34504_AVERY, PETE_20030625

DICAMA / ❑ DREDGE & FILL
GENERAL PERMIT Previous permit #
❑New ❑Modification []Complete Reissue ❑Partial Reissue Date previous permit issued a
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 I SA NCAC -
I] Rules attached.
Applicant Name f e4, d vr. y Project Location: County
Address 3w Jr Street Address/ State Road/ Lot #(s)
City A.A �.r �fe �j State NE" ZIPS%s
Phone # (" 1'1) *I?( %gE E Fax # ( )
Authorized Agent
Affected I] CW O EW ❑ PTA ❑ ES ❑ PTS
AEC(s): OEA ❑ HHF ❑ (H ❑ UBA ❑ N/A
❑ PWS: OFC:
ORW: yes / no PNA yes / , no Crit. Hab. yes / no
Subdivision
City J')'�L-.w r'X ZIP 7c- S 7'0
Phone # ( ) River Basin Olt � s67- 1t
Adj. Wtr. Body ,(hat /man /unkn)
Closest Maj. Wtr. Body
Type of Project/ Activity aE d• ft r, !, r�ri f ' + t".
NI'OfAA IlJ4 r�rd �iw4 1 tti- r�./tf (Scale: A)cNC )
Pier (dock) length ' c K'C,
Platfo
Finger
Groin
Bulkh
Basin,
Boat ;
Boath
Beach
Othe;
Shore
SAM
Sandi
Moral
Photc
WaivE
r
n
—i
m(s) 14- t
i !
pier(s) T
length I
-
umber -- ---- - -
_ t
!ad/ Riprap length
vg distance offshore I _� ry �� L- a _
nax distance offshore
channel I -
t
-- -
ubic yards 1 z:
amp i
ruse/ Boatlift
i
Bulldozing
I
- -- —
me Length
not sure yes no --
ags: not sure yes
Y __I �i� I YHF-, _ ic'
orium: lna es I I
>: yes C, I
71
r Attached v'Psl nn I
A building permit may be required by: �'>I It ++ El See note on back regarding River Basin rules.
Notes/ Special Conditions f- All �, i ' My Q j/l /y 4',t 4v ti G /•) �'� •/ r �' �I �t: b• ryL1 C v� d t% 7/ p« c ; ,/. cf
?.{p INI�e'I YM �CIO�'U CIA�1 U� '44
W IGCr/( (,k-� C{sGNNpI J•'� �UJt� Gf'f1�''rOr.7
tAli S NP %1:iM�f H^�Int��� C 6/?ip� i •,� �Y%Yfrii 7--� 'l y1_ l./ L� �i !✓'� J1+0rC%+!���rIC��
Agent or Applicant h'rinted Name
Signature * Please read compliance statement on back of permit"
fG(, CC J
Application Fee(s) Check #
Permit Officer's Signature
� ?(. ( 3
Issuing Date Expiration Date
�tr� rr-f4 J tI /
Local Planning Jurisdiction Rover File Name
A building permit may be required by: �'>I It ++ El See note on back regarding River Basin rules.
Notes/ Special Conditions f- All �, i ' My Q j/l /y 4',t 4v ti G /•) �'� •/ r �' �I �t: b• ryL1 C v� d t% 7/ p« c ; ,/. cf
?.{p INI�e'I YM �CIO�'U CIA�1 U� '44
W IGCr/( (,k-� C{sGNNpI J•'� �UJt� Gf'f1�''rOr.7
tAli S NP %1:iM�f H^�Int��� C 6/?ip� i •,� �Y%Yfrii 7--� 'l y1_ l./ L� �i !✓'� J1+0rC%+!���rIC��
Agent or Applicant h'rinted Name
Signature * Please read compliance statement on back of permit"
fG(, CC J
Application Fee(s) Check #
Permit Officer's Signature
� ?(. ( 3
Issuing Date Expiration Date
�tr� rr-f4 J tI /
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, certifythat 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:
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293 / I-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)
www.nccoastalmanagement.net
Revised 10/05/01

AIDJACEINTI' RIPARL- N PROPERTY OWiN-ER STAT:t 1 ENT
(FOR A PIER/MOORING PILINGSIBOATLIFTIROATHOC-SE)
I hereby C2:� fy that I own properly adiacent toAlj/z -' gen�Y r ,s
(Name of Property Owner)
proF'�:Ty lcc'-tc'�J at
(Lot, Block, Road, etc.)
on e:�515r 7Z h--=EFk , in C'f�ZT,�T2�� r�7LIoSCry , N.C.
(Waterbody) (Town and/or County)
He has desc-Libed to me, as saown below, t, e development he is proposi-_ a_ Chat location,
and, I have no oojections to his proposal. I unde=d a pier/mooring
pui:icsr voatil ulDoathouse rnusi be sz_ back a minimum distance o- F 1Lezn fe`, From my a e
or access unI-zss waived by me.
I dn not wish to waiv-- tr,e setback requir.-m--r�:.
l� I �n wish to waive
DESCRIPTION A.ND/OR DRAWr G OF PROPOSED DEVELC)D`IEtiT:
(To be filled i:: by indiyidufl proposir.; c relo�rzenc)
SiEna_urt
D-,rv,) !� 1'� . G Pa 8p
Print or Type Name
Telephone Number

ADJACEIN—f RIPARL�T
N PROPERTY OWNTR STATEMENT
(FOR A PIER/MOORING PILINGSIBOATUFTIBOATHOUSE)
I hereby certify that I own property adjacent to /AZ7 jZ `/ "sy.
(Name of Property Omer)
property Iocated at �iL J f-=-/ /- -1 Z�2 />
(Lot; Block, Road, etc.)
on C ;6,),-)S� , '— -/—
c 1-2% �c3t .:%T 7; N.C.
(Waterbody) (Town and/or County)
He has described to me, as s1hown below, the deve'.opmen: he is proposi-_ Z7 t: at location,
and, I have no objections to his proposal. I unders=.-d tha: a pie ,-'moor�n2
pEi.nas roatD:A- oathouse must be s..: back a minimum distance of ri�eea feet (5) tom my area
of riparian access unless waived by me.
I do rint wish to wa:v-- the setback requireme:,t.
I an wish to waive t`.at setback requirement.
DESCRIPTION AND/OR DRAWD G OF PROPOSED DEVELOP IEN-T:
(To be filled ir by individual proposirz; developmerzt)
Print or Tvoe Name
Telephone Numbe-
Date: