41380_FOWLER, DON_20050517

❑,CAMA / i ' DREDGE & FILL
GENERAL PERMIT %'�
Previous permit #
ONew EModification 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.
, 0 Applicant Name r' ]ice-G7r Project Location: County
.
Address i J x 4 �� r Street Address/ State Road/ Lot #(s)
City t State
Phone # ( )� �y '7 Vq4 Fax # �( ) Subdivision ;V
Authorized Agent 1`t�c� ? t f-; rYi 1 City f' }1 ZIP
Affected Cw (lw C`PPTA ❑ ES ❑ PTS Phone # ( ) River Basin
AEC s : ri OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A Ad'. Wtr. Body i �'' > / r " natnan /unkn
O C PWS: ❑FC: 1 Y )
ORW: yes / no PNA yes /,f n Crit. Hab. yes / no Closest Maj. Wtr. Body
Type of Project/ Activity
Pier (dock) length —
Platform(s)X_
Finger pier(s) '
Groin length
number
Bulkhead/ Riprap length
avg distance offshore__
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other __ _
Shoreline Length
SAM 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
i
I
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
E aee note on back regarding River Basin rules.
PeFmitCf c1 Ws Signature
Issuing Date Expiration Date
iJ f,, ) , , E OsJ I )kA.
Local Planning Jurisdiction
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 consistentwith the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
J Tar - Pamlico River Basin Buffer Rules i 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 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)
Wilmingaton 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

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FOR REFERENCE SEE
Cj�
DB 233, PG 100
PC A. SLIDE 6-1
PC At SLIDE 37-1 !
THE RATIO OF PRECISION WAS o'er EIP t
CALCULATED AT 1=10,000+
EIP - EXISTING IRON PIN
THIS SURVEY IS OF AN EXISTING PARCEL
AND DOES NOT CREATE A NEW STREET
OR CHANGE AN EXISTING ONE.
THIS SURVEY IS SUBJECT TO ANY FACTS
THAT MAY BE DISCLOSED BY A FULL AND,
ACCURATE TITLE SEARCH-
-
40, 0' 40' 80'
i
SCALE: 1" - 40'
P. 0. BOX 303
ARAPAHOE, NC 28510
TCI C ♦ mrok 316 - n*:) )R
FOWLER,.
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FROM : SASCO,Inc.
FAX NO. : 919-859-0310 May. 11 2005 05:05PM P1
SSCO, Inc' 10-5 T5O8a58 OOD DRIVL FAX RY, N,C. 27511-
0310
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FAXNUMBER-. 919/859-0310

ADJACENT RIPARIAN PROPERTY' OWNER STATEMENT
I hereby certif}' that I own property adjacent to 's
(;\'ame of Property Owner)
cff
Property located at
(Lot, Block, Road, etc.)
G�7
on In
(Waterbody) (Town and/or ounty)
He has described to me as shown belo,.v, the development he is proposing at that location,
and, I have no objections to his proposal.
DE' CRIPTION AR'D/OR DRAWfNG OF PROPOSED DEVELOPIMEN'T
(To be filled in by indii,idual proposing dei,elopm in!)
q1 �-
TelepMne Numb -'I'
Date: %
-29-

FROM :JOHN F POVLICH III PLLC FAX NO. :919-1676-3715 May. 16 2005 02:17PM P1
fi-Iv-la-z00� a1:zi rm rmm6[::Gf l' m m w 1 Hf-K ZJ A1`4 r- z!nz z-+"> 0737
ADJACENT RIPARIAN PROPERTY 0WNTER STATEMENT
I hereby certify' that I Own property 2djnent io
(Ngm`e of Property Owner)
rr� r ) ted at �acIV- �f!
(Lot, flock, Ro'bd, etc,)
(WRterbody) (Town and/o aunty)
He hn-s described to me P-41' thown below, the development lie -is proposing 2t that location,
ttiavc no objections to his proposal.
DPSCRIP7110 UP'IP'S opoSIJD DFUT, QMNIFN
To be filhud in by individual proposin eevelopn«no
JL
f
i'
ion2lur
Pr; n� or Typ: N?me
Telep16 �N�um
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PRESCOTT BROTHERS INC''2999
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141 TARA TRL z ,
GRANTSBORO, NC 28529 66-30/531
PAY f, =f, DATE an
THE OR
ORDER OF
DOLLARS
FIRST CITIZENS 472
U A Al7I First-Cttizans Bank &bust company`f`�`.�
ijral �1� Oriental, N.C. 29571
firstcitciti ns.
FOR
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