38360_SMITH, EVA BELLE_20040511

L-1CAMA 1 I DREDGE & FILL
GENERAL PERMIT
Previous permit #
E''New ❑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 I SA NCAC
❑ Rules attached.
Applicant Name j kV &Ile <, &"A
Project Location:
County
Address ►a � pt)d rfl) rl F"k fl j
Street Address/ State Road/ Lot #(s)
City 00Vr! -(V State ►`If ZIP 14 1? 32-
11-1 1
Phone # ( Z42) q - lily"' Fax # ( )
Subdivision
Authorized Agent fA nJ i_„vy /+ < c R 4
City
ZIP
CW ❑ EW [I PTA Z ES A PTS
Affected
Phone # ( )
River Basin Nc v re
El OEA ❑ ❑ HHF ❑ IH ❑ UBA N/A
AEC(s):
Adj. Wtr. Body
/ t
4,-f- K (nat man unkn
PWS: ❑ FC:
ORW: yes / no. PNA yes / no' Crit. Hab. yes / no
Closest Maj. Wtr.
Body fyp �� ✓*
r
r �
Type of Project/ Activity �j W L� v �':. - ��.� i^ • M
(Scale: N s NE )
Pier (dock) length --
Platform(s)
Finger pier(s)
Groin length
number 1 If' I "
Bulkhead/ Riprap length 2
avg distance offshore_
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
rl
Beach Bulldozing-t
- It -
Other I . ^ I `-rtfol,'rl f to -- — --- -
Shoreline Length `ram ti `" y�` J
SAM not sure yes lfo
Sandbags: not sure yes �o
Moratorium: n/a yes
Photos: yes 'ng
Waiver Attached: yes #-
A building permit may be required by: j� See note on back regarding River Basin rules.
Notes/Special Conditions ` if.,_ q.��^0'�F�j rc,c� ri^..'f I'� rlf c �n�
t - r
P,tJ.=� ?1fe �{ rz. r� �i,c rP 6 7�, /mot �c f-4 r c`�
ti EtF ! N� Y� f'rr I k
1 01 r'. b,. ��r� 1 �)rrT`r►. 1' r��Y,i YvPi/orL! 1y9/ T !L `;L„
Agent or Applicant Printed Name f'
j4tr
Signature * Please read compliance statement on back of permit
T 7
ftI%U.(i� �i� 4�1
Application Fee(s) Check #
t r
Per Officer's Signature
Issuing Date lr Expiration Date
r i- / 1 / / j i
Itlf�r �,
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 ❑ 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
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
151-13 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

JAY SMITH
NCDL 2105210 PH 336-349-6669
275 MAGNOLIA DR
REIDSVILLE, NC 27320
Date
WACHOVIA
Wachovia Bank, N.A.
www,wachoviaxom
Fo 8s6o ",-114 F-5;-11/ /
1:05300021911:10633711131&11ym 4 3
4873
66-21/530
BRANCH 77638
n
mP

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to L:Ph /3E LL E SM I LL 's
(Name of Property Owner)
property located at �nM 17- 4 rho e YA —R ai� o
(Lot, Block, Road, etc.)
on (6,W 6 FWT C Iz-E&K11(16 j 6 f t in /I &/&-c)C/e �Lre61yE N CUu wr � , N. C.
(Waterbody) (Town and/or County)
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 individual proposing development)
�s
Signature
i
Print or Type Name.
Telephone Number
Date:

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(Endorsement Required)
C:3 Restricted Delivery Fee
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PS Form 3800, June 2002 See Reverse f.., Instm.twa

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PARCEL ID
5-011 -047 _
OWNER
SMITH, ERA
BELLE
Mail Address
3175 ADAMS
CREEK'RD
Mail Address
HAVELOCK NC
28532
ADDRESS of Property
SMITH FARM RD
Land Value
98510
Improvement(s) Value
0
Total Value
98510
Assessed_Acreage
111.180'```
Calculated_Acreage
111.175
Deed Book Page
05240207
Recorded Date
1955
Survey
Tax Exempt
NO
City
Fire District
Township 5
Drainage District
Property Description
E/S CLUBFOOT
CR
Lot Description
Special District
_
Number of
0
Improvement(s)
Structure Type
Year Built J
Identify
1 U 55 AM

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