40723_LEWIS, JOHN_20050120

A�✓A DREDGE & FILL �!`�i' � �� 40'723
�� ,�
��NERAL PERMIT �v Previous pr mit #
4/_C#
New __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 I SA NCAC -7,�V- /2 00
ules attached.
Applicant Name 4 Project Location: County CO.
Address ��Dc,v� Street Address/ State Road/ Lot #(s)
City 6)01A bore State NC ZIP a175 q q q eeo -Spo C,rJe,
Phone # A9 ) '7�4 . -11 7 5 Fax # (`) Subdivision
Authorized Agent CityPDrt ZIP
Affected 0 Cw ❑ EW ❑ PTA ❑ ES ❑ PTS Phone # (�i i ) pp73 `�' % River Basin `' C a-V-
AEC s : 0 OEA ❑ HHF El IH ❑ UBA ❑ N/A Ad•. Wtr. Bod 6 Ile- 7cu wp
O ► y Qman /unkn}
❑ PWS: AFC:
ORW: e / no PNA yes 19 Crit. Hab. yes / no Closest Maj. Wtr. Body 1-y ��� N
Type of Project/ Activity `X I I f7► e- f -4v ct. L ;i P IV - f i r m LJ ;V A e --
j4 o;,^^ cj G q, z (Scale: b TS
Pier (dock) length rj X 147
Platform(s) +1P, X t 4t l i = C. `-- -- .
Finger pier(s) ►i��
Groin length
number -- —
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel ___ _ _- ti
' ,qujy-- - - --
cubic yards / V � "V
IC - -
Boat ramp
ol
Boathouse/ Boatlift 13X 0-
Beach Bulldozing
Other i 0&4-ev-
Shoreline Length 1
SAM not sure yes
Sandbags: not sure yes
Moratorium: n/a yes 1
Photos: yes
Waiver Attached: yes no - _ -. -- - ---- -_- .------------.__._. __
A building permit may be required by: CGtf�T l_:D ❑ See note on back regarding River Basin rules.
Notes/ Special Conditions ? V • p r -{ �cyVx � � 5 i 5 �� D r 1 z� z) !JD c- )rj
Ad �'Ci V ,)J . ir i pr ia,, 1 i` N f_�,5 .D" r>7 i ,-4 I e_ G le ,,,L4ec) V Lt-
wAa;_MeC&< U r e J k oc, e txle 5'Aci be rer,pve�
j l,ak 4,511e`5 �e+rare fiPA>ys 4,river ----WI.-
�4
or Applicant Printed Name
Signature ' Please read compliance statement on back of permit
Application Fee(s) Check #
Permit Officer's Signature
/
Z/ - ,46 _05
Issuing%Da}te
Expiration Date
(.�,�.r 'f'.
/. 0 / G Y ;2 C)/q
Local Planning Jurisdiction
Rover File Name

REAL ESTATE ACCOUNT 66-7404/531
JOHN D. LEWIS, JR. 1020003123 638
JENNY B. LEWIS
NCDL 9RiVE 3712660 919-
194 WHEELER DRIVE PH. 919-734-7875 DATE / �`-
GOLD/SBORO, NC 27530
PAY TO THE �� A
ORDER OF J� `/_L
/on
` DOLLARS
ffie little bank
IrEm
Tit(-b
Goldsboro, NC /� '� MEMO _ 4 te(-r3'-T Ali c 4V
1:053 1740481:10 20003 123,18

a IDEeet� ':�7 LEGlTCS , �rze.
Since 1927 -
200 E. Spruce Street • Box 127
Goldsboro, N.C. 27533
John D. Lewis, CPCU, AAI Phone [phone]
President Fax [phone]
[e-mail] 1-800-375-0072

ADJACENT RIPARIAN PROPERTY OWNERLAT OUSEMENT
(FOR A PIER/MOORING PILIr
I hereby certify that I own property adjacent to V6 .
is
(Name of Property ONner)
property located at �i y 7 �►� ;pie — 1— 3 J W
(Lot, Block, Road, etc.)
on
in �(Tv
e , N.C.
�Vaterbody) Fador 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/boatliNboathoust must be set back a minimum distance of fifteen feet (t5') from my area
of riparian access unless waived by me. �p 11W
I do not wish to waive the setback requir
ement.
I LID wish to waive that setback requirement.
JAN 14 2005
----------------
--------- i�©r&ead CAtY-DCM--
-----------------------
DESCRIPTION AND/OR DRAWING Or PROPOSED DEVELOPMENT:
(To be fillerl in by individual proposutg (levelopment)
60,
SU��I
C'
V CC
N mil`
�{ - - - - - - - - - - - - - - - - - - - -----
vJe��
Signature
t��,w•,�e���( Print or Type me
Telenhone Number
9

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSIBOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to t� `i e'S
(Name of Propert Owner)
property located at 14Li -7 Ta r So►^ s Je 3 J w-?&,r,,-7:s�py '
(Lot, Block, Road, etc.)
on , in /VLw���`f' �Gt;-��-�- - N.C.
aterbody) — (Wm and of 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/boatlift/boathouse 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 dd- wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPNIENT:
(To be filled in by individual proposing (levelopment) 4
-Lim
R9
J
r� y t�tl
I
y JAN 1 4 2005
i
r
t Morehead City DCM
0,14
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Signa LL Z
Li-7 Print or Type Name
C,�r��
Telephone Number

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ZURICH

CAMA DREDGE & FILL / , , y
GENERAL PERMIT `-�'eviooC��
L
PrNew _;Modification us permi #
Complete Reissue []Partial Reissue Date previous r it 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 <%'� �' 't ; i'' Project Location: County___
Address ' `� e i 'ti ' ' �'r Street Address/ State Road/ Lot # . -
City¢,,, c State ZIP
_
Phone # (} 'q �'> Fax # ( )—
Authorized Agent
Affected lir' &
AEC(s): OEA
PWS:
ORW: yes / no
Subdivision_
City_
kI W �TA = ES PTS Phone # (__) _ ! River Basin _
HHF -1 IH ❑ USA C N/A Adj. Wtr. Body _ 't-� (nat /man /unkn
i FC:
PNA yes / no Crit. Hab, yes / no Closest Maj. Wtr. Body
Type of Project/ Activity
(Scale: )
Pier (dock) length -_—
Platforms)----- L• Finger pier(s)
Groin length
number — - ---- `------ �:— - -
Bulkhead/ Riprap length
avg distance offshore`_
max distance offshore
Basin, channel
cubic -
Boat ram ...... _
Boathouse/Boatlift __-- +---._.--- ---- - _
I �
Beach Bulldozing _. r i I� '. •.�
l .
Other Y - ---- - --- - 4
v
Shoreline Length
SAV: not sure yes no - -
Sandbags: not sure yes no 4-� 4
Moratorium: n/a yes no
Photos: yes no y p l
Waiver Attached: yes no --
A building permit may be required by: See note on back regarding River Basin rules.
Notes/ Special Conditions
Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit
Application Fee(s) Check #
Permit Officer's Signature
Issuing Date Expiration Date
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 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 Cites 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