33931_SCHEPER, RICK_20040211

CAMA / ❑ DREDGE & FILL
GENERAL PERMIT
_
❑New Modification ❑Complete Reissue ❑Partial Reissue
Previous permit #
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
�� 1 Rules attached.
Applicant Name
Address .!6 P 3 %or<< idor F✓;
City State /�%l ZIP �K�)
Phone # Fax # ( )
Authorized Agent ` )57", 0<
Affected -i CW ElEW ElPTA ❑ ES ❑ PTS
AEC(s): OEA 1_ 1 HHF ❑ IH ❑ UBA ElN/A
C PWS: ❑FC:
ORW: yes / no PNA yes / no Crit. Hab. yes / no
Project Location: County / 'r-y
Street Address/ State Road/ Lot #(s) 2.
Subdivision
CiZIP ?4 S C-C
Phone #
River Basin
Adj. Wtr. Body i' / i "% r^. (nat /man /unkn)
Closest Maj. Wtr. Body
Type of Project/ Activity
Y , a /./„ /LV (
i� �� �:: %�� a,•� % Scale:
Pier (dock) length)
Platform(s)!] f f - } — _T
a
Finger pier(s)Ir
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
-
I
_
X
—
�
I
,
I
—V
--
-
cubic yards
Boat ramp
Boathouse/ Boatlift,
i
-
Beach Bulldozing
Other
I
I
�
i
Shoreline L ength.
SAV: not sure yes no
Sandbags: not sure yes no
. -
Moratorium: n/a yes no
Photos: yes no
Waiver Attached: yes no
A building permit may be required by:
Notes/ Special Conditions
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River Basin
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Gavtt
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❑ See note
on back regarding
rules.
Agent or Applicant �,rifit `d N6ne
Signature Please read compliance statgpaeftorfback of permit *
Application Fee(s) �/ - Check #
Permit Officer's Signature
Issuing Date
Expiration Date
/1 2 v �
Local Planning Jurisdiction
=J
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, certifythatthis project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
❑ Tar- Pamlico River Basin Buffer Rules E] 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 / 1-888ARCOAST
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
151-13 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

GPG33`%. �
1C'K s cis C3y�35 INC.
CH°� Av
06LEYs o o FOUR Y ROAD PH.A252 6366-RS,
p.O. BOX 3482
NEW BERN, NC 28564
PAY
TO THE
ORDER OF
RBC
Centura
RBC Centura Bank
yW , NC 26560
4615
66-85/531
DATE D
DOLLARS
FOR - 5�i■ �;0 5 3 LOOB 50i:0 3900 16 2 5Ms oclo
= ant
_

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGSIBOATLIF (BOATHOUSE)
I hereby certify that I own property adjacent to 21 k c,1 's
(Name of Pr6perty Owner)
property located at S%.2 3 // Q 11 6�, �Q :2)p, ,
(Lot, Block, Road, etc.)
on � th _ A) T� %�5K1 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 do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
�'< '0
---------------------------- --------------- ---
. v
Signa e
-j-- 4 - . 'T'
Print or Type Name
Telephone Number
Date: '�? 3 "- 0 V

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGS/BOA7LIFT/BOATHOUSE)
I hereby certify that I own property adjacent to (', 1 is
(Name of Property Owner)
property located at DP, >
(Lot, Block, Road, etc.)
on� lI i 1��.�ky� in N F4J /34d0 L°�c.6J , 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 dQ not wish to waive the setback requirement.
I ,dQ wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be fUled in by individual proposing development)
Print or Type Name
Telephone Number
Date: ` C;2-7 v :)-y

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