38374_ROYAL, DAVID_20040518

CAMA / ❑ DREDGE & FILL
GENERAL PERMIT Previous permit#
�, New VModification IJComplete 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 15A NCAC
❑ Rules attached.
Applicant Name k---4"k V i
ik ,,
..y
c.S cbv:-1
Address_
.1
'
City �i:�'�j�Ci t. !_t, State_ -C1_ZIP'
Phone #'J(6�y
Fax # ( )
Authorized Agent —I ,
❑ CW \>Z EW
Affected
!PTA ❑ ES
❑ PTS
AEC(s): L OEA A HHF
❑ IH ❑ UBA
ElN/A
❑ PWS:
❑FC:
ORW: yes / no PNA
yes / no Crit.
Hab. yes / no
Type of Project/ Activity
Pier (dock) length/
Finger piers) { (9
Groin length
number
Bulkhead/ Riprap length_
avg distance offshore_
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift_ -'
Beach Bulldozing -
Other
Project Location: County
Street Address/ State Road/ Lot #(s)
f ,
Subdivision
City#.+t i t lE. 7t t � r ZIP (L
Phone # ( ) River Basin(fJl
Adj. Wtr. Body �_j. .�4 j 1i 1,i`. k &at )rnan /unkn)
Closest Maj. Wtr. Body`�—
(Scale: A I�-k I)
Shoreline Length
I
SAM not sure yes no
-- -.
Sandbags: not sure yes no 1
Moratorium: n/a yes no'
Photos: yes no
I
C. tle 'Kit'
Waiver Attached: yes o -- -- 1
A building permit may be required by: ❑ See note on back regarding River Basin rules.
Notes/ Special Conditions Ai
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
Issuing to • piration Date
Loc— a- anningjurisdiction —Ro er 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 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
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
15 l -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

Personal Account Information
04I1'512004 14:22
0417.5/ 2004 12: 55
9105725395
252722499Q
BF I
ROGER CINNER
PAGE 04
PACE 02
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AWACEWT ItXP^RrA.X PROPVRTY OWNER STATEMENT
I hereby certlr „that r *Wn property adjacent to :
property located a,
rear (water body',
in ;county) 2, �,
h
The a,ppl —zant described to me as shown belov, the ve.lopa*nt
h*/She is ,p opoainq in that location arid;
1 hava no oiaJOetioris to this pxoposa2
I deg haVa objacztians to thin ,
proposal
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Description and/or drawing of proposed development.* ro sed���
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CAWnft-V COV14'ry CoURTNOUSE
CENTRAL. PERMIT OFFICE OF
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to:
property located at. �o t El v /ge
near (water body)
in ( county)
The applicant described to me as shown below, the development
hey/she is proposing in that location and:
I have no objections to this proposal ._
I do have objections to this proposal
Description and/or drawing of proposed developmept: �
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(
Signature:
Name:
Phone Number: L2 71 L 5JILL
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RevWw Dfflcer Certtficaticn
Division Survey For
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Febrticry 7, 2004

06/09/2004 09:4'° 9105725395 EFI FAaE 0.2
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AC101" R' P�i� PROPERTY OWN= STA'x'M(ZW
hereby c:rtifr that r own
property adjacent to:
r A
property located at:
n*Ar (water body) _ - r�:)
in (County)
any app siscribtd
he/she iss pro to ma as shown below, tht dsyslonsent
proposing in that location and:
I have Ho objections to this proposal
I do have objecttvns to this proposal
D03Cription and/or drawing of proposed d*velopsentiv%)rehL-:a
f•
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Toe
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Name:
Pmene Number,
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