33667_BLALOCK, BENTON AND CHARLES JONES_20030402

•ItCAMA / ❑ DREDGE & FILL
GENERAL PERMIT t-~~'
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
Applicant Name
Address
City N1 F t �r+ " State ,,/f ZIP
Phone # ( ) 1s y- eel' -3 Fax # ( )
Authorized Agent
Affected CW ❑ EW © PTA ❑ ES ❑ PTS
AEC(s): OEA [IHHF ❑ IH ❑ USA El NIA
PWS: ❑ FC:
ORW: yes / no PNA yes / mo Crit. Hab. yes / no
D Rules attached.
Project Location: Countyi,., , � r, ,
Street Address/ State Road/ Lot #(s)
Subdivision
City
Phone # (),
ZIP ''r'� f-?.'
River Basin W� • 1, To K
Adj. Wtr. Body bcrt l � Jc L -- d (nat /man /unkn)
Closest Maj. Wtr. Body-- '`Iror rcU&I
Type of Project/ Activity I r c l'c i,
V n f c
t v.
J
(Scale: i✓,r��E
)
Pier(dock)length
Platform(s)
Finger
Boatramp
Boat
Beac
Othe
Shor
SAV:
Sand
Photos: Waiver Attached:
A building permit may be required by: �� , 11).
Notes/ Special Conditions ��'j//�c nod ({i
rrle G.�,i �IFIMr'�.UNe a fd'vi�
rules.
-1 / c . � See note
rL' kipdt.f i- 0v C r i r• [� . f.rtt'
on back regarding
River Basin
it ^, /.� tl /�.l
pier(s) —
n length
f N L N G
number
head/ Riprap length
avg distance offshore
max distance offshore
I {
channel
cubic ands i
Y I f V 1
house/ oa ft t'!*rc.t.t�f�
h Bulldozing
_ e
eline Length
not sure yes no
I � � t
bags: not sure yes no ,
I;�ePtYryr r tt _ I � I
atorium: n/a yes no
os: yes no
i is-1� I it t N�-S_�
I i
Agent or Applicant
Primed Name
Signature ** Please read compliance statement on back of permit
Application Fee(s)
Check #
Permit Officer's Signature
y
Issuing Date Expiration Date
Local Planningf urisdiction 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 71 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 / I-888-4RCOAST
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
151-13 Hwy. 24
Hestron Plaza If
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.nccoastaimanagement.net
Revised 10/05/01

1968
BENTON C. BLALOCK 66-152/531
NCDL 2216822 PH 910-346-8855
1:23 ALDERSGATE ROAD DATE
JACKSONVILLE, NC 28546
YTO TI IL
.DER OF
jq/x/ DOLLARS
---W-A(H0"A
Wachovia Bank, N.A-
jmk.,nvjll., N(; 28540
L-0-1
:053 Lo LS 291: 4180
OHARLAND

ADJACENT RIPARLkN PROPERTY OW]NIR STATE--�,LE,,,-T
(FOR A PIER/MOORING PILINGSIBOAIZIFT/BOATHOUS'c)
x�*t��v d
I hereby certify that I own property adjacent to4�,��
(Name of Property Owner)3r---
prcc,t. l
(Lot. Block, Road; etc.) '
on
(Waterbody) , N.C.
(Town and/or County)
He has described to me, as shown below, the development he is proposi-_ a_ that Location,
and, I have no objections to his proposal. I understand tha_ pie,,/mooring
piiinpz'boatlirt/boathouse must be se: back a minimum distance of fize..n feet ,
of riparian access unless waived by me. " ( )from my area
I do not wish to wa ve the setback requirement.
I LI-Q wish to wa•�*v t
e C.2t setback re >>ire„ exit.
DESCRIPTION AND/OR DRAWriG OF PROPOSED DEVELO` :
(To be •filed in by individual propasin; development)
SEA � fA2E
Si`nature
P<<nt or Type--------------
Name
=1
Te'.epnone ember
Dale:

ADJACENT RIPARLAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGS/BOATLIFTIBOATHOC-SE)
I hereby certify that I own property adiacent toC%/�Q,�� z!•/1��J
(Name of Property Omer)
prone: Ly icc—,ted at
(Lot. Block, Road, etc.) '
in
(Waterhody)
' N.C.
(T�wnand/or County)
He has described to me, as shown below, the development he is proposi-, a: that location,
and, I have no objecdons to his proposal. I understand tha: -a pie;; mooring
Pdin°s,`boatlift/boathouse must be se: back a minimum distance of fifteen fen; from my area
of ri:-ia pan access unless waived by me.
I do not wish to wa %"e the setback requirement.
I d-Q w'ish to w"ve t:_, se,bac.< r=-u irement.
---------________--
DESCRIPTION AND/OR DRAWr+G OF PROPOSED DEVELOPMENT:
(To be fZlled in by individual proposirz; development)
------------------------
i e.'epnone NLmbe7
Da[e: �,

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