41144_HERLANDS, MAN_20050405

1J,6
1CAMA / - QRtDGE & FILL
GENERAL PERMIT Previous permit #
'New CModification71Complete Reissue LIPartial 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 15A NCAC
O Rules attached.
Applicant Name l L! f Project Location: County
Address_ __ i �. / W-� "" 12'd Street Address/ State Road/ Lot #(s)
City (.%/ / '' '- � State r� � _ ZIP `^
Phone # ( `) �S �� " Uhl Fax # ( ) Subdivision -� /' `' i'' ^'"' `� r
Authorized Agent •k City-� l / "'' t ZIP j
Affected - Cw 0•EW ETA ❑ ES ❑ PTS Phone # ( ) River Basin
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body t•, (at %man /unkn)
D PWS: ❑ FC:
Body Wtr.
ORW: yes / no PNA yes / no ,� Crit. Hab. yes / no Closest Maj. T
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
Sandbags: not sure yes `o)
Moratorium: n/a yes ,no
Photos: yes �, no
Waiver Attached: yes no --
A building permit may be required by:
Notes/ Special Conditions
P, - O" I
Agent or Applicant Printed Name
r
Signature "Please read compliance statement on back of permit"
�.—. i 1 ,. —4
(Scale: )
'See note on back regarding River Basin rules.
Permit Officer's Signature
Issuing Date Expiration Date
Local Planning Jurisdiction Rover File Name
Application Fee(s) Check #

e �
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 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 / 1-888ARCOAST
Fax: [phone]
Fax: [phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Morehead City District
151-13 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 10/05/01

(FOR A PREF"OORING MMGSBOATLYTIBOATH'OUSE)
I hereby certify that I awn properly adjacent to Mv�� 5 's
(Name of Property Owned
property loaa ai i 'W\Nz VwrIt", U .
aA4 Block, Road, ete.)
on N eu SC, �.�e� , in N.C.
(Waterbody) (Town and/at Caamdy)
He has descn'bed to me, as shown below, the development he is proposing at that
iochave no and, I hno objections to his poposaL I twlershwd that a -
must be sexback am fin nm ffista= offf=fed (15') from my area
of riparian access unless waived by me -
I do not wish to waive the setback
I —oo wish to waive that setback req i t.
DESCRIMON AND/OR DRAWINGOF PROPOSED DEVELOPMENT:
(To be fined in by vrdividual pmpoAzg devekpzw)
1t n\ v ki
Print or Type Name
A 461 ZI`1G'�
Telephone Number

■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
ti so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
J .IF-r—GD S c-�,,,toCcrT
CIO
� 2. Article Number
A. Signature
X
B. Received by ( Printed Name)
❑ Agent
C. Date of Delivery
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
3. Service Type
.Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
7004 0550 0000 3921 9393
102595-02-M-1540

UNITED STATES POSTAL SERVICE First -Class Mail
Postage & Fees Paid
USPS
Permit No. G-10
• Sender: Please print your name, address, and ZIP+4 in this box •
P.
A ❑ INSUFFICIENT ADDRESS
❑ ATTEMPTED NOT KNOWN ❑OTHER
❑ySUCH NUMBER/ STREET
S 'ip - UNABLE TO FORWARDDDRESSED
jus

U.S. POSTAGE
8ID
ORIENTAL.NC
28571
DEC 21.'Oq
uN rFos nTss
AMOUNT
POSTAL SERVICE
(
$1.12
0000
28560
70
</ (� i'N•-) 0 V ,- 4
SCHU903 2BS6020i0 1N 11 12/a3/04
z
/ (/ f (./ /I RETURN TO SENDER
( NO FORWARD ORDER ON FILE
UNABLE TO FORWARD
RETURN TO SENDER
�h

(FOR A HURIMOORMG PLUNGSBOATLIFTIBOATHOUSE)
M :V\
I hereby certify that Town Property adjacent to A%v1 's
(Name of Property Owner)
Property located at � � r � ��..�z V r w � U .
(Lot, Block, Road, etc-)
on N t'U yC' in 0 ' i -•� e-hX1,\ 1 I\:ItA\(,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 ejections to his proposaL I understand that a piedmooring
pilingslboatIiflboathouse must be aback a minimum distance of fifka feet (15') from my area
of riparian access unless waived by me.
I do not wish to waive the setback requiree =L
I Imo, wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWINGOF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
rn
Signature
X
Print or Type Name
Telephone Number
Date: X

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Obi-�°�`---�-5 ri l erihunced dnt�u mru t. ti -
INNERBANKS MARINE CONSTRUCTION, INC. 1848
P.O. BOX 190 PH. 252-249-1429
ORIENTAL, NC 28571
S Vs 66-30M I
PAY ` DATE 111 J 472
TO THE
ORDER OF Li) EN�Z,
$ * . oo
ryv l4u". rc� okh S� I U
1,-,/ DOLLARS 800-0
FIRST CITIZENS 472
D A 1�TI7 First -Citizens Bank 6 Trust Company
Oriental, N.C. 28571
t� www.first TjzeA'.c
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