33136_BENJAMIN, JACK_20030113

�-ICAMA / DREDGE & FILL r, I 33136 -c
GENERAL PERMIT
Previous permit #
[_]New _ 'Modification 'Complete Reissue [_'Partial 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 15A NCAC
❑ Rules attached.
Applicant Name ;roc l:frJ1AM1rj
Address 5-01 SOS Vf• Pr vP '�'v 0414„, tare
City . k E. —_-State' N)ZIP?F9;U 1gp1
Phone # L �3tf Fax # ( )
Authorized Agent
Affected D CW ❑ EW O PTA 0 ES Efl PTS
AEC(s): ❑ OEA ElHHF ❑ IH ElUBA ElN/A
❑ PWS: OFC:
ORW: yes / no PNA yes / no Crit. Hab. yes / no
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision ! Ott)
City i jc+r Zip 1C r3 2-
Phone # ( ) River Basin /1 v ,r
Adj. Wtr. Body /�, ow/ '�+ + _ (fiat' /man /unkn)
Closest Maj. Wtr. Body
Type of Project/ Activity ri ii V rK'1
PPfIM 1!�,! /io. �rdi. t,1 (Scale:
Pier (dock) length
Platform(s)
Finger piers) !
Groin length
number
Bulkhead/ Riprap length
avg distance offshore—
max distance offshore'
I
Basin, channel
cubic yards _
Boat ramp
Boathouse/oat�ift t { ) It
I
Beach Bulldozing
Other %'I ii
rf
Shoreline Length
SAM not sure yes no`
Sandbags: not sure yes no
Moratorium: n/a yes no
Photos: yes no��
Waiver Attached: yes no
A building permit may be required by: L4.
Notes/ Special Conditions %Gy
•. + I' Cis �.
l> �•
li
i II +'ra
1
-
1 =
1
;
�w
i
-
(cam_
t1
on back regarding
E�1 firu IPc+
1`
1
ysff 0.
+ O Ip v[
I See note
Mui rt 1 a
River
G
Basin
_
rules.
YJ hr Ao A i-jk*
4 r I
,t►t�n�.
r. .. i.­,'wcfi
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit*
Application Fee(s) Check #
Permit Officer's 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:
[] Tar - Pamlico River Basin Buffer Rules ❑ Other:
[X 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 / 1-888ARCOAST
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

PAY
TO THE
ORDER OF
—_ n h n n r r d d_ o r n e n f. i7- F a r k Jp Q��—I MS
v�33�3o DES-SA„1�t3Lsow1 6043304a
�Q
LANDSCAPE INCO'k-2 t3)
SANDLAND LAWN & az c,
105 GREAT NECK 33 ► cEs MALi Sx1 66-30/531
HAVELOCK, NC 28532-9092 6-P_tt,33 i 3`} UEAtz F(^1CH 278
PH. 252-447-5898 DATE /- 0 --
I
$
DOLLARS
IA R5T CIT17.CN5 s18
pirst.Citizens Bank Company
SANK Havelock, N.C. 2853Trust
2
www.firstcitizens.com
FOR E/
nennn; iRe j:0 5 3 L00 300i:00 2 78 2 3 L9 7 36ii'

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to S�-O-k .4- AR kEN E t3FN1F1,y�,�,
property located at ,(v'r -y-YN E,-q RQ ►a ►4ve�oa K 0, WArFR wi4 � Ed,( &
(lot, block, road, etc)
on �cfAm_S CREEK in
(body of water) (town)
North Carolina in C AvF County. The proposal has been described to
me as shown below; the development, a ier bulkhead/structure, and the
(circle one)'
proposed location, and I have not objection to the proposal. I under-
stand that if the development is a pier, it must be set back a minimum
distance of 15 feet from my area of riparian access unless waived by me.
I,Q/do not wish to waive that setback requirement.
circle one)
Description and/or drawing of proposed development: (to be filled in by
individual proposing development). INDICATE THE SIZE AND LOCATION OF THE
STRUCTURE AND THE DISTANCE BETWEEN EACH PROPERTY LINE AND THE WATER.
94 z-(f&o, ,_31%2-
r �' from
Q
c; L
� b-t 44
(Original must be retained in the Inspection Department)
' gnature
Date F
Name-7P ease Print)