41121_JAMES, TIM_20050324

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FICAMA / __' DREDGE & FILL
GENEAL PERMIT Previous Pus ermit#
_ P.r
-JNew, ! Modification jComplete 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
Rules attached.
Applicant Name Project Location: County C-,� j 1 v, / <
Address
/ A s r P
City - %
. State A-Y
p
ZIP 5L o
Phone # O
Fax # (}
Authorized Agent
Affected L i CW
❑ EW ❑ PTA -i ES
_j PTS
OEA
AEC(s):
i- I HHF r-i IH -, UBA
-
C I N/A
❑ PWs:
I FC:
ORW: yes / no
PNA yes / Cr . Hab. yes / no
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
SAV: not sure yes (no
Sandbags: not sure yes o
Moratorium: n/a yes
Photos: yes
Waiver Attached: yes (n 1
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 #
Street Address/ State Road/ Lot #(s)
Subdivision 1
City_
Phone # O River Basin
is
Adj. Wtr. Body i_i'- )" (nat /man /unkn)
Closest Maj. Wtr. Body
(Scale: )
❑ See note on back regarding River Basin rules.
Permit Officer's Signature
Issuing Datfi Expiratiofi Date
TO
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:
Tar - Pamlico River Basin Buffer Rules i_ 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
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 11
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

.. i �^t'�- 7i � y �—
"OJACE ` I �{.,- .3u'`ri.Jti!'* <a3 ° �' �� Y �){p�' �rFT;jGGj. 'T '^A frt
t +�....�'� vat;3�.�. .1::.:.- �..4
(FOR A PIERIUNCOVERE'D BOAT LIIFI)
I �,-t:ebv certify that I own property adjacent to I M0+' Sehnilfer mess
('`i4-un of Property Owner)
�. .. pro 3 y lccatzd at L.0.h �� p0
(L-ot BI k Road. etc.)
1
on i
Iv C.
aterbodv) (Town an'd/or County)
He has described to me, as shown below, the development he. is proposi:,- at tha.
location, and, I have no objections to his proposal. I understand That a pier/uncovered boat li
must be set back a minimum distance or riftevn re--t (IS') from my larea or riparian access vnies�
waived by me.
I do, not wish to waive the setback reouirement.
V I do wish to waive that setback requirement.
r
DESCRIP'TIO. A-N-D/OR DRAWENG OF PROPOSED;DEVELOP.NMNT:
roposirig develpment)
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Signature
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Pr-int or Type Name
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Telephone Numb r
Date: 0 a- 0 r-
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�� o, �d
m�-�'
4 ��,rx
(FOR A PIER/UNCOVERED ,BOAT LJIF7)
I hereby cerify that I own property adiac mt to T rno 4-k j Jeo t-�-r JarneS �s
„ (' 'I�Me, of Property O toner)
pro erty located at i o q ma_- ` Q. L ax) e
ICI uJ Y'
_ gip•
(Lot, Block, Road, etc.)
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� ou.nd Car re �_ ou-n
aterbodv) (Town and/or County) r—
I
He has described to me, as shown below, the development he. is proposing at tr a.�
iocation, and, I have no obje`tions to his pr000sal. I understand ��At a pier/uncovered boat EA
must be set back a minimum distance of nfteen refit (IS') from myarea or riparian ac: ess times
waived by me. f
_ I do. no. wish to waive the setback reauirement.
I do wish to waive that setback reauirement.
-�-------------------------- � -------------------------------
-----
P DESCRLPTIOi A.:D/OR DRAK IiV GOF PRO POSED 'i DEVELOP_NIE:'+i'I t--_---
(To be rLUed in by individ proposing deve ment)
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Print or ype Nalme
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Telephone Numb r
Date:

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TIME 1507 02 I i i'dh 1
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I: b0 2 1004001: 1,008 2 59 2 3 74490u-
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