39314_RAND, PHILLIP_20040901

❑CAMA / ❑DREDGE &FILL ,zJ
GENERAL PERMIT
Previous permit #
❑New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued j
1
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 fl i no it o�
Q Rules attached.
Applicant Name t �cha Project Location: County (a, ft,,, f
Address i 1 f t r t Street Address/ State Road/ Lot #(s)
City WU NJ i� G o State r ZIP r j t `t t j r✓.+# (' u r {
Phone # (-93- 011U
Fax # ( )
Subdivision
Authorized Agent
City :+, r,f a•
ZIP 72 Stt o y
ElCW ElEW
E PTA 0 ES © PTS
Phone # O
River Basin WLr' d fir' K
Affected OEA HHF
AEC(s): ElEl❑
IH UBA N/A
ElElAdj.
Wtr. Body yt�Cr, N`o jr • uin
c i lr /A / , ' /6if /Ka_n /unkn)
❑ PWS:
❑FC:
Closest Maj. Wtr. Body ►�' N '
Jar
ORW: yes /,no PNA
yes / no Crit. Hab. yes / no
Type of Project/ Activity i� .j b.1 N�+. rj �,. I7c %(a gym[ 'i t r c, .-� 1 6vF -j �r r �� �t B = i
i �r f !rri t-or� �rii �• ill r:: B/cOGk�+ G ( � r1 `af/aL 4 c rl �o p/a/ 16 M , (Scale:
Pier (dock) length r '
Platform(s)
Finger pier(s)
Groin length —
number ,
Bulkhead/ Riprap length
avg distance offshore
max distance offshore 1
Basin, channel
cubic yards_
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
OWN % I
llllllll�lr\`� __�
Shoreline Length !
SAM not sure yes no, I I I
Sandbags: not sure yes np t --
Moratorium: n a yes no
Photos es no P�A
Waiver Attached: yes r5o
A building permit maybe required by: ro r ❑ See note on back regarding River Basin rules.
Notes/ Special Conditions �-i N ° 14-, 1 un ci ; rM a r4 0►APf ' i r '�. 0`�
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
Permit icerff 'sSignature
9 I- L'/ /2 t t/
Issuing Date Expiration Date
(r , J, (ti'd,, ) r y o i f b?
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, certifythatthis project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
El Tar- Pamlico River Basin Buffer Rules F1 Other:
_J 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
Mailing Address:
1638 Mail Service Center
Raleigh, NC 27699-1638
Location:
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293 / 1-888ARCOAST
Fax: [phone]
Elizabeth City District
1367 U.S. 17 South
Elizabeth City, NC 27909
252-264-3901
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

PHILLIP R. RAND NCDL 2225213 3931� 4237
DIANE H. RAND NCDL 3738752
PHONE [phone]
139 CIRCLE DRIVE 66-8453/2531
SWANSBORO, NC 28584
LGLFCU
LOCAL GOVERNMENT 62
FEDERAL C R E D I T UN I ON MOREHEAD CITY, NC 28557 ` 1
1:2531845371:01 LOO la L7 2Lb 4 237

■ Complete items 1, 2, and 3. Also complete
i item 4 if Restricted Delivery is desired.
5 ■ Print your name and address on the reverse
l 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 Addresse to:
iUS�iv�� l VL' AS -
A.
D. Is delivery address different from item 1? U Yes
If YES, enter delivery address below: ❑ No
3. rvice Type
Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number 7003 1010 0005 4058 4985
(Transfer from service label
j PS Form ua 3811, February 2004 Domestic Return Receipt
- - - - - - -ry sc tu
- - - - - - - - - --- - - - - - - 102595-02-M-1540

UNITED STATES POSTAL SERVICE
E
1
First -Class Mail
Postage & Fees Paid
USPS
Permit No. G ,10
• Sender: Please prin our name, address, and ZIP+4 in this box •
i
p 8,::�'°rs'}'+i=.:76 1„1-111111111 till III IIII IIIf(,if„l fll//i11,i/l 11fif 111 ll/!7t

�" ,17'ER: COMPLETE THIS SECTION
k _.
S■ 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.
Article Addressed to:
T6. PO, 0111d Is
A.
®! J ❑ Agent
❑ Addressee
B. Received by ( Printed Name) ate of Delivery
V-oy
D. Is delivery address different from item V ❑ Yes
ff YES, enter delivery address below: ❑ No
3. Service Type
9 Certified Mail ❑ Express Mail
Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
{ 2. Article Number 7003 1010 0005 4058 4978
(rransfer from servi,
' PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540
- --
--- -------- - - - - --

i
UNITED STATES POSTAL SERVI
First -Class Mail--—, Postage & Feea.Pai6
Y •�° USPS
It Permit No. G-10 ....
Se7r:Sen er: Please print yourname, address, and ZIP+4 in this box
Please print • w. µ
a
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'_'�.4�.t'~µ.•a.i":''F u� �• 111�liltlflillli�tfllIII11I l711 (1111ItT71iF111l t�l t l t i e I r!(1

ADDRESS.OF THE RETURN PLACE STICKER AT C
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BtC*I^-�-�� 11 r 28
EO STATES J r
P . 0. Box 589 re,r ST°` IFB
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BEULAVILLE, NC 28518 0000q�gt
_ 2858q 00a7913,
7002 0860 0004 5625 2412
1st F'wT-^E
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3
40
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to& —a s
i4k_�t�w
�r,�
(Name of Propertty/Owner)�jproperty located at f�Gl/r2/)S s�� /U( �� l��'l 6),ck, Ro,c.)
on
, in
(Waterbody)
(Town and/or County)
N.C.
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 iad6vidual proposing development))
J
Sicynature
L arn5-
Print or Type Name
Telephone Number
Dn:: r/

•
� Hp� 21 U♦ OH:27a
Rlleh Bell survey1ne 2�t 393 6:01 p
0-r
LEc,E.'VD
NEW UAGNETIC NAIL
CX147INP+ JRCN P-Pr"
m NCIV IRON ROO WSIGE EXiSTIN? IRCN PiPf
NOTES -
REF.. AI6. 6, ad. J7
- ?J L07 AREA • 5• �:.: 5 C `
ti FLOOD Z:NE Al i'CL
VICINITY MAP —NOT TO SCALE
BOAT BASIN
57
/V&v wcol, k'ETa'
Cc' W,4TEQ5 EJUr \ t--
SC G FJEi.5
n
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c RIP R,*pwoop
ro Lc��it�
& v�
w c�� wj4wf-wh 9 $
I JO• CA EUFFFR LYIE _ L Nu -, I) G � C: L-L
IL
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f `
N
.v KS;'!jL.I' TC
WC NAIL' CEIvrEF' OF
PNvS%C.AL %/L - —�'�-
-- CUC-DE-$AC•
LONcIF-4F DR. (80' PIT)
2
��IE c�aR��TF�p
tea'�
Lot Survev for: j
1. ZIRUS At,AN Bf%�, I°ROFESSIONAL L4,YD
SH.-/E S VE NER£fiY >R0PER THAT
.i,.%E $LIRYEV£D ;},c PROPER'Y AS
.�
Phillip Rand �
.;,40 14C,PCOK IN ACCORrjr4rvCF
,�,,�,�,
,HE Cj PRAC7CE FXt
SUR.£YINC IN' NC'Rrlf C4RO41NA
, �.
LG%' 4, PE7IIF'ORDS BAY SURD -
ANC TNAT TNF RATIO OF PQFCISION
AND
a,,,
109 LOAG'LLEAF DR.
OF SAID SURVEY IS v:Ie.oce.
CAR
in
WHITE OAK TWSP., CARTERET COUNTY, 1�'.C.
o��~
Alan Bell Surveying, P.A.
604E CEDAR POIN 7 BLVD.
SWANSBORO, N.C. 28584
0�
TELEPHONE: (25V-393-610)
AUK
EMAIL: aDe1laurveylrjck-'01cp2•r•orlj

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONdWAIVER FORM
Name of Individual _applying for Permit: - - -
- /P q t o &4,6�ar
Address of Property:
Of -
(Lot or Street #, Street or Road, City &County)
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions, should be provided with this
letter.
I have no objections to this proposal.
If you have objections to )vhal is being proposed, please write the Division of Coastal
[Management, tlestron Plaza II, 151-B, H►vy. 24, Morehead City, NC, 28557 or call (252) 808-
2808 within 10 days of receipt of this notice. No response is considered the same as no objection
if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house, lift or sandbags must be
set back a minimum distance of 15' from my area of riparian access unless -'waived by me. (If you
wish to waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
Signature n Date
} r Y_'
Print Name
q J0 a9 F
Telephone Number With Area Code
wig
)C--,5iUCE !A) U,eOCQ io 1��
CLE iti 0 J!08
ft---- X/0
S�67I�A Tv

1A
27,
fell �
/(�ns0 )oC
a�sol

1440jel'�
l/i9 Ua�/i 11GC

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONM'AIVER FORIM
Name of Individual applying for Permit.
Address of Property.
lt)&
(Lot or Street #, Street or Road, City & County)
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drxving the development
they are proposing. A description or drawing, with dimensions, should be provided with this
letter.
I have no objections to this proposal.
If you have objections to what is being proposed, please write the Dirision of Coastal
Management, ,Hestron Plaza II, I51-B, Hivy. 24, Morehead City, PVC, 28557 or call (252) 808-
2808 within 10 days of receipt of this notice. No response is considered the same as no objection
if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house, lift or sandbags must be
set back a minimum distance of 15' from my area of riparian access unless waived by me. (If you
wish to waive the setback, you must initial the appropriate blank below.)
Signature
Print Name
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
Date
Telephone Number With Area Code

ADJACENT RIPARIAN PROPERTY ONVNER STATENIEN'T
Alp
I hereby certify that I own property adjacent Game of Property Oµ'ner)
4
property located at
r-r ,
(Lot, Block, Road, etc.)
in
on (Town a d/or County;
(Waterbody)
He has described to me as shown below, the development he is proposing at that location,
and, 1 have no objections to his proposal.
DESCRIPTION AND/OR DRANNTNG OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development)
Pz'
Signature
Print or Type N:ir, ,
Te;zphone Numher
D, .

Rpr 21 04 08:27a Pllen Sell Surveying 252-393-6101 p.2
AWW
% nog no.,oU m,
�� � /-- SITE
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„c, t• mo
,+a
ATAN*.0 PfFY1
VICINITY MAP —NOT TO SCALE
LEGEND
e NEW IIAGNETIC ,AM&
O EXISTING rRON PIPF
p NEW IRON ROD INSIDE £XISTIN6 IRON PIPE
NOTES.
1) REF,: M.S. 6, PG. 37
2) LOr AREA. 75,000 S.G FT.
3j FLOOD ZONE A£ EL. 7)
f.
c�
b�
BOAT BASINNE�
P Toiv
war
IVCW woOARET w �� �Z, NFuI wood Rr
ujW4 wx rwh q 1+
30' CAM I BUFFER L.'NE _ l= w(-f)k)6 LoG u-
I t I'�ruR
Alv,D ROMP, OK
`L
_o
N N N 51.36'75'Yi ar5.�s' ro
MAG NAIL 2 E. NAG NAIL CENTER OF
PHYSICAL C/L--� _ CUL—QE—SAC.
L0NGLCAF DR. LONGLEAF DR. (60' R/W)
I, CYRUS ALAN BELL, PROFESSIONAL LAND
Lot Survey for: j
SURVEYOR 00 HEREBY CERTIFY THAT
I HAVE SURVEYED TH£ PROPER.Y AS
Phillip Rand
SHOWN HEREON /N ACCORDANCE WiTH
re��
THE STANCKRDS OF PRACTICE FOR
LAND SURVEYING rN NORTH CAROUNA
. ,,,
LOT 4, PETTIFORDS BAY SURD.
ANC THAT THE RATIO OF PREGrSlON
DIAM
109 LONGLEAF DR.
OF SAID SURVEY lS r: 10, 000 r.
`°as--
WHITE 0,6X T1VSP., CARTERET COUNTY, N.C.
Alan Bell Surveying, P.A.
604E CEDAR POINT BLVD.
J
SWARTSBORO, Ati C. ,28584
L
TELEPHONE: [phone]
U ALAN
EMAIL: abe1lsurvevinELQtcv2.com
4iN,c(JG7N ���i�
0v1t�
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2,41
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