33990_CARLSON, ERIK_20030507

D CAMA / ❑ DREDGE & FILL
GENERAL PERMIT
EINew ElModification OComplete Reissue ElPartial Reissue
-a,
Previous permit #
Date previous permit issued
As aut: orizecl by the State of North Carolina, Department of Environment and Natural Resources
and the Coastil Resources Commission in an area of environmental concern pursuant to 15A NCAC
E Rules attached.
Applicant Name
-'i v
Address
City (ch r' kc- 1Ac k
State V ZIP. 341
Phone#
7 0
Authorized Agent
Affected El Cw i�M
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AEC(s): El OEA El HHF
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D PWS:
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ORW: yes / o PNA
yes / no Crit. Hab. yes / no
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision
City i'C) aJ ZIP
Phone# River Basin
Adj. Wtr. Body I " tc i y EQ Cat _man /unkn)
Closest Maj. Wtr. Body— NC'kj->c 'N4ce
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Agent or A4)plicant ,Panted N;4rner
Signatup( Please read compliance statement on back of permit"
Application gee(s) Check #
Permit Officer's Signature
Issuing Date Expiration Date
f lie
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 [)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:
❑ r- Pamlico River Basin Buffer Rules ElOther:
KNeuse 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 / 1-888-4RCOAST
Fax: [phone]
Elizabeth Citv 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 Citv 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.nccoastaimanagement.net
Revised 10/05/01

PAY
m TO THE
ORDER OF.
e n h a n c e d d o r u m rn t. -5 e e b n
DAVID SIMPSON CONSTRUCTION CO. INC.
800 BROAD ST.
P.O. BOX 590
ORIENTAL, NC 28571
16345
DATE - 03 66-30/531
472
DOLLARS
472
BANK
NK Firsi.Citi` Bank 8 Trusl Company
li Onontal, N.C. 28571
LL ti / www.firstc'tizens.com
®L FOR iEC�t21SL� L PC 3�J�7�I�
II'0 16345u' :0531003001:004711007D?9n' --- --Aop
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PAMLICO COUNTY BUILDING INSPECTIONS
P.O. BOX 776
BAYBORO, NC 28515
(252) 745 - 3861
ADJACENT RIPARIAN PROPERTY OWNERS STATEMENT EPN#
I HEREBY CERTIFY THAT I OWN PROPERTY ADJACENT TO MR. ERIK CARLSON
NAME OF LANDOWNER PROPOSING DEVELOPMENT
ON BRITES CREEK NEAR ORIENTAL LOT # 37 & 38 NEUSE WINDS
Body SUBDIVISION, IF APPLICABLE
TAX PARCEL
COMPLETE DESCRIPTION OF HOW TO LOCATE THIS PROPERTY: OFF SR 1308 @ 88
WINDMILL PT. FOOT OF ORIENTAL BRIDGE
THIS PROPOSED PROJECT: IS TO INSTALL A DOCK & BOAT LIFT WITH NO ROOF AS SHOWN ON
THE ATTACHED DRAWING.
FOR A PIER, CHECK ONE OF THE FOLLOWING:
I WISH TO WAIVE THE 15' MINIMUM SETBACK FROM MY RIPARIAN ACCESS.
I DO NOT WISH TO WAIVE THE 15' MINIMUM SETBACK REQUIREMENT
SEE ATTACHED DRAWING
After this form is completed by the landowner proposing the project, a copy is given to the adjacent landowners for their
consent and signature. The forms are then returned, along with a building plan and other applicable required information,
to the building inspection office for building permit application/processing.
SIGNATURE Z� CIA CA Q d � , 6AI'!�Al, ( DATE H - '� 0 ` (� 3
PRINTED NAME G f, R R i j .l at- Ca) n n L1R S

PAMLICO COUNTY BUILDING INSPECTIONS
P.O. BOX 776
BAYBORO, NC 28515
(252) 745 - 3861
ADJACENT RIPARIAN PROPERTY OWNERS STATEMENT EPN#
I HEREBY CERTIFY THAT I OWN PROPERTY ADJACENT TO MR. ERIK CARLSON
NAME OF LANDOWNER PROPOSING DEVELOPMENT
ON BRITES CREEK NEAR ORIENTAL LOT # 37 & 38 NEUSE WINDS
Body SUBDIVISION, IF APPLICABLE
TAX PARCEL
COMPLETE DESCRIPTION OF HOW TO LOCATE THIS PROPERTY : OFF SR 1308 @ 88
WINDMILL PT. FOOT OF ORIENTAL BRIDGE
THIS PROPOSED PROJECT: IS TO INSTALL A DOCK & BOAT LIFT WITH NO ROOF AS SHOWN ON
THE ATTACHED DRAWING.
FOR A PIER, CHECK ONE OF THE FOLLOWING:
I WISH TO WAIVE THE 15' MINIMUM SETBACK FROM MY RIPARIAN ACCESS.
x I DO NOT WISH TO WAIVE THE 15' MINIMUM SETBACK REQUIREMENT
............. 0 ............................ ■ ■ .............................. ■
SEE ATTACHED DRAWING
After this form is completed by the landowner proposing the project, a copy is given to the adjacent landowners for their
consent and signature. The forms are then returned, along with a building plan and other applicable required information,
to the building inspection office for building permit application/processing.
SIGNATURE V
PRINTED NAME a�--Lk:��
DATE `4 ]� C

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