42965_HARRIS, RICK_20050926

�' A VIA / U DREDGE & FILL cl .a I -Cis d,,� -w�+iV �.
._� NERAL PERMIT permit Previous #
New r]Modification ❑Complete Reissue ❑Partial Reissue Date previous permit iss ed
As authorized by the State of North Carolina, Department of Environment and Natural Resources i
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
❑ Rules attached'
Applicant Name E 1 i j County___
� Project Location:
Address Street Address/ State Road/ Lot #(s)
City - State ZIP
Phone # ( ) �( r { Fax # O Subdivision
Authorized Agent City , -' ( + ZIP
Affected CW 7EW ❑PTA ES C PTS Phone # River Basin
AEC(s): OEA ._ JC' HHF IH 1 UBA ❑ N/A Adj. Wtr. Body +{��
• _ (nat /man -/unkn
C' PWS: El 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, chanpel
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: t7vsrho
Waiver Attached: w--Jr
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 #
(Scale: )
❑ See note on back regarding River Basin rules.
Permit Officer's Signature
Issuing Date Expiration Date
Local Planningf urisdiction
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 J 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 (910-796-7215) for more information on how to comply with these buffer 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
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
400 Commerce Ave
Morehead City, NC 28557
202-808-2808/ 1-888-4RCOAST
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
910-796-7215
Fax: [phone]
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)
Revised 06/29/05

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� P�l�rESs
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT SjZ t,j4
I her6by certify that I own property adjacent to
�4�E'AN, Z.7be q
2ICg 1'46P- S gIQ- ZGG-��33 's property
located at 22-0,3 -1:7Q0fdr , on
(Lot, Block, Road, etc.)
1 A(fe-oil S e 26EK- in iiCA0 f ;o—PT - . N. C.
(Water Body) (Town and/or County) 28516
He has described to me as indicated below the development
he is proposing at that location and I have no objections
to his proposal. I understand that a pier, pilings and
dredging must be set back a minumum distance of fifteen feet
(15') from my area of riparian access unless waived by me.
I do not wish to waive that 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.)
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H ADJACENT RIPARIAN PROPERTY OWNER STATEMENT LESS ` $TE Z S
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I hereby certify that I own property adjacent to
2ICq, AAbP-021S gi4-?-&r' 3 s property
lobated at 2-Zo,3 !V(2o&1r 19rt--- , on
(Lot, Block, Road, etc.)
ACf t-OAeS e P66VC— i n 3,C-Ati Fob N.C.
(Water Body) (Town and/or County) 28S/G
He has described to me as indicated below the development
he is proposing at that location and I have no objections
to his proposal. I understand that a pier, pilings and
dredging must be set back a minumum distance of fifteen feet
(151) from my area of riparian access unless waived by me.
I do not wish to waive that 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.)
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