✓r",
(Lot. Block, Road, etc.)
on ��lT✓�DaaSi�.1 Gt1��yal�y , in r7- 7`e,-e , 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 pier/mooring
pilin gs/boatlift/boatho use must be se: back a minimum distance of fifte--n feet (15') from my area
of riparian access unless waived by me.
K I do not wish to wave the setback requirement.
I d_Q wish to waive that setback recuirement.
DESCRIPTION AN`D/OR DRAWP G OF PROPOSED DEVELOPNfE\?:
(To be filled in by individual proposing development) .See 07XI" S16F
)BioL�41--e4
Sic,natu
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Print or ype Name
7�J 2 33 _
Telephone Number
Date:

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ADJACENT RIPARL-kN PROPERTY OWNER STATEMENT"
(FOR A PIER/MOORING PILINGS/BOATLIFTIBOATHOUSE)
/7 31
I hereby certify that I own property adjacent to`jiJ��
(Name of Property Owner)
property located at �JQ �-ez �� t%F'
(Lot. Block, Road, etc.)
Core C-re,
on �i�r✓aLa�S�.l 46isTrAl'?y
(Waterbody)
in /v, r ' , N.C.
(Town and/or Countv)
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/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.
I do not wish to waive the setback requirement.
I d_ wish to waive that setback requirement.
-------------------------------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWLN-G OF PROPOSED DEVELOPNIE\-T:
(To be filled in by individual proposing development) See 0"I '
Signature
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PR r Type Name
SS3-7o-3
Telephone Number
Date: / z✓b %i/ ©�

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