39651_PELICAN PARK HOA_20040812

�CAMA / El DREDGE & FILL
WGENERAL PERMIT Previous permit #
DNew DModification ❑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 I SA NCAC
W Rules attached.
Applicant Name ! f ? r.. To, k % I _ Ei '!� /? f . (d, e+ ,I 4,
Project Location: County la : If • r 4
Address �c r y r, ' e Street Address/ State Road/ Lot #(s)
City__( 1c 1+1 State 4 ZIP = 7 y 16 ' � rl (a � ' r�o y �� / +�/Fl 4
Phone # (`� �`j) k 14 Fax # ( ) Subdivision �" rc« lU- K
Authorized Agent
Affected -I CW E EW Q PTA ❑ ES ❑ PTS
AEC(s): [IOEA ElHHF ❑ IH ❑ UBA ElN/A
❑ PWS: ❑ FC:
ORW: yes / no PNA yes / ,no Crit. Hab. yes / no
city P,'OV Ar 6e .r L ZIP
Phone # O River Basin ice%
Adj. Wtr. Body f - c of i c U o d (r Wit` /man /unkn)
Closest Mai. Wtr. Body;
Type of Project/ Activity i r! . J 1` r. ,I — I �nr� .� r Ft, ii f
(Scale: /Y;N f )
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
t'oty
4
r
$AM not sure yes rnv — - -- r
Sandbags: not sure yes P
Moratorium: n/a yes n� f,K."o
Photos: yes n]p how Iv `-
Waiver Attached: yes no J
✓ _ 1 , rW,r F.rf�u. i i �L
A building permit may be required by: h IrQ� fir hFgr l 1 ❑ See note on back regarding River Basin rules.
Notes/ Special Conditions f rr le r ri 1,010[ W+ , F- I E14 , v, t ^4 0
�'�ri L r+AMn N 1 r. i tArvr.i l N •✓ I .
Agent or App, scant Printed ame
Sig re ** Please read compliance statement on back of permit
- .PJ ,, k
Application Fee(s) Check #
!.Jr4kA
Permit Officer's Signature
&,, r1•C1 0 r c'!
Issuing Date Expiration Date
in Expiration
re.-tl !1
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 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 / 1-888-4RCOAST
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.nccoastaimanagement.net
Revised 10/05/01

FIRST CITIZENS BANK
MOREHEAD CITY, N.G. 28557
OUTER BANKS MARINE CONSTRUCTION, INC
1501 FIRST AVE
MOREHEAD CITY, NC 28557
[phone]
PAY TO THE
ORDER OF
1085
66.30/531
137
7/2/2004
Two Hundred and00/100************************************************************** DOLLARS
D.E.N.R.
MEM06
11600 108 SO 1:0 5 3 100 3001:00 13 12 18 2 12 7uf .

TOWN OF ATLANTIC- BEACH
125 WEST FORT MACON ROAD
ATLANTIC BEACH, NORTH CAROLINA
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
i
I hereby certify that I own pro erty adjoining 2 c ask �c1 c4 's
property located at'c c , N.C. He has described to me,
as shown below, the development 6e 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)
ignature
Name (printed)
hon umber
POST OFFICE BOX 10 • ATLANTIC BEACH, NORTH CAROLINA 28512 • [phone] • FAX [phone]

._'- — E-VV't 11V11 UU-L4 nit nu u1v Vr VUHZ)IHL IRTFINI t'HA NU. 4
P. 02
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING; PILINGSIBOATLIFTIBOATIIDUSF.)
I hereby certify that I own property adjacent to t 1
/ (Nance of Property Owner)
property lorllal at �� (` -`
(Lot, Block, Koad, etc.)
in C." -�i ( _!'� \�� N.C.
(�V1 erhody) (Town and/or County)
Ile has described to me, as shown below, the development he is proposing at that location,
and, I have no objections to his proposal. I understand that a pier/mooring
pilings/boatlift/boathouse n7ust be set back a minimum distance of fifteen feet (15') from my area
of riparian access unless waived by me.
I sto not wish to waive the setback requirement.
I do wish to waive that setback requirement.
V______ _
- -----------------------------------------------------=-`=---.�.,.- ,-----a,,
I)I�SCRIPTION AND/OR DRAWING OF PROPOSED 1'ICVEI,O64f.1 L)QM
(716 be filled in by individual proposing development)
DC L
Si�nature '
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Print ype Name
Telephone Number
Date, % —Z ��

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