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EDGE & FILL
GENEK41- PERMIT 4- #
L7'New IlModification Complete Reissue ate "e'..r 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
I
Applicant Name I-) V fk 0 r t P -Z r
Address ---
City
-4j State 14
Phone # Fax #
Authorized Agent
ES E
-- El
Affected -!CW EfrEW -PTA
AEC(s): OEA F-1 HHF El 1H El USA E
PWS: EIFC:
r '/
Project Location: County.
Street Address/ State Road/ Lot #(s)
114
Subdivision
City---- ZIP J4i!5 �p
rs Phw�� Basin ,River Wtr.
I/A
0
j. Wtr. o nat an Annkn)
Closest Mai WtrBod
ORW: yes / no PNA (yeJ / no Crit. Halb. yes / no
Type of Project/ Activity
(Scale: -,4/
Pier (dock) length
Platforrn(s)_
Finger pier(s)
V-
Grain length
number
Bulkhead/ Riprap length__
avg distance offshore
max distance offshore
Basin, channel
cubic yards__
Boat ramp
Boathouse/ Boatlift
Beach Bu
Other
Shoreline Length
SAM not sure
yes &n
Sandbags: not sure
yes n
Moratorium: n/a
yes
Photos:
yes
Waiver Attached:
yes no '-
A A building permit may be required by:
Notes/ Special Conditions _
I
Agent or Appliqant Printed Name
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
See note on back regarding River Basin rules.
Permit Officer's Signature
J
Issuing Date Expirfion D,*e
Local PlanningJurisdiction 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
I_] Neuse River Basin Buffer Rules
[j 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 (910-796-7215) for more information on how to comply with these buffer 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
Fax: [phone]
Fax: [phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Morehead City District
400 Commerce Ave
Morehead City, NC 28557
202-808-2808/ 1-888-4RCOAST
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
910-796-7215
Fax: [phone]
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)
Revised 06/29/05

KP
--Aug. 1, 2005-10.39RM Century 21 Waterway Realty
I.S.P.LFU1RON STAKE FOUND
R/'rY -- RiGHT-OF-WAY
C - CENTERLINE
M'.B,L. - MINIMUM BUILDING UNE
- FIELD DATA
RE13 - ELECTRIC sox
a PS - PHONE BOX
+ LP - UGHT POLE
p►C� 66'41'o711E
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g
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Radial Survey of 1 '�'�` , ' •
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7.
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Wetlands L1ner �^
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u��d 63
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Side Yard Setback--
5.032' Encroachment Of
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q
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(N72'47'36"W
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VICINITY 0<
140T TO SCALE
yll X �cL'EJ°CY ^'ec
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CPN 3703.40 0367D
'` effective Nov. 4, Ig92
C:anc porch
Ganc. J-552'
Walk
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R�35
10 Drainage 4
THIS MAP NOT FOR Utility Eas�merit---t-+�..t
RECORDIiNG PURPOSES PHYSICAL S UPVEY
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230 Marsh Hen Court
Marsh He
Court
501 R/ W
ry

Onslowl7948800B1739 jpg (JPEG Image, 548098 pixels) http://7/1.16.185.125/imag OB1739.'
01-1 I
October 19, 2005
Neighbors Signatures for Permission to Build Boat Dock at 230 Marsh Hen Court.
227 Marsh Hen Court
BARISTOW TIMOTHY M & INGRID S
I ll.ro-,o / � v
229 Marsh Hen Court
GORE SUSAN E
1 of 1
9/29/2005 8:16 PM

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