41721_MEUBERN, VIRGIL_20050519

r2CAMA / '--'DREDGE & FILL
GENERAL PERMIT Previous permit #
DNew EiModification ;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 15A NCAC / 1 r
L DRules attached.
Applicant Name �f f j ' `P ` J"r - Project Location: County
Address <<�� ^ . % '�' Street Address/ State Road/ Lot #(s)
City l i State •'1'( ZIP
Phone # O_
Authorized Agent
Affected F] Cw
AEC(s): _OEA
F ; PWS:
ORW: yes / no
Fax # ( )
❑EW D1PTA
HHF IH
F I FC:
PNA yes / no
Type of Project/ Activity
Pier (dock) length____
Platform(s)J;
Finger piers)
Groin length
number
Bulkhead/ Riprap length_____
avg distance offshore _
max distance offshore
Basin, channel
cubic yards ____
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing_
Other—_
Shoreline Length
SAM not sure
yes
t.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
❑ ES ❑ PTS
UBA ❑ N/A
Crit. Hab. yes / no
l� %Yl Lupo lL /T
Agent or Applicant rinted Name
Signat Pleato"re d compliance statement on back of ermit **
�3�
Application Fee(s) Check #
Subdivision
City--— ZIP
7
Phone # () _ _ —_ River Basin l^
Adj. Wtr. BodyT_ mat /man /unkn)
Closest Maj. Wtr. Body —_--
(Scale: /t/ "7I )
__ See note on back regarding River Basin rules.
Permit Officer's
Signature "a
Issuing to 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
landowners).
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 i 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:
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 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.nccaoastalmanagement.net
Revised 10/05/01

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSBOA��jjTLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to �/J n � j' ; l✓ on 's
(Name of Property Owner)
property located at ! /d � fij,'/,l p WAA 0 1
(Lot, Block, Road, etc.)
on ! SIP AM, _,in f2�%�'v� Gd 014- • , N.C.
aterbody) .(Town and/or 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.
L-� I do wish to waive that setback requirement.:
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
We propose to build a dock 390' X 5' walkway with a
10' X 20' tee. Girders will be bolted with X bracing.
Piling with be 2.5 salt treated. Joists, girders, and
decking will be .21 salt treated. Every third deck
board will be screwed, (stainless steel). In addition
two boat slips will be constructed approximately 100'
from the tee end.
Signature
ie1
Y Print or Type Name
X �-62-�2 --I.(o- K 5 /
Telephone Number
X Dater %

CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER
FORM
Name of individual applying for permit: ' z • L
Address of property: 4/40 t1 �� �l +1 A w,ar 10 jq,y,i
(tot or street #, street or road)
Cl e.74
& County} /
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 proposing. 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, 400 Commerce Ave., Morehead City, NC 28557 or call [phone]
within 10 days of receipt of this notice. No response is considered the same as no
objection if you have been notified by Certified Mail
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift or sandbags
must be set back 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.)
r I do wish to waive the 15' setback requirement.
I-Ir I do not wish to waive the 15' setback requirement.
s' AL
10�
t(g�nlattuur/eDate
(le5
Print Name
q I q q 199 59 ��S-
�r Telephone Number With Area Code

*11
a;
PROM
Name —
~,;:
Street.
_
City.
State '
lelephone
V, e herec: ^ra OSe to furnish c! ftie m„„gMrrCls'and tserfbIIP all the labor net .550 for the comnletioniof
r O r
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C b CTED Lw
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SDI 6- a:L, aller
t
All -material is guaranteed .tv be is specified, and the above work to be -performed .in accordance with the elrclwar Js
and specifications ubmitted for ai'ove 'whst 'rk and completed in a suar[tial workm6hlike manner foi the sui F61
Ea:
Dollars ($
wyments to be made as follows.
ith af
oam mpm-r- -mac: uGc'hl -bZ CLI V 6 P-V A44b PE91 i 1 /146
Q b' ��►
Any alteEra�l�oP evwion fr m above specifications involving extra costs, will
become an extra charge over and above the estimate. All agreements conting
control. Owner to carry fire, tornado and other necessary insurance upcW a,
iiabiiity insurance uri above w5rk v be toga`; But, byS`�D� Lt11
Respectfully, submitted "Re
Per
Note — This proposal may be withdruvin,by us if not accepted within days
ACCEPTANCE OF PROPO!
The above prices, specifications and conditions are satisfactory and are hereby.
specified. Payment will be made as outlined above.
Accepted
Date_
TOPS FOMI 31150 >
Signature—
Signature —
executed only upon wrifteh orders; rind ail
upon strikes, accidents or delays Beyond
work: Workrr)en's Compe6otion and P"ullir
,
i
>.pted. You are outhorized to do `the .work cis

CRAVEN EYE CENTER ODIPA
404 Winward Lane
Morehead City, NC 28557
AM
OF
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1136
/ 66-21/530
DATE BRANCH 01238
$ % �o
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WAICHOVM
Wachovia Bank, N.A.
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