47017_GREEN, MICHAEL_20061106

i
i
�I f, I L
C'CFE
/ ❑DREDGE &FILL U x
GRAL PERM 1 T Previous permit #
1]NModification El Complete Reissue ❑Partial Reissue Date previous 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
El Rules attached.
Applicant Name`
Address
City
Phone # (`)_
Authorized Agent
Affected ❑ CW
AEC(s): El OEA
❑ PWS:
ORW: yes / no
State ZIP
Fax # ( )
❑ EW ❑ PTA ❑ ES ❑ PTS
❑ HHF ❑ IH ❑ USA ❑ N/A
❑ FC:
PNA yes / no Crit. Hab. yes / no
Type of Project/ Activity
Pier (dock) ler h
Platform(s)_
Finger pier(s)_
Groin length
number
Bulkhead/ Rip
avg dista
max dirt
Basin, channe
cubic ya
Boat ramp _
Boathouse/ B,
Beach Bulldo;
Other
Shoreline Len
SAM ni
Sandbags: n,
Moratorium:
Photos:
Waiver Attacl
A building permit may be required by:
Notes/ Special Conditions
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision
City ZIP
Phone # ( ) River Basin
Adj. Wtr. Body (nat /man /unkn)
Closest Maj. Wtr. Body
(Scale: A.1 r— )
❑ See note on back regarding River Basin rules.
Agent or Applicant Printed Name mitofficer'sSignature. j
Signature 't* Please read com liance statement on back of permit Issuing Date a Eipiration/Date
g P P �
Local Plannin urisdiction Rover File Name
Application Fee(s) Check # Lg)

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, certifythatthis project is consistentwith the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
❑ Tar- Pamlico River Basin Buffer Rules Other:
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/ 1-888ARCOAST
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

NCDENR
North Carolina Department of Environment and Natural
Division of Coastal Management
Michael F. Easley, Governor Charles S. Jones, Director
j �IC�6��J3
Date
Applicant Name ! l l 16 i4 h e L- �,R6!�/V
Mailing Address 3 = 2 eMeOz Q a/`I/c
esoAg ` 2' 2006
MQWpggq.,`5elc1 dtaryDC M
I certify that I have authorized (agent) DeTCL'Q- , �OA I�k to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) ` 0CK ,
at (location) %l)l �7�6 SAW a�
This certification is valid thru (
Signature
:ii:t``, _ 'fin-i; �� r�/i=(•��e \,dnr^�1�(1;� (�tt�v' (�,.�n�F+ 11�f`l�lrl;j i�i�Cj�^-'

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGSIBOATLIFT/BOATHOI MUM% in)
I hereby certify that I own property adjacent to MG EL � s s
(Name of Property Owner or Applicant) NQ V — 2 2006
Mailing address if different from location address �Q� YYIrWGk1l�r�i�..
ty ACM
(town, state and zip) En—,,PJ CJ CA LS e- , NJ C 'L6 }
phone numbers you can be reached at ( q 1 '::;P1 ) 2-7 O - "-7 O 3 3 ,
property located at
(Lot, Block, Road, etc.)
on �O e �O u i'ld , inrrrc�l d , Carte
N.C.
(Waterbo y) (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 area of riparian access unless
waived by me.
I do not wish to waive the setback requirement.
initials
initials
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
---------------------------------------------------------------------------------------------------------------
Signature
f5uzanr-w-- Ev 1�J
Print or Type Name
Cg 19123o -r) o
Telephone Number

p c! & C,G(
Pt`e(- �c 6i41'[ 01 ;
NOV - 2 2006
11
Morehead City DCM

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGSIBOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to AINACL__ �F Il
(Name of Property Owner or ApPant)NO V - 2 2006
Mailing address if different from location address 'Atia-1-I )01'
town, state and zip) A Morehead City DGM
phone numbers you can be reached at 9', ,5- 3 S 3 4 9 oS ,
property located at 3 G o 9
(Lot, Block, Road, etc.)
on _ ��:6 a Al n in GA, q r —,e 0-7 , 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 area of riparian access unless
waived by me.
I do not wish to waive the setback requirement.
initials
I do wish to waive that setback requirement.
initials
-------------------------------------------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
---------------------------------------------------------
x
Signature
6 RA E m roR�
Print or Type Name
-3s3-y9/0
Telephone Number

• Proflo&O P+'er
�tl
'1
NOV - 2 Z006
Morehead City DCM