39395_ROUSE, MARVIN_20040727

�CAMA / ❑ DREDGE & FILL iL
GENERAL PERMIT PrZpermit e#
❑New DModification ❑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
Applicant Name �'C> r o- +i �;,_ Project Location: County
❑ Rules attached.
Address Street Address/ State Road/ Lot #(s)
City R o it < t State +� ZIP - -
-
Phone #
`'tio-�O
Fax # O
Subdivision
Authorized Agent
f 11 i
City P `'r,0 ZIP 7f', 12
El CW
❑EW
©PTA I-- ES PTS
Phone # ( ) River Basin WA /, 0"e
Affected
❑ OEA
AEC(s):
ElHHF
❑ IH '- UBA - N/A
Adj. Wtr. Body roVc' 1 (nat /Aa`q-�/unkn)
❑ PWS:
❑ FC:
leli
ORW: yes / no
PNA
yes / no Crit. Hab. yes / no
Closest Maj. Wtr. Body —
Type of Project/ Activity
(Scale: lwY )
Pier (dock) length_
Platform(s)-
Finger pier(s)
Groin length
- -
number
Bulkhead/ Riprap length
avg distance offshore ] +
max distance offshore
_�
h
_ !
___.'_..___.__�_.
p Anti,
s
{n
l
1.-__-
-
I
Basin, channel
{
cubic yards
_
J✓,
---
a
_
.._
i
._
..._,:_-
-
-._..
Boat ramp __.._. _�_...._
Boathouse/ Boatlift
Beach Bulldozing
I
t
Other_
lt�
�
.-
I
. _ _s,�..
� . . - ;-
. �++r.�`.
I _..
�„n- .. •
r
ter..' " . �+.+r.. . w"'Pr
'
Shoreline Length
SAV: not sure yes (no
j
�!'
,,
,r
Sandbags: not sure yes rno
Moratorium: n/a yes no
Photos: yes no
Waiver Attached: yes no
^'
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1
-------------- =
---
A building permit may be required by: �."o 0
k,
for
/
C
❑ See note on back regarding River Basin
rules.
,
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B• t `,
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Notes/ Special Conditions r'
t
i F r-
s I
r
Agent or Applicant Printed Name
Permit Officer's Signature �(
Signature ** Please read compliance statement on back of permit **
Application Fee(s) Check #
Issuing Date Expiration Date
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, 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 complywith 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 / 1-888-4RCOAST
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

ERIC B. ELLIS NCDL 65047 sq-5 .5'MPoevI�J ��` � 2764
JASA M. ELLIS PH [phone] 3�
205 NOTTINGHAM DR. LOt{�S,4 �7 66 3o/53t
MOREHEAD CITY, NC 28557 -Bpr Date l 133
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Pay to the �p
Order of �� /U,/L $ aco' p p
✓�ll�lC C '�Dollars
FlRST CITIZENS-3 Gist
p A Aj�I Fkst-Clt—ns Bank 8 Trust Company
j� K Atlantic Baach. N.C. 28512
,� ww Mrstcitizens.com
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For KSEd' ,& -EX P,--rzi-
im s 3 L00 300i 00 13 i 7448 78011- 0 2 761,
0cy—F ..
GUARDIAWSAFETY BLUE ESBL

Eric Ellis
DOCKS *SEAWALLS e BOAT LIFTS
CONSTRUCTION & REPAIRS
TELEPHONE: [phone]
205 Nottingham Lane Morehead City, NC 28557
N
M®t~ b
Capps Printing, Morehead City

ADJACRN'Z' RLPARIAN PROPERTY OWNFJR 5TATEmm, iv `
(POR A PIER/UNCOVERED BOAT LlF7)
I hereby certify that I own property adjacent to(�.•��,_ _ 5
(Name of Property Owner)
property located at _ ( e1
(I..ot, SIock,
d, etc.)
an — Ca-� in . a - -� , N.C.
(Waterbody) (Town and/or County)
He has described to me, as shown below, the development he is proposing at that
Iocaticn, and, I have no objections tQ his proposal, i urndzrsUnd that a pier/uncovered boat lift
must be set back a minimum distance of fifteen feet (15'l from ray armmf.riparian a t i
waived by me. r.
R io:
I do not wish to waive the setback requirement.
I do wis} to ware that setback requirement.JUL 2 3 2004
---------------------------------------------- _ Mgre -ea—d-CI,,-'-- M
DESCRWnON AND, OR DRAWING OF PROPOSED DEVELOI?nMMST.
M be,frlled in 6,v individualpropos�gg development)
�...zu -4-.A R-(k- S
r
Signature
Print or Type Name
K7 3 7-- _
Telephone Number
9001A 3189 sZta eat :sa TV.r erAt r�o�•GZ 9u -

ADJACENT RIPARIAN PROPERTY OWNER srAT VT
(FOR A PIERIONCOVEX" BOAT LIFT]
I hereby certify that 1 own p rry adjacent to
(Name of Property Owner)
(Lot, Block, Road, etc.)
on ��►-,►-til in.'u .�- , N.C.
(Wsterbwy) (Town ao&or County)
He has de9Ctiboi to me, as shown below, the devdopmmt he is pmpozing at that
location, and, I have no objections to his proposal. I understand Ow a pier/uncovemd bast lift
must be sat back a minimum distance of ME= feet (154) from my area of ripatW accw unless
waived by me_
I do Alga wish to waive the setback requirwrWat.
149 wish to waive that settback requimumt.
DMCRTPMIV AND/OR DRAWING OF PROPOSED DEVMOI'MEM:
(To be j ed M by t+a&WdiW pmP•+alnt developw4M)
JUL 2 3 2004
Morehead GitY ""0
print or Type Name
Telephone Number
Date. 00 k -
mote alaa LLB 99l ;SZ Xy3 LT;eT r9og-07,!90