37543_MONTAGUE, HARVEY_20040223

❑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 15A NCAC_
a�
k �
Previous permit #
Date previous permit issued
l /51,C,
TI Rules attached.
Applicant Name 01
v
-
Project Location: County r �: r�
Address
i
Street Address/ State Road/ Lot #(s)
City
State ZIP
W L , (I
Phone # (f ►9)
Fax # ( )
Subdivision
Authorized Agent
rral
City I 'y { ZIP
2 t lL
❑ CW
❑ EW
2 PTA ❑ ES ❑ PTS
Phone # ( ) River Basin
14�
Affected
AEC(s): ❑ OEA
❑ HHF
❑ IH ❑ UBA ❑ N/A
Adj. Wtr. Body OA t, w mo N 6 1
(nat /rfian /unkn)
❑ PWS:
❑ FC:
l
Closest Maj. Wtr. Body 7-4t" !mot•'"d
ORW: yes / no
PNA
yes / no Crit. Hab. yes / no
Type of Project/ Activity
(Scale:.' �R )
Pier (dock) length
I
Platform(s)
--I —
Finger pier(s)
\ 1
Groin length
—�---
number
—
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel ''
cubic yards y
Boat ramp
t t
Boathouse/ Boatlift
Beach Bulldozing
Other
i
q1
Shoreline Length ! I L r _ _
SAV: not sure yes 'no < < ' j I # u ✓ P (� t '
Sandbags: not sure yes no
y Moratorium: n/a es fio
Photos: yes no ` I I t i
Waiver Attached: yes. no --- — -- —
A building permit may be required by: ❑ See note on back regarding River Basin rules.
Notes/ Special Conditions 40P o ✓r N t vwj f ,
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 PlanningJurisdiction
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, certifythatthis project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
❑ Tar - Pamlico River Basin Buffer Rules
❑ Neuse River Basin Buffer Rules
❑ Other:
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:
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293 / 1-888-4RCOAST
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

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MUD BUCKET DREDGING, INC.
ATLANTIC BEACH CAUSEWAY NCDL 8039839
PO BOX 3355 PH(252)726-2191
ATLANTIC BEACH, NC 28512
Pay to the /e
Order of `f
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3782
66-30/531
Date Oo_ 133
Dollars
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
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I hereby certify that I own property adjacent to
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located at /3z e�1000e�QQIE) on
(Lot, Block, Road, etc.)
llee&YS '.eW4L- _ in ("DINe , N.C.
(Water Body) (Town and/or County) 28.C12-
He has described to me as indicated below the development
he is proposing at that location and I have no objections
to his proposal. I understand that a pier, pilings and
dredging must be set back a minumum distance of fifteen feet
(151) from my area of riparian access unless waived by me.
I do not wish to waive that setback requirement.
I do wish to waive that setback requirement.
Description and/or drawing of proposed development:
(To be filled in by individual proposing development.)
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT RA�gN AIC -I
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lie has described to me aS indicated below the development
he is proposing at that location and I have no objections
to his proposal. 1 understand that a pier, Pilings and
dredging must be set back a minumum distance of fifteen feet
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z do not wish to waive that setback requitement.
T do wish to waive that setback requirement.
Descri tion and/or drawin of zo o5ed develo meet:
(To be filled in by individual proposing development.)
Date
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