40701_LUIAN, JAMES_20041210

lU CAMA / ! -1 DREDGE & FILL
GENERAL PERMIT Previous permit #
i-1New --J Modification _ !Complete Reissue DiPartial 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
O Rules attached.
Applicant Name W h ) `� �� • L/ f 14 A/ Project Location: County
Address- ^= 7 1 Z2 ` n.. �+ _ Street Address/ State Road/ Lot #(s)
City -: 1, 5 : i i 4- — State _- ZIP_
Phone #(—) q"/''G- 1Fax #( )
Authorized Agent
Affected CW ❑ EW O PTA ❑ ES PTS
AEC(s): OEA HHF 0 IH ❑ UBA C N/A
PWS: ❑ FC:
ORW: yes / no PNA yes / no Crit. Hab. yes / no
Subdivision
City---------- - — — ZIP --
Phone # () River Basin
Adj. Wtr. Body-—.— —(nat /manJunkn)
Closest Maj. Wtr. Body_
Type of Project/ Activity j
(Scale:
Pier (dock) length_—--.--------.-_----_—
Platform(s)
Finger ier s _+
Groin length X
--- - t-i'
number -
Bulkhead/ Ripraplength
avg distance offshore �1
max distance offshore
Basin, channel ---- -- -- --- — --- - -- - .
cubic yards
Boat ramp
Boathous B atlift
Beach Bulldozing
Other
Shoreline Length
SAY: not sure yes
no
Sandbags: not sure yes
no
Moratorium: n/a yes
no
Photos: yes
no
Waiver Attached: yes
no
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 #
•. r
See note on back regarding River Basin rules.
Permit Officer's Signature
Issuing Date 'on Date
p
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, certifythatthis project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
i 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 howto complywith 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 / 1-888-4RCOAST
Fax: [phone]
Fax: [phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Morehead City District
151-B Hwy. 24
Hestron Plaza Il
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, Berrie, 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

--- --vPtLat LUIHN
3712 BENSON DR.
RALEICI H, NC 27609_7321 726
19/530 NC
yay �a Date ' _ �? 3901
to the order of
BankofAmeric a` Dollars
ACH R?053000196
Memo
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NOV 09,2004 13:58
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SIBOA i hcieby ce.rtifY that 1 ctwn pruperty �djac, nt to(Narne of proptrt.v Owner)
properiy koc: It7d at ,--.,2-•— --' - Rread etc.) Aj
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]iiltn�,�l�oal4rnil�uatiyt�nt`����t+aat�� �'
�,t' riparian access unl<<,5 waivul by trte.
1 d.4_I>.al �ti'ish W waive the s,rit�ack rci]uir�tnc.nt.
] wi"h to waivc that srrb ic.k. Ceglurr.inen .
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FROM :•PrPRASAL CO
FAX NO. : 252 72e6299 Aug. 11 2004 01:44PM P2
In au� l � zooa
AnrA ,ENT I�UpAVLkN PROPERTY OWNER STATLMTNT
(POR A 1'1E.R1M0oR1NG PILINGS1Rd�A�'LIFT113UAI HUus�)
I hereby certify that I own property 4acenc to s
(Name of Property Owner)
ply located at Zq D &,* c x ., j16- rC s
(Lot, Block, Read, etc.)
on
Y' Q f f c , in /3e .4�--FQ r N.C.
� W • C ,
(VYaterbodY) (1''owtt and/ar Caunly)
He ],as described to me, as shown below, the dcvelopr»e6t ha is proposing at that location
and, I have no objections to his proposal. I undar=md tha! a piar/maori:,g
pUin;slboatliftlboathouse must be set back a m'tnimurn distance of fifttrer. feet ([5') front my arm
of riparian access unldss waiver; by me.
I drat wish to wive the setback requiremenc.
I r r wish to waive that setback requirement_
------_•.......__.---•-----------------••------ - .�� - --
------
--DrSCi IPTION AND'
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