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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
[IRules attached.
Applicant Name
Project Location: County
Address
Street Address/ State Road/ Lot #(s)
CiState,4i1C. ZIP
Phone # (- 4') ? - // f Fax # ( )
Subdivision !�:. -; : _� ✓
Authorized Agent �f.../ /��� cl t/
City /& f— • 'I ZIP
Affected ❑•Cw [`3Ew ;kPTA El ES ❑PTS
Phone # ( ) River Basin !�'- s->•-
❑ OEA ❑ HHF ❑ IH ❑ USA ❑ N/A
AEC s :
— >
Adj. Wtr. Body • n i(nat /man /un kn
PWS: El FC:
�
.�
ORW: yes / no- PNA yes / no Crit. Hab. yes / no
Closest Maj. Wtr. Body
Type of Project/ Activity
Pier (dock) length /
Platform(s)__ '
Finger piers)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
l
A�
f 1
OtherA..i;
_::
Shoreline Length / (.,
SAV• not sure es
-
f )
(Scale:.,,,-
-If
Y . - t
_ - - --- -- —
Sandbags: not sure yes (no } is 1 t 1 (�
Moratorium: n/a yeso )
Photos: yes ;no
Waiver Attached: yes no�
A building permit may be required by: j % _ See note on back regarding River Basin rules.
Notes/ Special Conditions
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
Permit Officer's Signature) '
Z. (• S/rd/a y
Issuing 'Expiration Date 11
Local Plan ningJurisdiction Rover File Name
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
Permit Officer's Signature) '
Z. (• S/rd/a y
Issuing 'Expiration Date 11
Local Plan ningJurisdiction 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 I) 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:
❑ 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 complywith 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: 252-264-3723
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293 / 1-888ARCOAST
Fax: 919-733-1495
(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: 252-247-3330
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico Counties)
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax: 252-948-0478
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-395-3900
Fax: 910-350-2004
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)
www.nccoastalmanagement.net
Revised 10/05/01
1525
BROAD CREEK CONSTRUCTION 66-112/531
PH. 252-745-4252 O _ �QQl� 01901
11 CREEMEW CTIB
MERRITT, INC 28556
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BRANCH BAB G A�T COMPANY
NEW BERN, NORTH CAROLINA
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I hereby certify that I own property adjacent toJitrrn_S
(Name of Property Owner)
property located at bo- f 4 9 whom m A
(Lot, Block, Road, etc.)
in ) r 1
N.C.
aterbody) (Town and/or County)
He has described to me as shown below, the development he is proposing at that location,
and, I have no objections to his proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development)
BY vvn S i,re2K
30 �
mda I?ro�wly
-nature
• �P*tr Type Name
Ole
Telephone Number
Date: I &6
I hereby certify that I own property adjacent to _1
(Name of Property Owner)
Property located at " -tl- � .
(Lot, Block, Road, etc.)
on DU,
aterbLod y) (Town and/or Coun
He has described to me as shown below, the development he is proposing at that location,
and, I have no objections to his proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by individual proposin; development)
Nlda Pror Wyly
BY ®tins CrWK
W
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Print or Type Name
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Telephone Number
Date: 1 ';�- Z I / 0 :3
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