40365_GUMUCIO, JORGE_20041130

_i CAMA / DREDGE &FILL /
GENERAL PERMIT �� ������r
Pf�evious permit #
--?New I --Modification [-1Complete Reissue JPartial 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 arirea of enviro ental concern pursuant to 15A NCAC
cJ 6 t i-1 Rules attached.
Applicant Name Project Location: County_
�a
Address — Street Address/ State Road/ Lot #(s)
CityStateZIP 1
Phone # ( ) Fax # ( ) Subdivision
Authorized Agent City--____-____-----_-__---_-- ZIP -------------
Affected _- CW D EW G}PTA ❑ ES ❑ PTS Phone # () _ __ - -_ - River Basin _
OEA -i HHF ❑ IH [- USA [I N/A AEC(s): - Adj. Wtr. Body. ------- ----__-----_---_(nat /man /unkn)
0 PWS: ❑FC:
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
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
Agent or Applicant Printed Name
(Scale: ) I
See note on back regarding River Basin rules.
Permit Officer's Signature
Signature ** Please read compliance statement on back of permit **
Application Fee(s) Check #
Issuing Date
Local PlanningJurisdiction
Expiration Date
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:
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 / 1-888ARCOAST
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-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

NOE CONSTRUCTION & SERVICES 972 HIGHWAY 101 WACHOVIA BANK 1709
AA
BEAUFORT, NC 28516 BEAUFORT, NC 28516
[phone] 66-211530
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1r00170911, 1:0 5 3000 2 L 94
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2054600044753n2

t1Uj.-xt,Jr,LN t JtLWA j p►1v rKVY.&Kl Y V WPNEK 61'A1TAVlriNT
(FOR A PMRIMOORING MUNGSIBOATU BOATHOUM
I hereby certify that I own Property 4acent to 6 v w\U(-:%U 9s
sine of Property Owner)
PAY located at Q6 ; 't e-A
[Lot, BIock, Road, etc.)
an &o w m Lic e-1 () r, e���\ GRw��� c.n N.C.
(Waterbody) (Town and/or County)
He has descnfed to me, as shown below, the development he is proposing at that
location, and, I bave no objections to his proposal- I imdertand that a pier/mooring
p' ings/boailiMoathouse must be set back a minimum distance of Rf=n feet (15') from my a=
of riparian access unless waived by me.
I do not wish to waive the setback requirement
I Imo wish to waive that setback requirement
DESCRIMON AND/OR DRAWING OF PROPOSED DEVEI OFNIENT:
(To be,Bled in by &&idud Proposing developamw)
k�C LAA
Signature
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Print or Type Name �j
u
x�-5- -;:2 _,)y 9 373%
Telephone Number
Date:

riu�ri�,r�ty z zurtiman rKVrk KIL Y V YYAhK ,'tA VV1hN'1'
(FOR A PLU MOORING PILINGSBOATf.IFIBOAMOUSE)
L
I hereby certify that I own property adjacent to G u .v,\ Utr \ G'049s
ame of Property Owner)
party located at 1 a0 Fv ; k K R-� : \des A
0ot, BIock, Road, etc.)
on &U-Wv Ns C' C'e y' , in .T �.. w� G�w`�� ("0 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 pmposal. I understand that a pier/mooring
pilings/boatliMoathouse 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 go wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVUOF5ZEIV'T:
(To be , f �71ed in by indnulual pmposing development)
Print or Type Name
x -Z5Z. 1� � Z�-7-7 ?-,
Telephone Number
Date: ;(