41767_MAXWELL, H.C. III_20050607

❑0Ar MA / _] DREDGE & FILL i JV 4.1 76 7
GENERAL PERMIT
Previous permit #
❑New 11Modification Complete Reissue .iPartial 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
[-I Rules attached.
Applicant Name --~+ Project Location: County
Address_ 61 Street Address/ State Road/ Lot #(s)
City_ State_ ZIP
Phone # (_ ) Fax # ( ) Subdivision
Authorized Agent q ; CityZIP
D CW EW D PTA ❑ ES ❑ PTS Phone # (_ ) River Basin / 5
Affected -
IDEA J HHF ❑ IH ❑ UBA ❑ N/A
AEC(s): Adj. Wtr. Body nat /man unknJi
PWs: ❑ FC:
ORW: yes / no PNA yes / no Crit. Hab. yes / no Closest Maj. Wtr. Body
Type of Project/ Activity
(Scale: )
Pier (dock) length
Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
}
avg distance offshore
max distance offshore
Basin, channel _
cubic yards i
ittt
Boat ramp
Boathouse/ Boatlift
1
Beach Bulldozing
Other
Shoreline Length
i
SAM not sure yes no -.
i
Sandbags: not sure yes no
Moratorium: n/a yes no
r
Photos: yes no
_
Waiver Attached: yes no
A ` 1' he,4 cl
% 1- See back River Basin
building permit may be required by: / jL' c
IJ note on
regarding rules.
Notes/ Special Conditions
Agent,orA Iicant Prjnted ame
Permit Officer's Signature
Signati Please read compliance statement on back of permit
Issuing Date
Expiration Date
Application Fee(s) Check #
Local PlanningJurisdiction
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 consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
❑ Tar - Pamlico River Basin Buffer Rules I__J 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: Fax: [phone]
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293 / 1-888-4RCOAST
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

6CAAMA / ❑ DREDGE & FILL N? 41 1 s7C
GENERAL PERMIT Previous permit#
New 7-Modification '-Complete Reissue ''Partial Reissue Date permit ermit issued
P
As authorized by the State of North Carolina, Department of Environment and Natural Resources /
and the Coastal Resources Commission in area of environmental concern pursuant to 15A NCAC (� 1
,1 G �1'/TT s attached.
� ApplicantName / Protect Location: County
G (.��J✓ tc�
Address G 1 DC / c✓00 Street Address/ State Road/ Lot #(s)
City G61d3 Oit -()State /VC ZIP �17 S3 V -,� 70
Phone # (�Kl) -73 y-3'771 Fax
#!s ) Subdivision
�/_
Authorized Agent � Her PC l f 4 e e i� City / " ' D I�-C 4 PA � �i � i _ Z(P 2 61r 7
Affected ❑ CW ❑ EW )(PTA ❑ ES ❑ PTS Phone # ( ) /�River Basin C c/4;e
() l
AEC s : ❑ OEA ElHHF [IIH ❑ UBA ❑ N/A Ad'. Wtr. BodyD (� JO"A-vr
❑ PWS: ❑FC: 1 a man unkn
ORW: yes / no PNA yes / no Crit. Hab. yes / no
Closest Maj. Wtr. Body ,gam Jou.1
Type of Project/ Activity 13 , X Sr Jed- 6/ye IC
l YX7f Jet' 01oc1c
Pier (dock) length % '
f:
Platforms) A/ `fl rX7
Finger pier(s) , !.
Groin length _ I
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards
i
Boat ramp
Boathousee'VoatlR'0 13 .x Sf
Beach Bulldozing
Other
VO
Shoreline Length V
SAM not sure yes
Sandbags: not sure yes
Moratorium: n/a yes
(Scale: I(/ F. r )
V
Photos: yes fc4 p L '1, -7a/ CV�� STy P (L
Waiver Attached: yes / /� G— — —
A building permit may be required by: " C r- P 7 " )) ❑ See note on back regarding River Basin rules.
Notes/ Special Conditions v Crr"4 a C-4A O'/ Lei JO "74J'r J
Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit **
/GD" q3,06
Application Fee(s) Check #
Per fficer's Signature
b 7 oS
Issuing D to xpiration Date
JAI 01WIlC461 n 4/ To G O v h-
1 /
Local Planning Jurisdiction Rover File Name'--

A74
HCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Michael F. Easley, Governor Charles S. Jones, Director William G. Ross Jr., Secretary
June 7, 2005
Walter Pelletier
P O Box 10009
Goldsboro, NC 27532
Dear Mr. Pelletier:
Attached is General Permit #41767 to construct a 13' x 5' and a 14' x 7' jet ski dock at 2701
Evans Street, Morehead City, NC.
In order to validate this permit, please sign all three (3) copies as indicated. Retain the white
copy for your files and return the signed yellow and pink copies to us in the enclosed, self-
addressed envelope. If the signed permit copies are not returned to this office before the initiation
of development, you will be working without authorization and will be subject to a Notice of
Violation and subsequent civil penalties.
We appreciate your early attention to this matter.
Sincerely,
Mark Hardeman/lsb
Coastal Management Representative
Enclosures
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: [phone] \ FAX: [phone] \ Internet: www.nccoastalmanagement.net
An Equal Opportunity \ Affirmative Action Employer — 50% Recycled \ 10% Post Consumer Paper

WALTER' PELLETIER 9386
ELIZABETH M. PELLETIER
PH.
734-3779
601 DELLWOELLWO OD PL. CyJ�
GOLDSBORO, NC 27534 66-112/531
71201
?� tSCTDF-�l 1$ IO0,DO
BUT
BRANCH BANKING AND TRUST COMPANY
GOLDSBORO, NORTH CAROLINA
.91"
—Classic—
BA— l.�J
1:053101120:112333132820 9386

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MAY, 25-2005 WED 02:47 PM NO DIV OF COASTAL MGMNT FAX NO. 4 P. 03
MAJACENT RIPARIAN PROPERTY OWNER STNIMNI LL:NT
(, -OR A P11-RIMOOR1NG PILINGS180A77,II'7'/BOATI-IOUSE)
11i'-reby certify that I own props; ty adjacent to ti xf:., 1 ( (( S
(NI Tune of Property Owner)
_^
prop:;rty local= �.1 at _r%1 01 LVcL►nsS- ae+ - .w-
(Trot, Block, Road, etc.)
011 in
N.C.
(WatrrhQdy) Uj (Town and/orCounty).
Tie has dow ibed 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
p1lini;s/1;xoatlifV'boathuusc must be set back a 111ininit,un distance of fifteen feet (15') from my area
of riparian accoss unless waived by me.
I � Ojjot wish to waive the. setback rCquirement.
V I sl.Q wish to waive that setback requirement.
- T-----
-----------------
DESC RY110N kNT)/OIL Y)RAIVIN(1 OF PROPOSED DF,'VFI, PNIFNT:
(To be filled in by individual p)'0p0Si1cg developtnent)
-S �� tee- ► +�
Signature
Print or 'Cype Name
C� \c� - cLi> � - --�-1 C �
Telephone Number

2613 Evans
John T. Jenkins, Jr.
Wim-1 Mimi
we MIMI
2701 Evans
H. G. Maxwell, S

.0

r
KA
z�7 �3z-
�ql�) --7-76-3t3c.)
1 �
cad
Qilz 4�,-

MAY-25-2005 WED 02:47 PM NO DIV OF COASTAL MGMNT FAX NO. 4 P. 03
Ai.)RJACENT RIPARIAN PROPERTY ONVNFR STN1'ENLL;NT
(FOR A Pill-RIMOORIkN'G PILINGS/HOATI,IFTIBOATHOUSE)
I hereby certify that I own proporty adjacent to 's
(N,ulie of Property Ownet•)
prop'3rty locals-ci at .. J�/-1
(Lot, Block, Road, etc.)
(JL Y�/�'.✓C,c) _ in _�Sj` �,��_. _, N.C.
on _
^Wri,ody) (Town and/or County) .
He hade.scri1)ed 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
pilin;;s/l�t�atli(U'boatit��use must be set back -t minimum distance of fifteen feet (15') from my area
of riparian access unless waived by rile.
I si2t.1ot wish to waive the setback requirement.
V I sl.Q wish to w;tivc that setback requirement. -
- -- - - - - - - - - - - - - - - -
^ DFS(',RI1Y7'1{0N AND/OR Y)RAWYNG OF PROPOSED DEVELOPMENT;
(To be filled i« by individual proposing dcvelopme'tt)
�oocVt &c(L
"-44-JP-An ssj_t�-
CS"
-------------------------------------------------------
ig ture
Print or Type Name
';w,f
Telephone Number
l)itc:

2613 Evans
John T. Jenkins, Jr.
1'
Mr M�MI
�1 1 IM
�1 �1 �1�1 �► 7
1 /
�501 150' 1 20
Wc)n P
2701 Evans
H. G. Maxwell, A4 -I
2705 Evans
Ralph L. Falls, Jr.

2 2105
110orehead City DCM