40391_MCCOY, ALLEN_20041207

DCAMA / 'DREDGE & FILL
GENERAL PERMIT '
Previous permit #
DNew ❑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
[Rules attached.
Applicant Name Project Location: County (%�o
Address Street Address/ State Road/ Lot #(s)
City State- ``/ ZIP
r r
Phone# '/'/.¢• l7o Fax#( )
Authorized Agent U '.c 7� f"
Affected El CW L5'EW L!PTA ❑ ES ❑ PTS
AEC(s): i OEA ElHHF ElIH ❑ UBA ElN/A
❑ PWS: ❑ FC:
ORW: yes / no PNA yes / no Crit. Hab. yes / no
Type of Project/ Activity
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 oatli f De
Beach Bulldozing `
Other
Shoreline Length
SAM not sure yes na-------
Sandbags: not sure yes no
Moratorium: n/a yes no
Photos: yes (no
Waiver Attached: yes no
A building permit may be required by: 1 `
Notes/ Special Conditions
Agent or ApplicafgPrinted• Nme
Signature Please read compliance statei
'' (J^ c �. L) o
on back of permit
Check #
Subdivision-
city—P a-?►
J)l,c, i / J ZI_1 6
Phone # () River Basin ✓�✓� `R
Adj. Wtr. Body_ Cl / = �` (nat)/man /unkn)
Closest Maj. Wtr. Body
(Scale: )
lJ.
"See note on back regarding River Basin rules.
ermit icer's Signature
i3tuing Date Expiration Date
�r 1. �►1 o'71 y
Local Planning Jurisdiction Rover File Name
Application Fee(s)

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 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 / 1-888ARCOAST
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

PRESCOTT BROTHERS INC
141 TARA TRL
GRANTSBORO, NC 28529
PAY
TO THE
ORDER
P 14RST CITIZENS 4T2
D /AjK Criental, N.C.Bank&Trusl Company
Dru .l` Ori i-Citi N.028571
ank
it citize
FOR
ii'Cr0 2 78 7ii' �:0 3 L00 30 �:004
2787
_ 66-30/531
DATE 472
�$���
7110254290
DOLLARS 8 �.

UNITED STATES POSTAL
b
_. 'F1rs - iass Mail
Postage & Fees Paid
LISPS
Permit No. G-10
r
• Sender: Please print your name, address, and ZIP+4 in this box •
Jim and Lorrie Hickok
226 Cicero Riggs Road
Cove City, NC 28523
C7 2 fill 11111111F111I1I1l1111111111Illu fAllill,IllIll 13t11fill III
I

■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
Mr. & Mrs. Rudolph Rustin, Jr.
834 Lee Youngblood Road
Smithfield, NC 27577
2. A
n
PS F
A.
❑ Agent
B. R ived by'yrinted Name) C. Date .11
�� !� • bus . iD
D. Is delivery address different from item 1 - ❑ No
If YES, enter delivery address below:
3. Service Type
Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
102595-02-M-1540

FROM (THU)JUN 24 20.04 8:144T. 8:13/No.6807923269 P ?
ADJACENTRIPARIAN PROPERT Y OWNEER STATEMENT
I hereby certify that I Own property adjacent to �LLrN /4 ;Coy �
(game of Property, 0ti4,ner)
propertyloczted at %WVY�
(trot, Block, Road, etc.)
('4'Yaterbody) (Town and/or County)
He h2s described to me xs shown below, the development he is proposing at that location,
and, I have no objections to his proposal,
DESCRIPTION AI\TD/OR DRAjjq?\TG OF pROPOSED DEVEL{7PI hT
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Telephone Number
Date: 0 '�