40799_HATHAWAY, MIKE_20050201

'CAMA / '- DREDGE & FILL
;F-JNe4 GENERAL PERMIT
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Prpermit #
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DModification Complete Reissue 'Partial Reissue
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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.
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n Applicant Name , !� = M rs i !4 A44) 4y
Project Location: County__________
-
Address_ ' t `' !." X` 4"('4 -N t.,>lJ
Street Address/ State Road/ Lot #(s)
City_ i r C K) v . 1It State ? J� ZIP
"—
--------
Phone # (.,) ~ ' • Fax # (`JJ)
Subdivision
�.. Hj �i�: tit?
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Authorized Agent !�; C
r r'Z)x���G Kr ,�1�
City__' _ZIP
Affected - Cw 4 W ['PTA E7i ES ❑ PTS
Phone # () _ River Basin
AEC(s): i OEA ❑ HHF ❑ IH ❑ UBA C N/A
Adj. Wtr. Body _______
nat Jman /unkn)
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
cuoic yaras-_
Boat ramp
Boathouse/ Boati t
Beach Bulldozing
Other -- --_--_ _ _--
iN ,
r; I.-
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
Agent or Applicant Printed
Na/me
C W�
Signature ** Please read compliance statement on back of permit
Application Fee(s) Check #
(Scale:
See note on back regarding River Basin rules.
" l'" I Jirl•t�h- .!'f �C•-�.cFlt-K.-i+,(. �._._
Permit Officer's Signature
4
Issuing Date Expiration Date
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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 3o 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 complywith 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 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.nccoastaimanagement.net
Revised IO/OSl0I

THIS MULTI -TONE Am-
PAY TO THE -_
ORDER OF 1_�)
pli APER��RA TELFERS EXPRESS COMP
' O. BOX 9476. MINNEAPOLIS, MN 5548
;P_AWEE' FIRST INTERSTATE BANK, HE
11"Itti COLOR GRADUALLY AND EVENLY FROM DARK TO LIGHT WITH DARKER AREAS BOTH TOP AND
T) j7
NOT VALID OVER $1,000.00
ISSUING BRANCH 611
DATE - - --: �I-
--DOLLARS By SIGNING YOU AGRE,
- AND OTIJER TERMS
ANY. INC.
H AtF, LENA, MT ER FOR DRAWER
_rl-N
RE
T"STATE
III S 169 23 3 111, 1:09 2005I, 111:0 1 ?o ? 104 s loll 2111
9 THIS DOCUMENT HAS AN ARTIFICIAL WATERMARK PRINTED ON THE BACK. THE FRONT OF TPIE DOCUMENT HAS A MICRO -PRINT SIGNATURE LINE AND BORDER. ABSENCE OF THESE. FEArURr 3,4

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DJ CE_NT R!_ 4j rig ,_L: s1'i PR �FiR l 0 WNER S A AT Nn__�.1'� .
(FOR A PIERIUIYC-7OVERED BOAT Lil
I hereby c:ercify that I own propery adjacent to 's
(ti rime of Property Omer)
property located at
(Lot, Block, Road, etc.)
on in N.C_
(Waterbody) (Tow-n andlor! County) `
He has described to me, as shown below, the deve.'opment he is proposing at thac
location, and, I have no objections -to his proposal. I understand ghat a pier/uncovered boat lif`
must be set back a minimum distance of fifteen feet (15') from myjarea of riparian ac;. ss unless
waived by me.
i
I do not wish to waive the sc�back requirement.
I do wish to waive that setback requirement.
------------------------------------------------------------ _------------_-_--_-------------------------------
DESCRIP'ITO. .ND/OR DRAWT G OF PROPOSED;DEVELOP?NiE.NT:
(:To be )Wed in by individual proposing devel, pmerzt)
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Signature
Print or Type Name
Telephone Numb r
i Date:

� � 1
i
J1?t CE! O : Ai;
v Y 0 !W Y r f ~ate' ' 4� �i Tf
(FOR A PIER/UNC0YERED ,BOAT L+I
I hereby cer-�fy that I own property adjacent to S
(N e.bf Property er)
property located at I I
y
(Lot, Block, Road., etc.)
on &L�4'-
Waterbody)i.
(Town an'dlorCounty)
He has described to me, as shown below, the developr,ent he. is proposing at that
location; and, I have no objections to his prow&—:Lt. I understand 10 at a pier/uncovered boat 1ft
must be set back a minimum distance of riretin fe~t (15') from my a ea of riparian access t riles
waived by me.
I do dot wish to waive the. sc;Jack requirerrnent.
r
I do wish to waive that setback requirement. t
----------------------------------------I- - ---------'-'----_...--
DESCRIP'i'IOiv A-ND/OR DRAw�DEOP
YG OF PROPOSED,VEL.MZNT:
(To be filled irz by individual proposing devel *rent)
Ste-
F
MEJ
JAN 2 az
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-----------------------------------------------------------------------------------------------------------------
Signatur
soy( rE��
Print or Type Najne
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Telephone:Numb r
Date: 1-- 14— !> 15" _
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AXII CF—VI, -. X FA
(FOR A PIER/UNCOVERED BOAT. LJIFI)
I hefeby c--,-dfy that I own property adjacent to MLi I)Nf is y- 1 4,
C lum e b r Property 0 wrier)N:
property
oper-Ly located at
(Lot, Block, Road., etc.)
on (VAO MADE OFMaMC—T�:'C-4
C
(Waterbodv) (Town and/or g2y
He has desc,-ibed to me, as shown below, the devefopr�.ppt he.is proposinz at th4
location, and, T have no objections to his proposal. I understand IoAt a pier/uncovered boat Ii
must be set back a Minimum distance of Fifteen fe—'[ (15') from my i�'ea of dpaiian acc'�ss unI
es
Q
waived by me.
tT
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I do.not wish towaivethe se�back reQuirCment. '.
JAN 2 4 2GO
I do wish to waive that setback 1-ecui-rement.
Morehead City. DCM
---------------------------- ------ - ---- — -- - ---------------- - --------------
DESCR=0,N.A.ND/OR DRAW-ENG OF PROPOSED' DEVELOP M EN T:
(To be fWed in by ire-dividual proposing deve pment)
5 i5e-
rint or Type Nalrie
T-Ilephone:Num
Date:

0
g JA N 2 4 2005
o��head City 4
ft�

(FOR A PIERIUNt:OVERED BOATLIIF7)
i
I hereby'cerLify. that I own property adiac;nt to
(N ltie.`of Property Owner)
property located at a -S-4K� �L
(Lot, Block, Road., etc.)
(W'aterbody)
(Town an;d/o) County)
He has described to me, as shown below, the devulopr-Went he. is proposing at tl;a.
location, and, I have no objections to his proposal. I undrstand (haC a pier/uncovered boat l
must be set back a minimum distance of fI tern fit (15') from my ja.rea of riparian access uri es'
waived by me.
I do not wish to waive the setback requirement.
I do wish to waive that setback reauiremen:t. 4 Z005-
� JAN
---------------------- ------------- ----- -------------------- -------------------- -- - _
DESCPJPUO.v A,N-D/OR DRAW -G OF PROPOSE �:
(Ta be )Wed in by individual rn osin deve ment
i P P g ,(.,P )
`1'
i
Print or Type NaMe
�Sa - 7a4,-2
Telephone.' -Numb r
Date: / h2 I `IOS

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSIBOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to M� w '� 's
,(�, �,' �, niqLt
(Na ne ofProperty Owner)
located at a s�-t� Q
property
(Lot, Block,
//Road,
,,etc.)
on , in ll-'C-SZ� 9-:�S rail& 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/boatliftlboathouSe must be set back a minimum distance of fifteen feet (15') from my area
of riparian access unless waived by me. i
I do not wish to waive the setback requirement.
FFE?,
I & wish to waive that setback requirement. Mow-hadd CiI Y I)CM
------------------------------------------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOP`1ENT:
(To be filled in hy inditi,idual proposing development)
5zx J" JNau�
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iR attire
Print or Type Name
Te phone Number
Date:

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