40753_HOOPER, TOM_20041221

MAY-04-2005 04:09 AM SHORELINE MARINE CONST. 1 910 S26 8523 P.02
• 46AMA / 06 & FILL
NQ 407534
GENERAL PERMIT
eta �'Modffication --'Complete Reissue--lPartial Reissue
Previous permit #
As authorized by the state of North Carolina, Department of Environment and Natural Resources �fDate previous permit issued
and the Coastal Resources CommISSIon in an area of environmental concern pursuant to I SA NCAC7f ` /; C; ('�
Applicant Name ^TC2'-'t
`�-
lea attached.
Project Location; County, -4�i��-�.�t-.
Ad�dyress/„_�� (} , ���, ,: , /
i✓,,.
—�
Ci'/ LJ
Street Address/ State Road/ Lot #{s)
-. L' —. _. state ./L4f zip h 7 f P / /
Phone # (• 1-L) - /� �' Fax #
Subdivision (M ivk7�'�t
Authorized Ag ent }`�,�.i t� J=-'
_P
r -�
Cityl'�-r r/ CZIP
Affected `'�� �v 'A c fg '� Prs
Z 0 I1A ❑ HHF
Phone # (_._ } River Basin �.
AEC(s): ❑ IH ElUdA ❑ WA PWS; FC;
❑
Adj. Wtr. Body— c Z_� rG"'P cI __manan unkp)
ORW: yes - no PNA yes I CNt. Mab. yes ( ;
Closest Maj, Wtr, Body,
of Project/ Activi
Type ty C: [Je-�• � ����ir4; c.Q � C�� �� %y't.q,-.I+'1 3 C 1i 3 2 �' vc,:�: ,
X r 1 sa >iY �" ti� Z aC
Pler (dock) length-
- — _ ... ..,.
Platform(a) /�� �Jf ! i, r �- - _, ,_. --.. .. ._..._._.- _.-....•..
FlnSer piers) •!' _ +l�„ � i,,%� �,� ,I'!
Groin length number
Bulkheadl Ripmp length o' '
an distance off:horo •-'' L' _
max distance offshore_ - - -
Basin, channel _._L - ---- \ -.._ -
r
cubic ds
Boat ramp --
I
Beach Bulldozing \ X L
Other
T_
Shoreline Lenst►t i
$AM not sure yes kno
lj 1 l
lktSandtrags: not aura yes
Moratorium; nra yes � e,,_TPhotos;
Waiver Atraci,ad:
A building permit may be required by: ►'w11,4. �}�G ' C See note on back regarding River Basin rules.
Notes/ Special Conditions �i to /1-1 11f1 e./ Gy � �1' E),�� � C 11,4?1 r -C-
Agent
Sisre / PI se read compliance statement on back of /aj-_
Permit
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Name 5- uPJE-
Account No
PAY TO THE
ORDER OF --.----
WACHOVIA Wachovia Bank, National Association
Charlotte, NC 28288
FOR q
t:0 5 3000 2 191:
0000 532070 (1000/BX Rev 02)
92479
1005 66-021l530
DATE
='—
DOLLARS

CAMA / ` DREDGE & FILL t" ,; � A
GENERAL PERMIT Previous permit #
-�Nevv 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 15A NCAC
n'Rules attached.
Applicant Name d +^'' /C C, . F f' Project Location: County C � J r ,' '
Address_ 91.' !«^ �'„ G= Street Address/ State Road/ Lot #(s)
City { . `, �} State _ ZIP --
Phone # {) `7 j Fax # (u) Subdivision r ,
Authorized Agent i j /r ' r� , .` City— a : 1 f _ ,f , r -- ZIP
f �..- f
--I CW P1 EW Ll PTA ❑ ES ❑ PTS Phone # () _ River Basin
Affected OEA HHF IH Ci USA ❑ N/A
AEC{s): Adj. Wtr. Body______ (nat ban unkn
1_1 PWS: �- = FC:
ORW: yes / no PNA yes / no Crit. Hab. yes / no
Closest Maj. Wtr. Body Sr'
Type of Project/ Activity {
(Scale: ,V 7,.1 )
Pier (dock) length j
Platform(s) % t / ----- L
Finger pier(s)
Groin length
number - ------
Bulkhead/ Riprap length
t'
avg distance offshore_ -''� �
max distance offshore
Basin, channel - - ---
cubic yards 0 �/
Boat ramp .�
s
Boathouse/ Boatlift r t
Beach Bulldozing_— _—_ \ X' ,, !
Other
-- --- ---
Shoreline Length
SAV: not sure yes no .
Sandbags: not sure yes no C ??
Moratorium: n/a yes no a <
Photos: yes no ` r
Waiver Attached: yes
A building permit may be required by: 0,1 lorAt J/o C See note on back regarding River Basin rules.
Notes/ Special Conditions rr IlYp/6
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
Permit Officer's Signature
Iz
IssulngDae Expiratio Date
j j i i r(_ it
Local Planning)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 Other:
I_ j 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
Mailing Address:
1638 Mail Service Center
Raleigh, NC 27699-1638
Location:
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293 / 1-888ARCOAST
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 10/05/01

SHORELINE MARINE CONST.
ASHLEY BROOKS NCDL 7666496
PH (252)-646-3212
99 CENTURY COURT
SWANSBORO, NC 28584
TO THE
PAY
ORDER OF
WACHOVIA
Wachovia Bank, N.A.
wwhwachov{ca.com 1
FOR
1160 I L68 1116 i:053000 2 L9i:20546
28011681
1 66-21 /530
DATE/Of
BRANCH 77614
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Dec 13 04 08:05a
Rshiey Brooks
910-326-8523
Shoreline Marine Construction, Inc.
Floating Docks - Piers - Sea Walls - DEALER for Hi Tide Boat Lifts
[e-mail]
fax # 910 - 326 - 8523
m# 252-646-3212 Fax Cover Sheet
Date 1;(// 310g
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To: jQp�
From: 4S#CFy DOM
Fax # ,247,1330
Pages Fazed: ✓�
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Dec 13 04 08:05a Ashley Brooks
910-326-8523 p.4
"k'OM :Mark E. MCGee,DDS FAY, NO. :910-686-6512 Dec. 01 2004 10:56AM P1
... V 3 eJc a Hooper
2915062
Nov 21 04 MazIop f1shI�s �.Z
b Brooks �10-3c^B-8fi23
A P.6
ADJACEWT RIPARLAN PROPERTY 0VVNER ST'ATEMFNr
(FOX A P14~RIWWORrJVO PWAIGS/BOATUMSOAMOUSE)
1 hereby certify that i own property adjacent to / �4 �F-� c
D (INlame of Properly Owner)
,r
Property located at��-/�'�%�IQ_$�IIJV"
(L*t, Block, Road, etc.) l
on in N.C-
(Waterbody) (Toion 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
pilingslboatliftlboathomst must be set back a minimum distance of fifteen felt (15') from my area
of riparian access tin ;3ess waived by me.
i do ttnt wish m v,-aive tits sett'lcl"r quircntenl'
I dQ «•ish to % aive that seib:tck rcquirzmcnt.
---------------------- ---------------- --------- -- ------ --- ---
DIESCRtPTin1 AND/OR PRANNTNc, Or PROPOSED DEYCt,OPNIC•,IT:
(To beflled in by individual propusiirs development)
7
ep.lo tJ 01 uSE ©F �s iE�c
_-_---------------------------------------------- -- - . - --- -----
Signature
MR& R Mtn D
print or Ty -pc Nam:
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Dec 13 04 08:05a Ashley Brooks 910-326-8523 p.5
'Hov 21 04 03:10p Ashley Brooks 910-326-8523 p.4
ADJACENT RR'ARxAN PROPERTY OWNER STATEMENT
(FOR A PIER1Af00RJIVG PILIrVGS-IBOATLIFT/ OArROUSE)
I hereby certify that T own property adjacent to(NTame of Propeily Owner')
r
ro rt located at
P y (Lot, $Ioc1c, Road, etc.) l
�
L � J� c.t/J1� , in Emil--o E. - �, - N.C.
on (Town and/or- County)
(waterbody)
He has described to me, as shown belO\X, the
development
h is understand t that loc. pier/n oorong
and, I have no objections to his proposal.
pilings/boatliftlboathouse must be sct back a mmim�im distance of fifteen feet (15') from my area
of riparian access unless %VaiVCd by me.
I n nn wish !o waive the se(back-rt:quircnlei' L
✓ I s}n ��ish to waive th<`,t se!bacn requirzrnen:.
-- I7LSCI-,II'TIC)N AND/01? I)RA'WING OI- I ROPOS�D D1✓ti'GLOI'i\I N?:
(To be fllccl ill hv inrlirirlual pr-oposing (ievviop"Ielzi)
S i/g�n:�t.�hrz
1 %
Print or 7ypr- Namc
'�"elephone Numlzer
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