43602_FREEDEEN, FRED_20051130

LCAMA / _1DREDGE & FILL
13ENERAL PERMIT
Previous permit #
DNew LModification L;Complete Reissue ❑Partial Reissue Date previous permit issu
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
Rules attached.
1
Applicant Name ; �• `f °/ f � r " ~ ` � e' Project Location: County_
Address / c,> t� ` ��`� y� Street Address/ State Road/ Lot #(s)
City_ J�- Statep ZIP 1Ff f t/ — -
Phone # ( �°� Fb ax # () Subdivision
Authorized Agent /) Z A, City �``" � � ZIP
Affected
CW Ew L fg
TA ES ❑PTS Phone # River Basin
-_ (-" )
AEC(s): i OEA HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body (� ` ^� % (nat Iman, /unkn)
PWS: ❑FC:
ORW: yes / no PNA yes / no) Crit. Hab. yes / no Closest Maj. Wtr. Body `
Type of Project/ Activity y
Pier (dock) length_
Platforms)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap. length
avg distance offshore
max distance offshore
Basin, channel
cubic yards___ —
Boat ramp
Boathouse/ Boatlift
i
(Scale: / J ° , ' `
Beach Bulldozing
Other -
Shoreline ---- _
— — ---- ..n �l ' I� . ` '""'�,--ter• - ���-- I---
,J �;3a���,�tri`3='S1�tz:�.i�:A.,td�;,✓ k ".,;:ll�-1-'V���_ '• '-� ,� �f' ,�,1-9
Shoreline Length f�f!
SAV: not sure yes
Sandbags: not sure yes(no
Moratorium: n/a yes
Photos: yes no
Waiver Attached:ygs �o ----- -
A building permit may -be required by: V f/ ^ r ° ❑ See note on back regarding River Basin rules.
f
Notes/ Special Conditions
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit
0
Application Fee(s) Check #
E
r
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, 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 ❑ Other:
j] 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 (910-796-7215) 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/OS

ACV 21, 2C05 14:26 Bopae Banks Marine Const (252) 2V-4427
Page 1
Adjacent Riparian Property Owner Statement
(FOR A PIER/MOORING PHANCWHOATUFrIBOAMOUSE)
1 hereby certify than 1 awn proper r, acl atxilt in red4
/ ,�A 1 h une OE PToM OAVIleY
property locaed at L' / S l ` 4AA1^,k 64,re—
as in_�Gr��' _,. NC
He has described to me, as shown }+slow, the development he is proposing w tbxt location and I have
no ubj"tions to his Proposal.
I da„not wish to waive the setback requirement.
I do wistr to waive the setback requirement.
Dwription anddor Drawing of Proposed Development
(To be filled in by the individual proposing development)
s(G
rant or type name
Telephone number
O'0
6b0ue- R^-, L<-5
vyw irk. C'o"(r

Adjacent Riparian Property Owner Statement
(FOR A PIER/MOORING PILINGSBOATLIFTBOATHOUSE)
r e d►� e 2 ciee l,-i
I hereby certify that I own property adjacent to 's
property located at l a T -4 R
/ Name of Pro rty Owner
Lot, block, road, etc.
on ��Va W4 " , in 0 je_ 9 , NC
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 do not wish to waive the setback requirement.
—4 I do wish to waive the setback requirement.
Description and/or Drawing of Proposed Development
(To be filled in by the individual proposing development)
�-fWe L
P 'nt or type name
25Z- -72 8— (a6 1 0
Telep one n ber
Date

WACHOVIA BANK. N.A.
MOREHEAD CITY NC 28557
U_ F. S., LLC
101 DOLPHIN 28516
BEAUFORT,
252-728-7576
g Dollars
00/1p0
PAY Mom°- One Hundred and
7 TO THE
ORDER
OF: LAMA
AD �:05310 15 2ql.
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