38312_SAFRIT, ROBERT_20040415

�/ DREDGE &FILL EJCAMA Cy
GENERAL PERMIT
Previous permit #
[_ New ❑ Modification .--'Complete Reissue `Tartial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources j
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
C:. } C' Rules attached.
Applicant Name 'i 4 �,� �`i t L �_`{ Project Location: County _
Address—, '� .-x Ll � ; j �; Street Address/ State Road/ Lot #(s) .(
City;-j!_ i t 4 jr State._._ ZIP
Phone # (J Fax # () Subdivision —'—�
Authorized Agent `'1 City >F -140 ( Q i C _ ZIP
❑ CW ❑ EW b7 PTA _ ES PTS Phone # ( �� River Basin
Affected ❑ OEA `❑ HHF IH : UBA N/A
AEC(s): Adj. Wtr. Body 1! C : l / ,F' i� j C (nat /man /unkn) 1
❑ PWS: F-1 FC:
ORW: yes / no PNA yes / no Crit. Hab. yes / no Closest Mai. Wtr. Body
Type of Project/ Activity
Pier (dock) length
1
Platform(s)
Finger pier(s)
I
i
!
(Scale: r )
- - ....
Groin length
number
Bulkhead/ Riprap length_—
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Y
Boat ramp — -- --r -
Boathouse/ Boatlift
Beach Bulldozing
I
Other
Shoreline Length
SAV: not sure yes no
Sandbags: not sure yes no -
Moratorium: n/a yes no
y
Waiver Attached: yes no
A building permit may be required by:
Notes/ Special Conditions
-
L
—_
-
!
-- -
171
-
-
I
I
-
1
1
1
1
1i
I
I
__
_ -
- - •
- -. - _ _- .
- tlt ,.
River Basin rules.
.
�i
#
See note
on back regarding
Agent or Applicant Printed Name Permit Officer's Signature
- 3
Signature ** Please read compliance statement on back of permit **
Issuing Date
Application Fee(s) Check # Local Planningf urisdiction
Expiration Date
Rover File Name

U
1
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, certifythatthis project is consistentwith the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
❑ Tar- Pamlico River Basin Buffer Rules
❑ Neuse River Basin Buffer Rules
Other:
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

4
R W SAFRIT
PH. 919-782-3128
3716 STONEHAVEN DR
RALEIGH, NC 27609-7028
Pay to the
Order of
4473
66-112/531
Date YYY 13014
BLEW um ,
BRANCH BANKING AND TRUST COMPANY
1.
RALEIGH, NORTH CAROLINA ..... c o 1 o
Ior3F53I'�-
i:053101 12 0: 1303 2 2 1 23SO 1,473
DC'.—gmerKan
I $
Dollars
NP
i

ADJACENT RIPARL-kN PROPERTY O"NER STATEMENT
(FOR A PIER/MOORING PILINGSIBOATLIF (BOATHOUSE)
I hereby certify that I own property adjacent to Robtv�- VEAFRJ 's
(Name of Property Owner)
property located at /4 0 8 B Fy-P n�
j (Lot. Block, Road, etc.)
-�
on l o F's C�` Q P, , in BP.A u C4Nt *V� 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
pdin gs,'boatliftlboathouse must be se: back a minimum distance of fifteen feet (1 ') from my area
of riparian access unless waived by me.
I do not wish to waive the setback requirement.
I da wish to waive ti-at setback requirement.
DESCRIPTION AND/OR DRAWLN- G OF PROPOSED DEVELOPNfEtiZ':
(To be filled in by individual proposirc; development)
Print or Type Name
�7 4 L -B
Telephone Dumber
Date: i � — \ �'— — '-�' ►k-

ADJACENT RIPARL-kN PROPERTY OWNER STATE-NMN f
(FOR A PIER/MOORING PILINGS/BOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to f o�eA � SAF 1t�'s
(Name of Property Owner)
property located at 16 OS B F r o 6f Jt
/ (Lot. Block, Road, etc.) J
on MIOUS in B.e"%RP1 / yC , 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; aoatlirt/boathouse must be se: 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 d-Q wish to waive tat setback recuirement.
DESCRIPTIONND/OR DRAWLN- G OF PROPOSED DEVELOP.NIENT:
(To e filled in by individual proposing development)
tq - • 1!0
ADA<
- 16+'gr. ie
a
--------- - ----------- ------- r------ -----------------------------------
,L0q0qp,1-
Signature
Print or Type Name
Telephone Number
\Nfe i ss
Date: " a� - 0 �