41124_JELLEY, ALAN_20050329

L]CAN ,A / CJ DREDGE & FILL
GENERAL PERMIT
LNew Modification IJComplete Reissue ❑Partial Reissue
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
r 41 24(
Previous permit #
Date previous permit issued
attached.
Applicant Name ` Project Location: County__
Address / ( �'[r ;,� Street Address/ State Road/ Lot #(s)
City ` ` State ZIP CIL
Phone # O ''' / Fax # O Subdivision
Authorized Agent /" City_ 'AJ"'-'®=�r ' Z 0
Affected Cw _i Ew PTA li ES � PTS Phone # O River Basin
1 OEA a HHF C IH F= UBA ❑ N/A i }
AEC(s): Adj. Wtr. Body __ nat : man unkn)
1] Pws: FC:
ORW: yes / no PNA yes / no Crit. Hab. yes / no
Closest Maj. Wtr. Body__ = �`
Type of Project/ Activity ; i
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
no
Sandbags: not sure yes
na.
Moratorium: n/a yes
no
Photos: yes
no
Waiver Attached: yes
no
A building permit may be required by:
Notes/ Special Conditions
Agent or
Signature **P
Application Fee(s)
read compliance statement o� back -of permit
Y.: 1
Check #
n�
(Scale: /t/ (� )
[ See note on back regarding River Basin rules.
. 1
Permit Officer's Signature
Issuing Date �Expiration Date
j_.y' ; r� n � �0-3 7 y / 64
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 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-B Hwy. 24
Hestron Plaza It
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 Mail
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

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(Bulkhead/rip rap)
I hereby certify that I own property adjacent to %� �� _ 4, 's
(Name of Prope Owner)
property located
(Lot, Block, Road, etc.)
on in I'1'10,tn�,Faj C. & 00447 iz , N.C.
(Water body) (Town and/or County)
He has described to me -as shown below, the development he is proposing at the
location, and, I have no objections to his proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(to be filled in by individual proposing development)
Foley & Foley Contractors, Inc. signature
Phone#: [phone] Ll
Fax# [phone]
Print or Type Name
Telephone Number
Date

MAR 21 '05 05:44PM GLAXO WELLCOME
P.4/4
CggliFIED MAIL RETURN RECEXPT R)EQUSTE
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTI<FICATIONfWAIVER
FORM
Dame of individual applying for Permit: AYan Jell
Address of Property: 1 3 inch Ct
Newport/Carteret - - - - -
(Lot or Street #, Street or Road, City & c: aunty)
I hereby certify ihat i nwm property adjacent to the above referenced property. The
xodividual appl-y-ing for this permit has described to me as shown. on the attached drawing
the dcl,elopmeant they ore Mposing. A. description or drawing, with dimensions, should
be provided wu th this tetter.
I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coastal
MatragemwI4 Restron Plaza Id .I Sl lf, Hwy. 24, Morehead City, NC, 28557 or call
(252) 8o8-28o8 within .1© days of receipt of this' notice No response is consr4fered the
same as no objection Lyou have been notified by Certi iq Maio
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift or sandbags
must be set back a minimum distance of 15' from my area of riparian access unless
waived by me. (Tf you wish to waive the setback, you nnust initial the appropriate blank -
below)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15, setback requirement.
S tua'e
ate
.holey & Foley ConUwtors
Print Name Phone4- (252) 53� 2515
Fax#= [phone]
Telephone Number With Area Code
,el. 01-y) �;G10'`a014

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FOLEY & FOLEY CONTRACTORS INC.".r�' �� gtr \.,"fT<``+i //,4�jr� /T �yjj
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1810 OLD AIRPORT RD.per �\ �t `{/ ,;� ?
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DOLLARS °
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BRANCH BANgNG AND TRUST COMPANY /,, _r
NEWIBRN, NORTH CARO A ti r �r't ' M+
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