40945_HARRISS, THELMA_20050207

'---'LAMA J DREDGE & FILL
GENERAL PERMIT Pre 6permit#
LJNew L iModification _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
❑ Rules attached.
Applicant Name__ - '' `� �'`�� 1 �� Project Location: County
' �' y (•
Address _ _ � •` '' '/ ' Street Address/ State Road/ Lot #(s)_--__-_
City------ �`�— State .qi ZIP ; ----------
Phone # { _) Fax # (,) Subdivision _
Authorized Agent 4", City--------- '; r•; < t ZIP--------------
Affected CW ElEW ff PTA ❑ ES ❑ PTS Phone # (__--) River Basin
OEA ❑ HHF ❑ IH ❑ UBA El N/A AEC(s): Adj. Wtr. Body ` " -(Rat /man- /unkn)
PWS: ❑FC:
ORW: yes / no PNA yes / no Crit. Hab. yes / no
Closest Maj. Wtr. Body O
Type of Project/ Activity
(Scale: )
Pier (dock) length _.
Platform(s)
Finger pier(s)__ __ j
Groin length
number -- — -- _
Bulkhead/ Riprap length______
avg distance offshore___
max distance offshore
Basin, channel
cubic
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other -
t
Shoreline Length
SAM not sure yes
no
Sandbags: not sure yes
no
Moratorium: n/a yes
no
Photos: yes
ho
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 #
i - '
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, certify that this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
El 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 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: Fax: [phone]
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293 / 1-888ARCOAST
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

001�t)NITAL 1�l".1 h Y ( 11 IJEll 0
POSTdI SERVICES 00
SERIAL NUMBER YEAR, MONTH, DAY POST OFFICE U.S'. DOLLARS AND CENTS
0 7 =3 5 9 0? 9 2 7 8 2005-01-14 2e5700 ,' N4 2 !2 d,
AMOUNT. ►_ NE HUNDRED DOLLARS & 00s
PAY TO "�A-Z
NEGOTIABLE ONLY IN THE U.S. AND POSSESSIONS
d
SEE REVS SE WARNING
ADDRESS
FROM %
CLERK
ADD
C.O.O. NO. OR-T
USED FOR
t7j.1,
I
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1:00000800 21: 0 7 3 S90 29 2 7811'

•
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ADjA.CEN T RIpAA,RI&N PROPERTY OWNER
ST AT ENW N '
(FOR A PJ�EfilXfOORING Plt.t G
I hereby certify that I own property adjacent ta(���n1e of Pralae�Y Owner)
s
property located at
(Lot. $itdck, Road, etc.)
N.C.
on / _ (Town an I r Cur►ntY)
(Waterbody)
I-Ie has described to nit, as shown below, the development he is proposing at that Imation,
and, I have no objeCtinns to his proposal, I understand that a pier/mooring
pilings/boatlifUboathousc must be set back a minimum distance of fifteen feast (I5' ) from my area
of riparian access unless waived by me.
I wish to waive the setback requirement.
I do wish to Waive that setback requirement
-------•-------------
DESCRWTISON A'NWOR hRANV I dG O �o PRsing OPOSED
�DEVELOPMENT:
ELOPMEN :
(To be fd' led in
T
60
............ -------
S►gnature
L E S
Print or Type Name
Telephone Number
Date: � ,Z /�_.......-..--..-•--�----_,----__

AjAC]E T RIPARIAN PROPERTY OWNER S Ovs ENT
(FOR A PIERIAtOORIMG RIL GS
,g
J hereby certify that 1 own property adjac�nc ►c+`Nanle of Property Owner) ^-�I
property located at �F Blo, Road, etc.) T_
N.C.
in
on (Town and/o CoUnty)
(1N terbody)
)fie } described W ns+e, as shown below, the development he is proposing at that location,
and, 1 have no objections to his proposal. I understand that a pier/Mooring
pilingslboatlifV'boathouse must be set back a minimum distance of fiftetr, feet (SS') from my area
of riparian access unless waived by me.
J wish to waive the setback requirement.
J to wish to waive that setback requirement.
------- •--------------- - - - - -•
--_-_...DESCRIFIVO" 1 AND/OR DRANVING OF PROPOSED DEVELOPMENT*.
(To be filled in by individual proposing de+,elopment)
� * " ---�
---------------------
Signature
Print or Type Narne
Telephone Number
Date: - (' D - v