41752_NASH, KEN_20050609

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CAIZIA / -5 DREDGE & FILL
GENERAL PERMIT
Previous permit #
ENew DModification Complete Reissue C1Partial Reissue Date previous permit issued ' j
As authorized by the State of North Carolina, Department of Environment and Natural Resources /
and the Coastal Resources mmjs 1P In an area of environmental concern pursuant to I SA NCAC
0o4\ W u JV� 7 Rules attached. /
Applicant Name Project Location: County
Address _ Street Address/ State Road/ Lot #(s)
City State ZIP
Phone # (} Fax # (`}
Authorized Agent't
Affected -I CW l EW D PTA ES ❑ PTS
AEC(s): Ll OEA - HHF [ IH - UBA i 7 N/A
`1 PWS: is � FC:
ORW: yes / no PNA yes / no Crit. Hab. yes / no
Type of Project/ Activity
Pier (dock) length_
Platform(s)
Finger pier(s) _
Groin length
number
Bulkhead/ Ripraplength_____
avg distance offshore_
max distance offshore
Basin, channel
cubic yards _
Boat ramp
Boathouse/ Boatlift
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
no
A building permit may be required
by:
Notes/ Special Conditions
Aw
Agent or Applicant Printed Name ,10
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
Subdivision . ` '' _ ""`
City. _ ZIP
Phone # ( ) River Basin
Adj. Wtr. Body " _ A`aat. ;man /unkn)
Closest Maj. Wtr. Body!
(Scale:
See note on back regarding River Basin rules.
Permit Officer's Signature
Issuing Date 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, certifythat this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
Tar- Pamlico River Basin Buffer Rules
L _I Neuse River Basin Buffer Rules
(Other:
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 (9 l 0-395-3900) 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: Fax: [phone]
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293 / 1-888ARCOAST
Fax: [phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Morehead City District
151-13 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

I hereby certify that I own property adjacent to
(Name of property Owner)
property located ati•�
� (Lot, Block, Road, etc.)
N.C.
in
(Waterhody) (Town and/or County)
He has descnbed to me as shown below, the development he is proposing at that location,
and, I have no objections to his proposal.
DESCRDMON ANDr'OR DRAWING OF PROPOSED DEVELOPMENT
(Tv be flled' in by individual proposing develapmant)
Cl
i
Signature
Print or Type Name
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Telephone Number
Date;
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I hereby certify that T own property adjacent tonnia
5
(Name of Property Owner)
prcpeTty located at a a14 . -1 a qo
� (Lot, Block, Road, etc.) '
on L (��z_ in PA N.C.
(Waterbody) (Town and/or County)
He has described to me ;:u s,`town below, the development he is proposing at that location,
and, I have no objections to tU.s proposal,
DESCRIPTION ANT),,0A DRA WING OF' PROPOSED DEVFI:,opp
(To in by individual proposing deveLopmeat)
T- -.Il
I �
4
S ianatu re
Print or Type Name
Te?cphone Numbar
Z0 39dd
onaiSN00 A33b0 GVOdS
ESZbGVLZSZ 00:60 900Z/S0/S0

BROAD CREEK CONSTRUCTION
PH. 252-745.4252
11 CREEKVIEW CT
MERRITT, NC 28556
FAIN
BB&T ,/i� 1, � , G
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BRANCH BANKING AND TRUST COMPANY
NEW
BE�R NO TH77IN
1:0 5 3 LO L 12 W: 5 2 900 5 L L 6000 30 2 3
3023
66-112/531
01901
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