36780_POE, BARRY_20031216

ElCAMA / ❑ DREDGE & FILL
GENERAL PERMIT Previous permit#
ENew El Modification ❑Complete Reissue ElPartial 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
�2 Rules attached.
Applicant Name dr~;,. `va; Project Location: County 3Z,
Address 6 ✓u fie , rr tO� Z4 „l Street Address/ State Road/ Lot #(s) 7c-c.-
City State_ ZIP
Phone # J,,, V1 Fax # ( ) Subdivision
Authorized Agent City_ ZIP
Affected ❑ CW ❑ EW ❑ P A ES ❑ PTS Phone # ( ) River Basin
F.: pWS: El FC: OEA ❑ HHF ElIH ❑ USA ❑ N/A
i ] j
AEC(s): Adj. Wtr. Body/ (hat /man /unkn
ORW: yes / no PNA yes / no Crit. Hab. yes / no Closest Maj. Wtr. Body
Type of Project/ Activity
T ,
(Scale: )
Pier (dock) length d
Platform(s) I
—
Finger pier(s)_
Groin length i.
number =— --- I— --- �1
Bulkhead/ Riprap length
avg distance offshore . D
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
Shoreline Length
SAM not sure yes
no
Sandbags: not sure yes
no
Moratorium: n/a yes
no
Photos: yes
no
Waiver Attached: yes
no
A building permit may be required by:
Notes/ Special Conditions
1
7� 1 1 rf,1
Agent or Applicant Printed Name t 1r
Signature Please read compliance statement on back of permit"
fJ,
Application Fee(s) IFCheck #
— See note on back regarding River Basin rules.
i
Permit fficer'sSignature
3 ZG & y"
Issuing Date / Expiration Date
Local Planning jurisdiction Rover File Name
----•---4c=� ......; .mot_-: _.

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 consistentwith 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.nccoastalmanagement.net
Revised 10/05/01

FOLEY & FOLEY CONTRACTORS, INC. 2732
MATERIAL ACCOUNT
1810 OLD AIRPORT RD. PH. 252-636-2515
P.O. BOX 3482
NEW BERN, NC 28564 - 66-85/531
DATE
PAY
TO THE
ORDER OF {V . 9co, 0a
o LLARS '
RBC
Centura
RBC Centura Bank
wrNen, o
NC 28560 \ ol-j(o(r
FOR G3/Q ((� �(p7%S -3% � 3 ab luo.oc�
6r
1110000 2 7 3 211' ii:0 5 3 1008 5Db 16 3 6 511'

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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(Bulkhead/rip rap)
I hereby certify that I own property adjacent to 134aft 's
(Name of Property Owner)
property located at Qdpd,`(1
(Lot, Block, Road, etc.)
on A)&jI l�•,%x , in v-Ac) �-1 10_0 , N.C.
(Water body) (Townind/or County)
He has described to me as shown below, the development he is proposing at the
location, and, I have no objections to his proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(to beJilled i,t by individual proposing development)
/U to n.
RLr. tC--
1' 40 w r I pv
RDLOV-
Pbley Contractors, Inc.
[phone]
i2) 636-3127
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Signature
Print or Type Name
z,- -1- gg )'- � z y 6
Telephone Number
VDate
J

12/03/03 16:49 FAX [phone] RALEIGH PEDIATRIC
l 101/U3 10:03 FAX
R 003/003
[�jo}
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i
ADJACENT RMAJAAN PROPERTY OWNI B, STATEME?, Ic
(Bulkhta&rip rap)
I hereby certify that I owit property adjacent io
(N, to x of Property �: lwner)
r+ !
on A)iZjiK ?L,A In N. � t-A j i LPL? C_
(Water body) �.. (Town Jwwor Ca z ity)
He has described to me ear, shown below, the develop n mt he is propo!. ling at the
location, and, I have no objections!;, to his proposal.
DESCRIPTION AND/Olt, (DRAWING OF P11OPOE 10 DEVI1 L OIIIJ 4ENT
(to beflffed In 1)F IMWVMWW prvpvslng,► do d Iopment)
/ iEoz
-.oe
Foley & Foley Contractors, Inc.
Phone#: [phone]
fax# [phone] W
Onature
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Prim. (,r Type Name
Tele p'lone Number