41749_JONES, BUCK_20050624

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C-3'CAMA / ❑ DREDGE & FILL
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GFEWERAL PERMIT
��'' Previous permit # Al %I`}
New ❑Modification El Complete Reissue ❑Partial Reissue
Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources ✓ —� t_.1
and the Coastal Resources Commission in an area of environmental concern
pursuant to 15A NCAC
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` J
[JRules attached.
" i`'
Applicant Name
Project Location: County f `
Address t("'' �`/
Street Address/ State Road/,Lot #(s)
City N 1'` �. State l" � ZIP ��' I U
? � �.> ` ,•�
_ l
Phone # (c�f } .0 Fax # O
Subdivision
� r �- � �! .
Authorized ,agent � ' � � " C.c
j.t'r ?' i,� ;�
City ° ZIP _
Affected ElCW ❑ EW F�TA ❑ ES ❑ PTS
Phone # ( ) River Basin
k
AEC(s): ❑ OEA ❑ HHF ❑ IH El USA El WA
Adj. Wtr. Body'' �' at man unkn ^'
ORW: yes /63n PNA yes / n9 Crit. Hab. yes (no :
Closest Maj. Wtr. Body
f
Type of Project/ Activity
Pier (dock) length _
Platform(s)h "
Finger pier(s) _
Groin length _-
number
Bulkhead/ Riprap length
avg distance offshore______
max distance offshore
Basin, channel_ -
cubic yards_____
Boat ram
Boathouse! Boatlift
Beach Bulldozing
Other
Shoreline Length
SAY: not sure yes not 'i
Sandbags: not sure yes no
Moratorium: n/a yes o'
Photos: yes no'
Waiver Attached: yes no,
A building permit may be required by:
Notes/ Special Conditions J
Agent or Applicant Printed Name
Signature "Please read compliance statement on back of permit"
' 1
Application Fee(s) Check #
i
i
L
(Scale:
See note on back regarding River Basin rules.
Permit OffiSpp'sSignature
Issuing Date Expiration Date
Local PlanningJurisdiction
Rover File

-I CAMA / -' DREDGE & FILL
GENERAL PERMIT
'-'New ❑Modification [ Complete 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
)or1
-;'f49
Previous permit #
Date previous permit issued
Rules attached.
Applicant Name` Project Location: County_
Address r "`' '`-J Street Address/ State Road/ Lot #(s)
en,/ ' Z� � • ! J
City " r State ' 'ZIP
Phone # (%} �) " Fax # ( ) Subdivision
Authorized Agent i _.z, :.1 % F d % (c �� City /!y /,. ., _ ZIP_ -_-
Affected GW ❑ EW gpTA I ES PTS Phone # (_ ) River Basin
AEC(s): ElOEA ElHHF ❑ IH UBA ❑ N/A Adj. Wtr. Body J� _gnat man unkn)
❑ PWS: ❑ FQ aa JJ
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
cubic yards
Boat, ramp
1? Ix
Boathouse) Boatlift
Beach Bulldozing
Other
Shoreline Length -
SAV: not sure yes
Sandbags: not sure yes r}o
Moratorium: n/a yes n
31
Photos: yes no),
t
Waiver Attached: yes no --- - -- -- -- —7- - - r
A building permit may be required by:
Notes/ Special Conditions
P,N 6 x e 1y d'Al
Agent or Applicant Printed Name
Signature "Please read compliance statement on back of permit"
i >
10-
Application Fee(s) Check #
(Scale: IV.),,<' )
See note on back regarding River Basin rules.
PermitOfficer-•'s ignature
Issuing Date Expiration Date
Local Planningf urisdiction
040
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:
E Tar- Pamlico River Basin Buffer Rules _I Other:
1 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.nccoastalmanagement.net
Revised 10/05/01

ADJACENT RIPARIAN PRopERTY ovvNM STAB 77
(FOR A PIERIMOORING PILINGSIROAT"'FTIROA7WOUSE
I hereby certify that I awn property adjacent to 's
(Name of Property ®caner)
ply located at D
. (Lot, Block, Road, etc-)
----�� in 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/boatlif iboathouse must be set back a minimum distance of fifteen feet (15') from my area
of riparian access unless waived by me.
I do not wish to waive the setback requirement.
I dQ wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be , f lied in by individual proposing development)
1
\n
o P�r o _
Sign re
PrintoName
Telephone Number
Date: o S - �.o O S

Jun 03 05 04:28a p•2
jun ue ub U3:5up Don Uxendine 252-248-3714 p.e
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOOJUNG PILINGS/BOATLIFT/BOATHOUSE)
I hereby certify that I own property adjaacnt rn,,,,�,
(Name of Property Owner)
pmpetty itx=4 at
(Lot, Block, xoa'd, etr-)
(Watcrbodr) (Town and/or County)
He bas d==bW to Inc, as shown below, the develop UWt he is proposing at that Iocation,
and, I have no objections to his - I understand that a pies/mooring
piiingsJboatlittlboathouse must be set bade a minimum dirt mce of fifmw feet (IS') from my area
of ripanan access unless waived by me.
I &jUg wish to waive the setback requirement.
I da wish to waive that setback requirement.
DESCRurMN ANDIOR DRAWING OF PROPOSED DEVELOPMENT --
(To be wed is by in&1 idag PmPostua develOPntent)
i
Print or Type Name
f-?_.sue-Z.Ll-?-/4,aZ
Tdcphone Number
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