37570_ROGERS, TOMMY GENE_20040315

'CAMA / __' DREDGE & FILL
GENERAL PERMIT
❑New ❑Modification `,Complete Reissue -Partial Reissue
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
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Previous permit # 0
Date previous permit issued
�.� i ❑ Rules attached.
Applicant Name ; 1) _. ` , _�'l_-b E__? Project Location: County I
Address -�—r'1 ��, i ' ; l fi'r !"t.0 ;, i'-. i Street Address/ State Road/ Lot #(s)�i ice, L
.ter
City i State _, ZIP oC S.
Phone # O 7{ Fax # (�) Subdivision �(({
Authorized AgentCity_` ; ZIP
Ll CW ❑ EW t� PTA [I ES ❑ PTS Phone # ( ) r"�T� River Basin 1
Affected ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
AEC(s): Adj. Wtr. Body gnat /man /unkn)
1 PWS: ❑FC: t
CIRW: yes / no PNA yes / no Crit. Hab. yes / no Closest Maj. Wtr. Body
Type of Project/ Activity
i - (Scale:
Pier (dock) length i
Platform(s)_
Finger pier(s) i
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
OthertE
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Shoreline Length
SAM not sure yes no
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Sandbags: not sure yes no -
Moratorium: n/a yes no
Photos: yes no
Waiver Attached: yes no
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A building permit may be required by:
Notes/ Special Conditions
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❑ See note
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on back regarding River Basin
rules.
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Agent or Applicant Printed Name
Permit Officer's Signature
Signature ** Please read compliance statement on back of permit
Application Fee(s)
Issuing Date
Check# Local Planning Jurisdiction
Expiration Date
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 [)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
Mailing Address:
1638 Mail Service Center
Raleigh, NC 27699-1638
Location:
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293 / I-888-4RCOAST
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

TOMMY G. ROGERS
PH 910-326-5162
375 GREAT NECK LANDING RD
HUBERT, NC 28539-3730
i ay to the � Iv
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3 _ f 8 — o4 531 07 66-30/
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Date
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fj F[R5"r CITIZCNS 076 yy//
f/ . �'r First-Citizc Bank & Trusl Company
JacksonvAla, N C.20546
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www.firstcitizens.com
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DWISION OF COASTAL MAN-AOEWNTT
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151-B HWY. 24, HESTRON BUMMING
MOREHEAD CITY, NC 28557
TELEPHONE: [phone]
PAX: [phone]
TO:
OFFICE:
TELEPHONT: #: f I__ __ FAX #: 12/01
OI:I�ICF: RM S_ ION_OE �:OA�_i
DATE; SENT.
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ADJACENT RD?ARL- N PROPERTY OMNIR STATT-NMN`T
(FOR A PIER/MOORING Pl1-INGS/13OA71IFTIROATHOUSE)
MAR 0 i 2604
hereby cerdry that I own property adjacent to � 01.•. �Oer
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(Name of
p-, oce:--'J locate at 375 6«4+ Akk Lids • Lod 3 :� �o,.. Z
(Lot, Block, Road; etc.)
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(Waterbadv) (Town and/or County) N.C.
F-e hac de;c;Ibrd to me, as s1,own below, L�e developm-:�t
a_d I hay,: no bo ,� propos.-� �_ teat location
_iccdons tc his proposes_
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t be Sc: back a n11nIMIU T1 distance C;1
access unless waived by mz,
n nnt wish to Se'back require. cn
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ALL rlleASWS
DESCRIPTION ANIXOR DRAWENG OF PROPOSED ---------------------
DEtiELOPNEF.N-':
(To be filL2d in by indiv&ucl proposin; deveZopr,-zarz-j
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ADJACE_-,�fi RT'ARL�1 PROPERTY OWI ER STATEtiaN7
(FOR A PIER/MOORING PILINGSIROA7ZIFT/EOATHOUSE)
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I hereby cer&y that I own property adjacent to / a M, end l�0 8!�1
(Name of Property Ohner)
prer:­,y Itxat 2t 3�S G-� eo1G Can Zmd log 3 C�vero �1ti� ec`�`rn.
(L(-c; Z
j Block, Road, etc.}
or, Am O S I e rP %art
(Water odv) (Town and/or County) --
He ha-s de_,�-_-I;bed to me, as SLlown below, df e dcv e!
opllle:;: h.. i_ pre_ csir.=:! a: rr,G: iocaaor:,
aid I have no objections to his propel 1. I unce-_'nd
pLi.�;i G' .iP�bOcuL 'S: Musi be a niiI
zz: bac{;k 7:ITlum distLrif-P 0 I Zt
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OT I.U�:�r1`^U�C'$S ll111E$a- Wi32V�C IJ y f` L=01Ti lily Grew
ini-.
n n nt wish to w_iv� CI,c set�ac`<;eeuirze _-
_v_ I jn �v sh to wave t at setbac rec,�i . semen..
------------------------------------- -------- -- -
DESCRIPTION AND/OR DPAWLNG OF PROPOSED DEVELOP%MI -
(To be juzed it by i,�dividuet prcpOs:r_; c ,el��rren'J
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