33956_BANDY, DON_20030430

CI CAMA / DREDGE & FILL r(�
GENERAL PERMIT _ Previous permit # ��
C_'INew !_ Modification C 'iComplete Reissue LJPartial Reissue 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 I SA NCAC r ���JT �''
❑ Rules attached.
Applicant Name 6 AN ,>,J Project Location: County %6 r 4 <v e,4
Address
City- F curt ( k 1 state ZIP `k�.�
Phone # (<`I G) S `I Z 510 Fax # ( )
Authorized Agent h)(
Affected 0 cw
AEC(s): OEA
❑ PWS:
ORW: yes / 'no
O EW 91 PTA ❑ ES C PTS
❑ HHF ❑ IH ❑ USA O N/A
❑ FC:
PNA yes /' no Crit. Hab. yes / no
Street Address/ State Road/ Lot #(s)
Subdivision
City- 'ur - ZIP NV2_
Phone # O River Basin
Adj. Wtr. Body N d N +ter d < '. fiy o + (nat /man /unkn)
Closest Maj. Wtr. Body Lr N v :i u ti r� _
Type of Project/ Activity
N N
- bo:
1� -�rl �.
�,x ,i, H . �«
7 it
M u ri
/�w c t ��
�t +�
<<'►� J� u r
(Scale:.✓c,✓�'
I
)
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
r
Boathouse/ atli Li to 4V4-4d
+
Beach Bulldozing-------
Other
i
I
-
I
-
J •*Ji
-
C kv
i
I
II
i
JL
+
I
i
"-
:
Shoreline Length
SAV: not sure yes Ito -
Sandbags: not sure yes o
- - — -
Moratorium: n/a yes brio I
Photos: yes ho _ =—
Waiver Attached: yes no ! ► !(
A building permit may be required by: �pin"h< &of � ❑ See note on back regarding
/r River Basin rules.
Notes/ Special Conditions (� 4 "JAM str �r (. (iNt�r j / 11c^4L -*fd gp
//�'� ' �� 4 u 1 L�„ � �z, - A. sr'/ A0 + 1" i
fit/ )VrIVI,
Agent or Applicant Printed.N e
Signature Please read compliance statement on back of permits (�
j.I ' f. L . C C i��l oe�i L
Application Fee(s) 'heck #
ia /)4K
Permit is Signature
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 that this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
Ej 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 / 1-888ARCOAST
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)
www.nccoastalmanagement.net
Revised 10/05/0 )

HOLD DOCUMENT UP TO THE LIGHT TO VIEW TRUE WATERMARK
HOLD DOCUMENT UP TO THE LIGHT TO VIEW TRUE WATERMARK _ r 278212512 10.86/220
1028105
Pay To The Order Of bt / 3 0 / 2 0 0 3
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Dollars
*ONE HUNDRED DOLLARS AND 00 CENTS
Sender �
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Address V l" �C F X i i / Gi %�
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WACHOVIA
Not Good For More Than $1,000.00
Issued by Integrated Payment Systems Inc., Englewood, Colorado _ ---_------
To Citibank (rdew York Slate), Buffalo_N Y __.__---___—_—______—_------------
il' 3 S09 2 711' i:0 2 2000868D: 6800 2 78 2 1 2 S L 2611'
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>'TT.f1 r'Te'Wir' WN�R L'TA '..:ATE`11.
(FOR A PIERI UNCO VERED BOAT 41F1)
I hereby ce; tify that I own property adjacent to
(N�_me of Property Owner)
property Iocated at / BiV'7',/ Q� ��'/ q L9 2�
(Lot, Block, Road, etc.)
on i.-i — /���. Nf e �J 'c -
(Waterbodv) (Town and/orl County)
He has described to me, as shown below, the develop*nt he is proposin.- at that
Iocation, and, I have no objections to his proposal. I understand Ghat a pier/uncovered boat lift
must be set back a minimum distance of fifteen fit (I5') from myjarea of riparian access unless
waived by me.
I do rot wish to waive tie setback r�um ueent.
I do wish to waive that setback requirement.
DESCRIPTION -A.:N-D/OR DRAWS G OF PROPOSED DEVELOP_Nf ENT:
(To be filled in by individual proposing devel+pment)
,L /Oi;�/,�G ova
--
------------- -------- ---------- -------------- -------------
Signature
&
Print or Type Natm/e
Telephone I umoTr
Date: 1�1` 1 d-1-3

TI,3t.x.^i l ( i�nl' .: I 1'� OEP 'r
Lam_ .z
' (FOR A PIER'UNCOVERED-BOAT LIFI)
I hereby ce, tify that I own properry adjacent to
('N�me of Property Owner)
property located at .208 1-001jeo/
(Lot, Block, Road, etc.)
on M TO
(Waterbody) (Town and/or nty)
He has described to me, as shown below, the development he. is proposing at that
Iocation, and, I have no objections to his ororosaI. I understand 1" at a pier/uncovered boat lift
must be set back a minimum distance or n-�ern r"e�t (IS') from mylarea of riparian access unless
waived by me.
• 1
/ I do not wish to waive the secb_ck require.-Ident.
✓ I do wish to waive that setback reauirernent.
DESCR=O?N+—N-D/OR DRA WDiG OF PROPOSEDiDEVELOP-MF—N-T:
(To be Fdlled in bY individual propo,,sing deVOIPMerzt)
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Print or Typz Name
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Telephone Numb�r
Date: -
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