36749_SHELTON, HUGH AND CAROLYN_20031202

, --. ❑ CAMA /' _ i DREDGE &FILL
GENERAL PERMIT Previous permit #
nNew i-lModification ElComplete Reissue LIPartial 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`2 Project Location: County
Address J*� i ,( -,- �:�('_ Street Address/ State Road/ Lot #(s)
City State ZIP
Phone #;.- 7% ;- Fax # ( ) Subdivision
Authorized Agent /°' `-1 City-,__ ZIP
Affected J CW ❑ EW C} PTA ES ❑ PTS Phone # (__.) _ _ River Basin
El OEA ❑ HHF 1-1IH UBA El N/A AEC(s): Adj. Wtr. Body (nat / man / unkn
I PWS: DFC:
ORW: yes / no PNA yes / no Crit. Hab. yes / no
Closest Maj. Wtr. Body
Type of Project/ Activity
(Scale: )
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 _ E
Boathouse/ Boatli
Beach Bulldozing
Other
�? ,t
Shoreline Length • 5 �� ��, i
SAV: not sure yes no-_�--_- ---- ! _--- — —
Sandbags: not sure yes no
Moratorium: n/a yes no
Photos: yes no -
WaiverAttached: yes no - - F7 7C 7
A building permit may be required by: ❑ See note on back regarding River Basin rules.
Notes/ Special Conditions
CLF;Re�lce � q,.� �c1 S
Agentor Applicant Printed Name
{{
Signature* Please read compliance statement on back of permit
Check
Permit Officer's Signature
Issuing ate expiration Date
Local Planningf urisdiction TRover 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 / 1-888ARCOAST
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

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NEWPORT, NC 28570 _1
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66-21/530
PAY TO THE ORDER OF EA) DATE 6RANCH 90331
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGSIBOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to K&3k f C'A,c6LX i .Shealgw 's
(Name of Property Owner)
property located at
3S I H oLLv ►.A,,,
(Lot, $lock, Road, etc.)
on GN.+L (So4,)J u i e c.,) , in C A cre- e'er , 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. I understand that a pier/mooring
pilings/boatliftiboathouse must be set back a minimum distance of fifteen feet (15') from my area
of riparian access unless waived by me.
I do not wish to waive the setback requirement.
I dQ wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
-See p,9-�-c 2
Print or Type Name
Telephone Number
Date: z � �—�— 3P3

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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGSIBOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to
property located at
331 No t.
N 14.
N'"th � 64ADLYa V+e1Ta.'J 's
(Name of Property Owner)
(Lot, Block, Road, etc.)
on CANAL ( Sowrd view) , in C49reR4-r , 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. I understand that a pier/mooring
pilings/boatlift/boathouse must be set back a minimum distance of fifteen feet (15') from my area
of riparian access unless waived by me.
I do not wish to waive the setback requirement.
I da wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be, filled in by individual proposing development)
Se.t PAS e z
Print or Type Name
Telephone Number
Date:

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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Individual applying for Permit:
E-1 u f CR rza L S he,t.To.o
Address of Property: 3 31 Eio ll.� l,A N
tale w ager IJ a C. 28570
(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
rawing, with dimensions, should be provided with this
they are proposing. A description or d
letter.
I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coastal
Management, Hestron Plaza II, I51-B, Hwy. 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.
Telephone Number With Area Code

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STING ]RON s(IsratG � ; i
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Secluily Light 17 PATIO _---
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SLAB ON GRADE
J. W. STACKFIO USE
' PROPERTY
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Ref. Deed Book 578 Page 300 iu
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C) AREA 1N LOT �.
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APPRDX jagUAg HIGH 1rA
BOGUS SOUND
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GRAPHIC SCALE - FEET

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CERTIFIED MAIL * REETM RFS'FItT F,Q� iFsST
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual applying for Permit: -
Address of Property: 31 N o LL,I
nle�a o T C. 28S70
(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 what is being proposed, please ►vrite the Division of Coastal
Management, Hestron Plaza 11, 151-B, Hwy. 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.)
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 OWNER STATEMENT
(FOR A PIERIMOORING PILINGSIBOATLIFT/BOATHOUSE)
NOk21 ?
003
I hereby certify that I own property adjacent to Huh t C,gRolya %V,,cLToN �s
(Name of Property Owner)
property located at 331 "a Uy LAN e
(Lot, Block, Road, etc.)
on CANAL view) , in , 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. I understand that a pier/mooring
pilings/boadift/boathouse must be set back a minimum distance of fifteen feet (15') from my area
of riparian access unless waived by me.
I do not wish to waive the setback requirement.
I da wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT;
(To be filled in by individual proposing development)
J
Print or Type Name
Telephone Number
Date: - D---3

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NEWPORT, North Carolina
285707929
3613950570-0097
11/13/2003 [phone] 11:06:53 A14
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Sales Receipt
Product Sale Unit Final
Description Qty Price Price
Mail Pickup Delivered
Label # 70031010000184984318
# of Mail Pieces : 1
Mail Pickup Date:11/13/2003 11:06:46 AM
Total: $0.00
Paid by:
Bill#: 1000300149480
Clerk: 02
— All sales final on stamps and postage. —
Refunds for guaranteed services only.
Thank you for your business.
Customer Copy
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