40321_FREEMON, JOSEPH_20041104

C
CAMA / REDGE &FILL
� f} ♦
;. � of 21
GENERAL PERMIT
_ r
Previous permit#
[_. _New JModification L !Complete Reissue DPartial 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
r
J / `
['Rules attached.
Applicant Name �� '�
Project Location:
County
Address _ %
Street Address/ State Road/ Lot #(s)
City- `�`�.., State:'': C. ZIP 6
s -
Phone # O ' 7 Fax # (_)
Subdivision
Authorized Agent "� _
City
ZIP
J
CW D EW ❑ PTA Fj ES O PTS
Affected
Phone #
River Basin J
�� oEA ❑ HHF ElIH � USA ['I N/A
AEC(s):
Adj. Wtr. Body
/ t t r
`� (nat /man /unkn)
ORW: yes / no PNA yes / no.; Crit. Hab. yes / no
Closest Maj. Wtr.
Body_ __— __—
Type of Project/ Activity
Pier (dock) length `
Platform(s)
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
b" 'N' 11:.' L,
• i V 4� " C
;J: .
r�
+- K
f,N
Shoreline Length
SAV: not sure yes no
Sandbags: notsure yes no;
Moratorium: n/a yes no
Photos: yes no i
Waiver Attached: yes no:
A building permit may be required by:
Notes/ Special Conditions
Agent or Ap scant Print d Na e
Signature * lease'readcompliance statement onback ofpermit"
Application Fee(s) Check #
a -See note on back regarding River Basin rules.
ermit icer'sSignature
ty
Issuing Date
Expiration Datt
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:
i_
i Tar --Pamlico River Basin Buffer Rules 1 Other:
-; euse 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
151-B Hwy. 24
Hestron Plaza 11
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.nccoastaimanagement.net
Revised 10/05/01

JOSEPH M. FREEMON 6Pc 1<0 2 1 7904
DL 327247 PH. WK. 2524"7647
2800 OLD CHERRY POINT RD. ,, , 66-19/530 NC
NEW BERN, NC 28560 Date 3100
Dollars 8 � t
BankofAmerica
Ij Bank of Am rica Advant eO
ACH R(f 05300019¢
For (.�- - -`-1121-� _
1:0 5 3000 1961: 000 3 1309 7 5011' 7904
Cc-1e4merican GUARDIANASAFET BLUE DESL
7

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
(name of property owner)
property located at &I'l U 1 $r"�=
(Lot, Block, Road, etc.)
on �'� l -. t qC 1 in a l3e� r. c��ysr't , NC
(Waterbody) (Town and/or County)
He/She has described to me as shown below, the development he/she is proposing
at that location, and I have no objections to his/her proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development)
Ly t� 6ry I I—Fc
Print or Type Name
ZS676 '5Lff
G Telephone Number
Date

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to �JL,"jaC�j �� ,=t,�-.,'�.� '� �h 1c�►
(name of,property owner)
property located at �..� YOB` 1
(Lot, Block, Road, etcL--)L.1
on �11t t 1+iE �y,4k in U,NC
(Waterbody) (Town and/or County)
He/She has described to me as shown below, the development he/she is proposing
at that location, and I have no objections to his/her proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development)
AS - �-� L 4
Signature
rr� T
Print or Type Name
A D
2 F) D - \A -
Telephone Number
�pj!K
Date