40080_HAINES, LINDA_20041018

C]CAMA / 1_I DREDGE & FILL
GENERAL PERMIT Previous permit#
❑New —]Modification ]Complete 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 I SA NCAC
f 7.j{ "-5 ❑ Rules attached.
Applicant Name ! ' A.,17R � %� "- e' ? Project Location: County
Address '� ��/,�1 x oe r, Street Address/ State Road/ Lot #(s)
City ; ; � .k"� c'�i `' ��' vVState ZIP
Phone # ( ) ''' ' `� Fax # ( ) Subdivision
Authorized Agent City___ _ ZIP_
Affected F7 CW aEW ❑ PTA !ES I PTS Phone # ( ) River Basin
AEC(s): -' OEA ❑ HHF ❑ IH L UBA -1 N/A Adj. Wtr. Body (nat /man /unkn)
PWS: ❑ FC:
ORW: yes / no PNA yes / no Crit. HabClosest Maj. Wtr. Body
. yes / no — _
Type of Project/ Activity
Pier (dock) length
Platform(s) z�
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
,c
.. ...:.....
(Scale: ) I
Shoreline Length
SAM not sure yes no i
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
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
See note on back regarding River Basin rules.
Permit Officer's Signature
Issuing Date Expiration Date
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, certifythat 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:
Ji 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 / 1-888-4RCOAST
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

ALve
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Michael F. Easley, Governor Charles S. Jones, Director William G. Ross Jr., Secretary
October 18, 2004
Linda G. Haines
128 Maxwell Drive
Harker's Island, NC 28531
Dear Ms. Haines:
Attached is General Permit #C-40080 to install a 4' x 24' pier to a 12' x 24' "L" head platform in
Carteret County within the Harker's Point S/D adjacent to Brooks Creek at Lot 27 Maxwell
Drive, Harker's Island, NC.
In order to validate this permit, please sign all three (3) copies as indicated. Retain the white
copy for your files and return the signed yellow and pink copies to us in the enclosed, self-
addressed envelope. If the signed permit copies are not returned to this office before the initiation
of development, you will be working without authorization and will be subject to a Notice of
Violation and subsequent civil penalties.
We appreciate your early attention to this matter.
Sincerely,
Mark Hardeman
Coastal Management Representative
MH/srk
Enclosures
151-B Hwy. 24, Hestron Plaza II, Morehead City, North Carolina 28557
Phone: [phone] \ FAX: [phone] \ Internet: www.nccoastalmanagement.net
An Equal Opportunity \ Affirmative Action Employer — 50% Recycled \ 10% Post Consumer Paper

LINDA G. HAINES
128 MAXWELL DR
HARKERS ISLAND, NC 28531 Date
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Pay to the
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Credit Union
CARY, NC
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88-9290/3119
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSIBOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to y (i! _ ct�'-, -or, 1 /J.'U 's
(Name of Property Owner)
property located at %-t�� r -7- 4,,ty- h -d TD ! n--L SaGJJ,'b1S/0rA
(Lot Block, Road, etc.)
on c �'f�Dk `� �rC� , in Par" 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/boadift/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 & wish to waive that setback requirement.
-------------------------------------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
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------------------------------------------------------------------------------------------------------------------
Signature
Print or Type Name
Telephone Numb r
Date: (/

Brooks Creek Channel Harker's Island
Lot 27, Harkers Point Subdivision
Harbor of Refuge
Boat
Brooks Creek Channel
QPffry-
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSIBOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to)L—L d0- (= 1. � l ji t5` 's
(Name of Property Owner)
property located at )�/ S A
f (Lot, Block, Road, etc.)
on in 4r-J S - ,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)
alo-Jqe� 0'9�g-y &i� )A-
OL'i W-J-
--------------------------------------------------------
A� -
Signature
Print or Type Name
Telephone Number
Date: �� _

0 y rLe ✓ 1-0T
Brooks Creek Channel Harker's Island
Lot 27, Harkers Point Subdivision
Harbor of Refuge Brooks Creek Channel
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