41949_MCKENZIE, BUTCH_20050624

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GENERAL PERMIT _ Previous permit#
!_'1New !-!Modification DComplete Reissue ClPartial Reissue Date previous permit issu
As authorized by the State of North Carolina, Department of Environment and Natural Resources 7 J
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC / r7
❑ Rules attached.
Applicant Name i r_ I. f 4 Project Location: County CA- -i
Address Street Address/ State Road/ Lot #(s)
City d% ✓�' i , A P l ` r State ZIP s� / Y i l ( [ a .
Phone # (�` ) ''� �� 3 Fax # ( ) Subdivision
Authorized Agent City_�pr/' �.• ,f �' ZIP
Affected _i CW CAW k-PTA ❑ ES ❑ PTS Phone # (`) River Basin
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
AEC(s): Adj. Wtr. Body (nat_ man unkn
❑ PWS: _7 FC: i'
Closest Maj. Wtr. Body
ORW: 'yes 'J no PNA yes / no Crit. Hab. yes / no
Type of Project/ Activity
Pier (dock) length
Platform(s)_ ` S
Finger piers)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore___
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse% Boatlih) ! f 1
Beach Bulldozing_
Other
Shoreline Length _7
SAM not sure
yes
no
Sandbags: not sure
yes
no
Moratorium: n/a
yes
no
Photos:
yes
bo
Waiver Attached:
f yes
no
A building permit may be required by
Notes/ Special Conditions
4��U , I -
Agent or Applicant Pri6tted Nam
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
(Scale: )
See note on back regarding River Basin rules.
Permit Officer's Signature
Issu ni g aD 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
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:
E 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.nccoastalmanagement.net
Revised 10/05/01

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Jun 21 05 05:11p
9197729249 p.l
Jun 21 2005-1 9 HAM.-r'-Qwi-.k Patti & ShiPmVMALI VVVI'11:x019931 P- 2i2
(FOR A N RIMOOR NG P[LINGSIBOATLIFT/80ATHOUSE)
I hereby certify that I own property adjacent to , AkP 1 L .'s
(Name of Property Owner)
property 1<=tcd at .5`21V,2 .7 c"h s&- f 4gC?sr -
(Lot, Block, Road, etc.)
on _ ad'zw .�Du.r? , inm� r�/� �� /� N.C.
(Waterbody) (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 arca
of riparian access unless waived by me.
I do not wish to waive the setback requirement.
I d-o wish to waive that setback requirement -
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMEN-17:
(To be filled in by individual proposing development)
---- ---------------------------- --------------ig
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Print or Type Name
Telephone Nu ber
Date:

DAVID'S QUALITY CONSTRUCTION
P. O. BOX 4818 252-354-3331
EMERALD ISLE, NC 28594
PAY A J
TO THE
ORDER OF
Bankof America
(/` ems— 6e-191530 NC
DATE 7 " J 2002
- 1 $ le9e , caJ
OLL.ARS 8
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ACH fl/T 053000196
FOR
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