40333_MOORE, TIMOTHY_20041110

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L1 CAMA / C_ DREDGE & FILL
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GENERAL PERMIT
Previous permit# -
❑New-iModification i_-'Complete Reissue
DPartial 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
1-1 Rules attached.
Applicant Name_ +' '� �� }E' f
Project Location: County
Address '= :. _ . ; r 1-� L
Street Address/ State Road/ Lot #(s)
City Jy State ZIP
Phone # Fax # ( }
Subdivision _
Authorized Agent
City__ __ _ ZIP
❑ CW EMW [j}PTA ] ES Cl PTS
Phone # (__) River Basin
Affected
_ _ _ _
ElOEA ElHHF � IH L7 UBA C N/A
AEC(s):
-
Adj. Wtr. Body-_ ., r , .. - �. : , i�,(na6 /man /unkn)
PWS: OFC:
ORW: yes / no PNA yes / no Crit. Hab.
Closest Maj. Wtr. Body ____
yes / no
Type of Project/ Activity
Pier (dock) length _
Platform(s)__ __
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distancee-offshore
max distance offshore
Basin, channel
cubic yards_
Boat ramp _
Boathouse/ Boatlift
Beach Bulldozing
Other
I
Shoreline Length.
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 required
by:
Notes/ Special Conditions
Agent or Applicant Printed Name -
!
Signature Please read compliance statement on back of permit
Application Feels) Check #
(Scale: )
k. U
❑ See note on back regarding River Basin rules.
Permit Officer's Signature
Issuing Date
Local Planning Jurisdiction
Expiration Date
G �i0_ & "O}
Rover File Name

r
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:
_I Tar - Pamlico River Basin Buffer Rules 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 / 1-888ARCOAST
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 Mail
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

TIMOTHY A. MOORE
JENNIFER C. MOORE
108 TRACEY CREEK CT.
APEX, NC 27502
PAY TO THE C 11
ORDER OF /��lll
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DATE
66-7711/2531
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FEDERAL
CREDIT UNION Post office Box 12607
Q 1 Research Triangle Park, NC 27709
MEMO
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ADJACTNI' RTI'ARYAN PROPE11'rY OWNIER STATEM ENT
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I hereby certify that I own proporty a(Ijacent to 'j_— (I(eol L Is
(Nome of Property Owner)
prolvrty Iocated at J C 4'
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(Lot, Block, Road, etc.)in
Oil k-t��LvC,, N. C.
(Waterbody) (Town and/or County)
He luau desciibm to me as shown below, the development he is proposing at (flat location,
ond, I have no objections to his proposal
DESCRIPTION ANWOR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing developrrlent)
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Signature
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Print or "Type Name
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ADJACENT RIPARIAN PIZOPERTY OWNER STATEM E NT
pv., `v`Moir
l hereby certify that I own property adjacent to
(Narne of Prop . y wrier)
properly located at i U1 Q!J \nLS��.
(Lot, Block, Road, etc.)i
on Cofr , in _ %
�.J� � y N. C.
(Waterbody) (Town and/or County)
He has desmibol to mo ws shown below, the development he is proposing at that location,
atld, I have no objections to his proposal.
DESCRIPTION ANTI/011 DRAWING OF PROVOSED DEVELOPMENT
(To be filled in by individual proposing development)
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