44211_HAIGHTS, CHUCK & NANCY_20060130

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GENERAL PERMIT
GENERAL
ElModification [:]Complete Reissue El 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 I SA NCAC_
Applicant Name , it
Project Location: County_
Address Street Address/ State Road/ Lot #
City --t- J State ZIP z-
Previous permit #
Date previous u permit i
permit
D RL
Phone # 5`� ='.3 7 Fax # Subdivision
Authorized Agent ij 1 02 1 &j
City ZIP
-V
0 Cw El EW El PTA �[�El ES PTS Phone# (A) 1(`-/ -
Affected ❑River Basin
El OEA El HHF 01H 0 UBA 0 N/A
AEC(s): Adj. Wtr. Body OWa'�j/man /unkn)
El Pws: El FC:
ORW: yes / no PNA yes / no Crit. Hab. yes no Closest Maj. Wtr. Body-'
I Type of Project/ Activity
(Scale:
Pier (dock) length_
Platform(s)__
Finger pier(s)__
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards_
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
Shoreline
c �77 7
Length
SAM not sure yes no
Sandbags: not sure yes
Moratorium: n/a yes
Photos: Yes no;'
Waiver Attached: yes ,no
A building permit may be required by: ❑ See note on back regarding River Basin rules,
Notes/ Special Conditions
L
Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit
Application Fee(s) Check #
Permit Officer's Signature
Issuing Date Expiration Date
X�A 2
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:
L] Tar - Pamlico River Basin Buffer Rules [ j Other:
0 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
Mailing Address:
1638 Mail Service Center
Raleigh, NC 27699-1638
Location:
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
Fax: [phone]
Elizabeth City District
1367 U.S. 17 South
Elizabeth City, NC 27909
252-264-3901
Fax: [phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax: [phone]
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Morehead City District Wilmington District
400 Commerce Ave 127 Cardinal Drive Ext.
Morehead City, NC 28557 Wilmington, NC 28405-3845
202-808-2808/ 1-888-4RCOAST 910-796-7215
Fax: [phone] Fax: [phone]
(Serves: Carteret, Craven, Onslow -above (Serves: Brunswick, New Hanover,
New River Inlet- and Pamlico Counties) Orslow -below New River Inlet- and
Pender Counties)
Revised 06/29/05

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Ell 4/#?v4.ea
(Name of Property Own r)
property located at z-or cm- n2 qs;q
(Lot, Block, Road, etc.)
on � I� p.�.�Sc � L �l�=7'` , in �)— �� 1, P%��S NC.
(Waterbody) (Town and/County)
He has described to me as shown below, the development he is pro)osinia at
that location, and I have no objections to his proposal. Ric
,IAN 2 6 2006
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (To be filled in by individual proposing development) M head hh
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are y
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Signatu
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Print or Type Name
AsS 3 - ww3
Telephone Number
Date: /� ✓ C--C-

ADJACENT RIPARIAN PROPERTY OWNER STAT ENTIqSIVED
N 6 2006
I hereby certify that I own property adjacent to C'1f'U(�'�
(Name of Pr6W UkAblIlIPA"Ity DCM
property located at 0T q6: ANC q 5 A
n (Lot, Block, Road, etc.)
on4`77� , in Ste! /�/,v �S . , NC.
(Waterbody) (Town d/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.
U
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development)
i �tG Z,v 46
Print or Type Vame
-zg3 3 y e 6
Telephone Number
Date:

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