42482_MERRYMAN, TOM_20050803

F -' CAMA / i _ 1 DREDGE & FILL
GENERAL PERMIT
LNew _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
pfv
Previous permit #
Date previous permit issued
i
❑ Rules attached.
Applicant Name �2r) I k k� + rt ✓•'-14 t�' Project Location: County
Address / X �%> Street Address/ State Road/ Lot #(s)
City ! ,y�.i ! "' :�, State_ ZIP
r.-54�_ c1- ; J
Phone # ( ) �� � Fax # ( ) Subdivision
Authorized Agent City-----__—_ _ ZIP %
Affected =1 CW [SEW/ p PTA ❑ ES J PTS Phone # ( ) -- River Basin
OEA ElHHF ❑ IH ❑ UBA ❑ N/A
AEC(s): Adj. Wtr. Body___. (nat /man /unkn)
❑ PWS: ❑FC:
ORW: yes / no PNA yes / no Crit. Hab. yes / no Closest Maj. Wtr. Body
Type of Project/ Activity
Pier (dock) length
Platform(s) �' L
Finger pier(s)
Groin length
number —
Bulkhead/ Riprap length
avg distance offshore
Max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse! BoatliftJ ! Y / 5
Beach Bulldozing __
Other
Shoreline Length
SAM not sure yes
no
Sandbags: not sure yes
no
Moratorium: n/a yes
no
Photos: yes
no
Waiver Attached: yes
'60,
A building permit may be required by:
Notes/ Special Conditions
A L '
A'
'r~
/
Agent r ppl16ni Printed Name
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
(Scale: A I )
— --
❑ See note on back regarding River Basin rules.
Permit Officer's Signature
Issuing Date Expiration Date
r Lob'C�� l/
�r.'I
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:
L_I 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:
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-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.nccoastaimanagement.net
Revised 10/05/01

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/�WAIVER FORM
Name of Individual Applying For Permit: T1i ;,a,9.s /`=
Address of Property: 44 u�o,✓
(Lot or Street €, Street or Road)
-r, Lg m!!-� / C
(City and County)
I hereby certify that I o«'n proper adjacent to the above -referenced proper-Ly. The individual
applying for this r-e.mit has described to me as sho%vn on the attached drawing the dzve11opM-e:-.7tre1,'
are proposmz. A description or drawing, with dimensions; sh ould be provided tiv.ith this le.Lc-.
I have no objections to this proposal.
If you have objections to ,vhat is being proposed; please write the Division of Coastal
Manazemen . 127 Cardinal �rive Exte �'on. ` iimington INC�Z '0� cr call 910--95-3900
ii-ithin 10 days of r�e pt o t is`n t � n s c�d er2- i tl�e same as no ob'e: Lion if
you have been notified by Certified Mail.
WAIVER SECTION
I under_tand that a pier, dock, mooring pilings, breal-m ater, bo.:t house or boat lift must be se:
bck a minimuc distance of 15' from my area of riparian access - unless Nvaived by me. (I' "-ou
Wish to ziaiye t-e Setback. you must initial the ac.pr print bi:ni below.)
I co tivish to ave th,e 1 5' se:,,�_:; recut:e -�-
I c2 not wish, to waive the 15' se,back recuiremnent.
Z D�
. i0—n— e T)nTl
Print Name
J17- 33 D r
Telephone Number with Area
S:1carn* she lls`r_parianproperty.f m,
A7iA.
cote u4CDENR

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit:
Address of Property
13 O/V b
(Lot or Street 9, Street o R aoret d
(City and County)
r
11
I hereby certify that I own property adjacent to the above -referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development they
are proposir,
g. A description or drawing, with dimensions, should be provided with this letter.
I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coastal
Management�y tee' /� ' h K: " or cell 910-395-3900
within 10 da�3 �re�e o this toti�. �No espon a is co a fhif�e as?no objection if
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must be set
bck a minimum distance of 15' from my area of riparian access _ unless waived by me. (If you
wish to waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
e
Print Name
Telephone umber with Area Code
Date
NCDENR
NORTH CIROUkA DEPARTMENT OF
ENVIRONMENT MO NAUl L RESOURCES

THOMAS E. MERRYMAN
MRS. THOMAS E. MERRYMAN
910-458-4724
104 E. BRIDGE CT.
CAROLINA BEACH, N�C-2284228-33903
toaihP aC / /V /�
BankofAmerica
ACH R/i 053000 g5
';w
7208
66-19/530 NC
Date _ 3_— 1606
Memo `!
I:0 S 3000 14 6I: 000 i800 6 3 7 7 u i
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