37255_MOMAN, MIKE_20040202

❑CAMA / ❑ DREDGE & FILL
GENERAL PERMIT
❑New ❑Modification ❑Complete Reissue ❑Partial Reissue
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
a 1
/v
Previous permit #
Date previous permit issuec
Applicant Name '''1" r ZOANA Project Location: County
Address III) (� �t at y ( Imo. G o, ,f.
CiState ZIP
Phone # ( `7)"I 1 E Fax # ( )
Authorized Agent j
Affected ❑ CW ❑ EW ❑ PTA
AEC(s): ❑ OEA ❑ HHF ❑ IH
❑ PWS: ❑ FC:
ORW: yes / no PNA yes / no
Type of Project/ Activity
❑ ES ❑ PTS
UBA ❑ N/A
Crit. Hab. yes / no
Street Address/ State Road/ Lot #(s)
Subdivision
wl
❑ Rules attached.
City ZIP
Phone # O River Basin
Adj. Wtr. Body_ w I i /f. Ic (fiat /man /unkn)
Closest Maj. Wtr. Body ' ' ` "�
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
Boathouse/ Boatlift -
Beach Bulldozing
Other
Shoreline Length
SAV. not sure yes
no
Sandbags: not sure yes
no
Moratorium: n/a yes
no .
Photos: yes
na
L
Waiver Attached: yes
nc,.
A building permit may be required by:
Notes/ Special Conditions
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit`
Application Fee(s) Check #
6T;
it, :- r
® See note on back regarding River Basin rules.
Permit Officer's Signature
77�y r� �•f
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:
❑ Tar - Pamlico River Basin Buffer Rules ❑ Other:
[� Neuse River Basin Buffer Rules
If indicated own f"ront 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:
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293 / 1-888ARCOAST
Fax: [phone]
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

WESTERN MONEY
UNIONI IORDERs" INTEGR
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E,)yjDwuodl Colorado
AGENT 32614S DATE 0z02a 06-631907908
TIME 1032 07 �r
066319079082 LOCATION 82-40n021
PAY EXACTLY
PAY EXACTLY
ONE HUNDRED DOLLAR 0Ar�D @ tjo
PAY TO THE _ CENTS
ORDER OF t rJi
Western y �n; SIGNWG V-- q
Union Money Drder and Design is a service mark of Western Union Holdings. Inc. / Payable at Wells Fargo Bank Gr I 1 r - TERMS ON THE REVERSE SIDE?0 THE
' L O 2 1 O O �+ O O►1100
AurH R12ED EPRESENTg71VE
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02/02/2004 09:06 12526395425 MEDFORD MARINE CONT PAGE 01
Medford Marine Contractors
P.O. Box 3562
New Bern, N.C. 28564-3562
Phone: [phone]
Fix: 252-638-5425
FAX COVER LETTER
TO:Cr�
Company ri
FAX Phone 1- a �p_ C�? q "7 3 33 6
44
Date - - C)-00
•
MESSAGE:
64-�Lz C�s�
V
46
�QJv� Q�t I Ci a rv� a- � d- ✓k]� .
TOTAL NUMBER OF PAGES INCLUDING THIS COVER SHEET:
If you do not reoeiw3 all pepea Utatrwntftd. ples" corrtact us 11-1 dietely.

02/02/2004 09:06 12526385425 MEDFORD MARINE CONT PAGE 02
ADJACENT EUp" A... PRopERTX OV1tttiER STATELENT
(FOR A PIERIMOORJNG PILINGS/80ATUMBOATXOCSE)
I hereby certify that I own property adjacent to Mr. & Mrs. M ke Moman 's
dame of Property Owner)
propcM located at 1112 Country Club Dr. _....r
(Let, Block, Rnd, etc.)
on Jimmy's Creek in New Bern Craven , N.C.
(, ,ody) (Town andtor CoutdY)
Ile )iNwj
below, the dev�Utp posI a: thiiat location,
and, I havis proposal. pie:lmoor�ng
IrA
k a minimum distf from my area
of riparian
N
wi A,7e
ht setback requirem
/A
etback require�rne.7
DE,SCRUMON AND/OR DRAWLN- G OF PROPOSED DEVELOP' MST -
(To beXed in by individual proposinzd`velopmew)
(See the attached drawing)
Signature
Print or Type
(2s--2) G,3F-F:�9�
Terephon umber
Dare: ZL O

02/02/2004 09:06 12526395425 MEDFORD MARINE CONT PAGE 03
ADJACENT RWARL-k.N PROPERTY OWNM STATEN'0�-�'T
(FOR A PIIFRIMOORING PILINGS/BOATIJFFIBOATH01"S )
I hereby certify that I own property adjacent to Mr. dt Mrs. Mike Moman is
(Name of Prapaq Owner)
pwpe:V b� j at 1112 C#Untff Club Dr.
(Lot, Bioek, Road, am)
Ott Jimmy's Creek , in New Bern Craven , N.C.
(woody) (Town and/or County)
He bas own below, the dev� t p s' at dot la don,
and, I hava } his proposal. I Pie:/moor�n;
p gy u k a minimum di o f hom my area
of riparian uni b
t4twA,'�e'h4tc,
setback requirem
rquiremea
DESCRIPTION AND/OR DPLAWr G OF PROPOSED DEVELOP�M','T:
(To be jW d in by indFvidual proposing development)
(See the attached drawing)
Sig re
Print Zr Type Name
�3-7-L 7 03
Teftphod Number
Date:

02/02/2004 09:06 12526385425 MEDFORD MARINE CONT PAGE 04
me*wd manwe coxvwaom
P.O. Box 3562
New Bern, NC 285643562
P*ow.-152-05-5242
Flow 252-638-5425
pwW 1-30-w
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supper
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Mr. A Mm )WIlke)Womms
1112 Country Club Dr.
New Bern, N. C- 28562
Phone: [phone]