41371_MEYER, DWAYNE_20050505

JCAMA / I-= DREDGE & FILL
GENtRAL PERMIT
LA'44ew L i 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 I SA NCA
Previous permit #
Date previous permit issued
C
[] Rules attached.
Applicant Name jU �t�'r p " Project Location: County ___
Address b (.) / /t' ` + ` e /� i . ' Street Address/ State Road/ Lot #(s)
City ) rt` < G State N C ZIP r
Phone # (�' ) t, +; 7 _ kP Fax # ( ) aR Subdivision I1`
Authorized Agent
/" >. f-'l`"`i
City__ "L ` �''� y� ZIP
1�
_
p�'
CI CW
S-EW 3 PTA ❑ ES ❑ PTS
Phone # (,) River Basin
Affected
11 OEA
AEC(s):
❑ HHF ❑ IH O UBA ❑ N/A
r�+ ;� �. ;
Adj. Wtr. Body_
fnat /man /unkn�
-_1 PWS:
.
ORW: yes /, no)
PNA yes(!.)Crit. Hab. yes / no
Closest Maj. Wtr. Body —
Type of Project/ Activity
Pier (dock) length
Platform(s) _
Fingerpier(s)___ _
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 7 C)
SAV: 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 requirea uy.
Notes/ Special Conditions
� � rG 4
Agent or ca `Printed Nae
3 i/
(1 R
i
(Scale:
c..
Signature t Please read compliance st on back of permit
_ t
Application Fee(s) Check #
Issuing Date
Local Planning] uriscliction
Expiration Date
IP p rCsrl � /1'
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 I) 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 _ _i Other:
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
Mailing Address:
1638 Mail Service Center
Raleigh, NC 27699-1638
Location:
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293 / 1-888-4RCOAST
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
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

ADJACENT AIPARUN PROPERTY OWNER STATEMENT
(13uUewVhp rap)
i hereby certify that I Awn property adjacent to'*N mot/# RAPIt . 's
(Name of Property Owner)
property located
solt6ALPC— wl
(Lot, Block, Road,
(Wattr body) (Town and/or County)
He has dewxd d to me as shown below, the development he is proposing at the
location, and, I have no objoctions to his proposal.
DESLRWrION AND/QR DRAWING OF PROPOSED DEVE.LOPMZNT
\(to bejiAW In by; pA*hWxg dAwkpwwd)
�`'T''i•er�cR�c `- 3
3
�A
r
Regarding the diagram above:
Foley & Foley Contractors, tic '('he boat lift, but NOT the fi»tier pier as shown
Phone#: [phone]
Fax# [phone] in the diagram above is acceptable within slip
#10, (owned by nN+ayne/Barb Mercer) by the
Mitchell Barbour flock Qwners association
Board.
Nancy Ray, Pr dent Mitch I larbour I)bci: Owners Assn Date
Sally Comsto Secretary; Creasurer Ivl1MA Date
Telephone number: (INaucy Ray) 937-393-3671

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to. C ��s
(�ame of property owner)
property located at /� D �i/• ��! W
(Lot, block, road, etc.)
on M,—Fe,l ; XU lil6 , in H&2�40clC_ N_(• e26j'�;J , N.C.
(Water body) (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.
1 do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(to be filled in by individual proposing development)
T 4., / t
0Rail�
Foley & Foley Contractors, Inc.
Phone#: [phone]
Fax#: [phone]
0
s
Signature
ly
Print or Type Name
Telephone Number and Date

lb
1701
66-112/631 01901
01901
C.c �d d
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FOLEY & FOLEY CONTRACTORS INC.
PH [phone]
1810 OLD AIRPORT RD.
NEW BERM, NC 28562 N,""
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PAY DATE
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