45113_GODFREY, RALPH_20060522

I
❑CAMA / ❑ DREDGE & FILL
-� GENERAL PERMIT
❑New - $F1odification El Complete Reissue ❑Partial Reissue
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_
Previous permit #
Date previous permit issued
Applicant Name Project Location: County
Address j Street Address/ State Road/ Lot #(s)
City ;, `� L t ; State ZIP
Phone # ��_) Fax # ( ) Subdivision
Authorized AgentCity ZIP
Affected ❑ Cw ❑ EW X PTA ❑ ES ❑ PTS Phone # ( ) River Basin
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body , s .� (nat /man /unkn)
❑ PWS: ❑ FC:
ORW: yes / no PNA yes /'no Crit. Hab. yes / no Closest Maj. Wtr. Body
Type of Project/ Activity
(Scale: 1� )
Pier (dock) length
Platform(s)
Finger pier(s) j
- - -
Groin length
numberBulkhead/ Riprap length Cavg distance offshore--
distance offshore-i
channel44yaU��-rh:�i
APBasin,
2O--
?trL
+ -
---
—max
cubic rdsiBoat ramp -
Boathouse/ Boatlift LL
-
-
Beach Bulldozing
Other
,—
o
i
Shoreline Length_
SAM not sure yes no
Sandbags: not sure yes n/a es . 9
Moratorium: Y n I
Photos: Yes no
Waiver Attached:
j ►"
1 ,
--
A building permit may be required by:
❑ See note on back regarding River Basin rules.
Notes/ Special Conditions
]DIME
W
lam
Agent or Applicant Printed Name r r ,ce's Signature Cityr
•(/ -Ifa r I
Signature Please read compliance statement Fodn' back of permit Issuing Date Expiration Date
15.Z ` V (/ S�� i�
Application Fee(s) Check# Local Planningf urisdiction 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 U 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 (252-946-648 [)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,
Orslow -below New River Inlet- and
Pender Counties)
Revised 06/29/05

y
'MAY-04-2006 THU 01:41 PM NO DIV OF COASTAL MGMNT FAX NO. 4
P. 03
AIQ41M.'E14V,Ys �L�D�i�i.Yh9)%' 13'R01I'hR'.I'Y OWN ER S7'A't11.lYll'll' ' 1
0108 A rl,rF,M OA7Ift0USE)
l �
1 1104411y cc:flil;y Ilsal, i o it pi-opuity �uljacc.Jlt to
(Naxlw of Property Owner)
d e111N!... �'. /� 'JS_� 2 1
(':.Arcot A( duess, l,(;l, Much, Roa(1, etc.)
l
fr�l��rtiY) (`l'own .1ziii/or C 0111 fy)
110:1'-te, h is -descril>etl to mi;, as•showo below, the development he/she is proposiag at that
lt7^„""ion f+lid j havo no 01-jQctimis to this proposal. I understand. Nit it pier/limi-ing
piITnpq/ll[lod l fc io:i IlimuSc 7nu.9L { iG ;:et 1: ick a minimum. distaiice of fiftecti feet (151) from my uca of'
ripirinn accct;s w�iived by wc., 1 have indicated niy intentions by initialing below;
_. 1 dq Llrit-naree to waive the 15' setback reciuiremeiit.
OT,
ngrco to waive the 15' setback repirement.
ANT> IOR DRAWING OY PROPOSED 1: EVCLOPMEN'T:
(h) belled irs by irtdiridual proposing depelopment)
36 1.
¢ U
•3 y
3L
3 C.
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40
ti
�r'a c✓ar/
A ram.
s ea, ✓vle
Sipittiire
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Print or Type Name
Telephoue Number
Dato; S ^ 5- " d l

� AY-04-2006 THU 01:40 PM NC D I V OF COASTAL MGMNT FAX NO. 4 P. 02
�"RTY OWNER
AMAIq 1'11011).'
("t;Ih(y flmt I own pl-opcay ad.jac.clit to '- - Aey -4 Cev,,ri z --- `q
11110 of'Property 0)Y110-1.)
14,0j)".-i ly lbh,Atcd al
N. c.
"111(110k. C01111ty)
-bL t �h� iy,�.&sshow ow, j)j f1j,
hill, J hi ni) objuct-lbris (o Ili's proposal. .
M,'S'C".l019 T0N ANDIOR IMAWING OF PROPOSED DE VF110PW,.N'r
(110 be fiffed fit by indiddual proposing de velopinent)
*ef
la
3,N? 1-,ov & )"/
;re,rSH" P' "c'
Signature
Print cir Type N-Ae
Telephone Number
Date: S-- 11(i'j
�/��r'�i�-

DAVID K..OR .PEGGY A. GALLOWAY 64-7131/2610 152
PH. 252-504-2338 000000077881345
177 JENNIFER DR. Date ^z 20
HARKERS ISLAND, NC 28531
Pay to the
Order of_r
Delta Community
ATLANTA, CINCINNAT`
Credit Union DALLASIF. WOR'TjjjjF{, I
SALT LAKE I1
Delta
Memo �d e -- -- ----- 1� - ""--
i: 26 107 L3 L5II: 00000078 L34S0 0 L5 2

MAY-04-2006 THU 01:40 PM NO DIV OF COASTAL MGMNT FAX NO. 4 P. 02
f "A t It
z
("(;lfi�y fli-A I own propcay ad ac.ent to�m�
0,-ac (All"l-opedy olyllex)
IVAI Ilrly Illod" Road, c4c.)
It hso0-1bdowis prci. l',
.� ,hdlat tl
J 11-wo no (A)jxUbnS to his proposal..
------------- ----------- MAY­2-'t-t�ffe
ANW(7R I)RAWING OF 1JROP0SFD.DEj"j"Md City DCM
(TO be filled is by indiddualproposfag developinew)
d - lel , Idea /— t' , ;�-
6,7
/ -,// 3, ei-'7V
Signature
Print or Type Name
q1 6? _? S,3 —
Telephone Number
Date:

MAY-04-2006 THU 01:40 PM NO DIV OF COASTAL MGMNT FAX NO. 4
f! i))A(11HNl. 1'41trA(tfya,Tq-��,P,c(. Ali{�8.�/.k�k� ��1�1Vl��rR 1''J" 'IS:TEMON1,R,
P, 02
f
t hoikby v*al•ify ii1^i I own )yrulxrty.ldjacent tc� � �/ �rdrs✓�`rC �_ _ '
(Marne of I'►rolvriy Ownuf
�}!'r)�?.,a ty Ic+; ;�t•ut �I ....._� �. _. % v��Cyiv , �"�Y._ �_ � , ., ..,.......--------- ...._ ,
(Lot, Wirl" Road, Cie.)
N,C.
% � i • � '•'t .L•;i
r,,:.r :l t�• , ' "i • r.•,1'•r:•yt.
df;�- as
'i•rr .
shoNyf};below,
yir ' .+ �'
the'develcpill.t
!t`'4•} •�t.
�p"
,Es:
�1
�
t110) I bavo 140 o1 juctityns to his
proposal..
, it
41-V
.0
MAY- 2 4 2006
DES'C"itIPTION ANUIOR J)RAWIN(: Or, Morosrn DPWAMM City DCM
Ub be f illed In lu, indirul'unl proposing de veloprnent)
Lo
aZ4�
�LI ,fir. all—
,� ►� T ley�f.7-
�Or Sea
iaWAe"oev �.
Signature
a v,_� a Ile) tel2y
Print or Type Name
_ z�z
Telephone Number