43148_MALMO, DAVID_20050930

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❑CAMA / I-1 DREDGE & FILL
_ GENERAL PERMIT Previous per it#
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
// !!, i (]Rules attached.
Applicant Name �A " ' I / 1, ' f C. Project Location: County
d ? i` `'` ` `" ")', ✓ Q S Add S R d L #
Ad ress
�- City • }'f State -' ZIP
Phone # { ) -' �' 2 r Fax #
k
O
Authorized Agent -
Affected CYCW —IEW D41TA ❑ ES ❑ PTS
AEC(s): ❑ OEA ❑ HHF ElIH El USA ❑ N/A
ElPWS: ❑FC:
ORW: yes / no PNA yes / no, Crit. Hab. yes / no
trees ress/ tare oa / of (s)
Subdivision
City % �y" lj� ZIP
WPh ne # ( River Sasin Body � -- --- (nat /man [unk�
Closest Maj. Wtr. Body
l�
Type of Project/ Activity
(Scale:
�'
)
Pier (dock) length
Platforms)
qt
Finger pier(s)
Groin length
1
'
number
Bulkhead/ Riprap length
avg distance offshore
_�
/
I
_�
max distance offshore _...__�
Basin, channel
cubic yards
Boat ramp
Boathouse/�Boatlift)
1
l—
—7—
E'
(
j
Beach Bulldozing
Other
—
l
Shoreline Length
SAV: not sure yes /ho
I
Sandbags: not sure yes no
I
Moratorium: n/a yes no _
—�--
J
- —
;
Photos: yes no
Attached: yes no ; ---
A building permit may be required by:
iWaiver —
`^ �
F $ee note on back regarding River Basin rules.
Notes/ Special Conditions
Agent or Applicant Printed Naffie
Signature ** Please read compliance statement on back of permit
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Application Fee(s) Check #
'�Ice .
Permit Officer's Signature
Issuing Date Expiration Date
JJ i�
Local Planningf urisdiction 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, certifythat this project is consistentwith the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
❑ Tar - Pamlico River Basin Buffer Rules n Other:
E] 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 (910-796-7215) for more information on how to comply with these buffer 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
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
400 Commerce Ave
Morehead City, NC 28557
202-808-2808/ I-888-4RCOAST
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
910-796-7215
Fax: [phone]
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)
Revised 06/29/05

nujti%.try i tore uan rKVrkKl Y V MUM , lATMAMF
'(FOR A MBlMOORING PIf"GSBOA IDTIROATFOUSR)
I hereby certify #hat I own property adjacent to .M ,A -,o 's
e amme of Property Owner)
OLotq Bkwk,, Road., etc-3
m Mev-r �c , N.C.
Materbody) I (Town an&ok County)
He has desa Umd to me, as shown below, the d— opo�nt he is popvadng at )hat
ion aad, I have wo ckecffim W his p mposaL I d that a pfimdmoormg
mmtbe setbackamiaimum ffistaum offftm Amt (M from my area
of z4zd n access waived by me
I do IIOf wash to waive the seback requireent
I &n wish to waive that setback requirement
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVU,0PHOM,
Mo be fi&d in by bulividrral p�st�g derelopm &)
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DOCK
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Pam or I)qx Name
Telephone Nmmber
Date: X

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70n3 2260 n0n2 2n63 7772
OA ❑ INSUFFICIENT ADDRESS
❑ ATTEMPTED NOT KNOWN ❑ OTHER
NO SUCH NUMBER/ STREET
$ NOT DELIVERABLE AS ADDRESSED -A? T9
UNABLE TO FORWARD '
sb's&i��1�11►�111isi1l1,liI„iii3,:11„ill ,i1 Ili I,i,i3fill E11 fill

■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
Article Addressed to:
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A. Signature
X
B. Received by ( Printed Name)
❑ Agent
❑ Addressee
C. Date of Delivery
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
sv,+an.�ha�, r1�_ a� •� a
3. Service Type
t ta'Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
II ❑ Insured Mail ❑ C.O.D.
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4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number 7003 2260 0002 2063 7772
(Transfer from service label)
!—PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540 ;

UNITED STATES POSTAL SERVICE
First -Class Mail
Postage & Fees Paid
USPS
Permit No. G-10
• Sender: Please print your name, address, and ZIP+4 in this box •

■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1 1. Article Addressed to:
3L*� VA t y:r,.A VA � � Y✓1
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tMalOV,)
2. Article Number
(Transfer from service label)
PS Form 3811, February 2004
Domestic Return Receipt
A.
X ❑ Agent
❑ Addressee
B. Received b Printed Name) Date of D ery
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
3. Service Type
A ertified Mail ❑Express Mail ;
❑ Registered ❑ Return Receipt for Merchandise ,
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
7003 2260 0002 2063 7765
102595-02-M-1540

UNITED STATES POSTAL SERVICE
First -Class Mail
Postage & Fees Paid
USPS
Permit No. G-10
• Sender: Please print your name, address, and ZIP+4 in this box •

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INNERBANKS MARINE CONSTRUCTION
DOCKS, SEAWALLS, BOATLIFTS,PERMITS
NICK WAMBROSIA - VICE PRESIDENT
PH ONE: 252-249-1429
1 CELL: 252-671-7757
FAX. [phone]
P.O. BOX 190, ORIENTAL, NC 28571
LICENSED & INSURED #55828
MM INNERBANKS. BIZ

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9NNERBANKS MARINE CONSTRUCTION,
r P.O BOX 190 PH. 252 249-1429 �j j i , 11 66 30/531
• r\±. `< ORIENTAL, NC 28571 ,�,i'�>>�1� (`;/,� �� ! q 36 05 ,�f �� ' 472
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PAY���,��� `i\��<.i`/�'!�'/t�%', _ N00. OG
TO THE
{ ORDER
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