45723_HAYES, SUSAN_20060605 (2)

QiCAMA / C I DREDGE & FILL NY 45'723c
C
ENERAL. PERMIT Previous permit #
ew ❑Modification IComplete 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 Commissilinaea of environmental concern pursuant to 15A NCACr ules attached.
Applicant Name ! ✓ _ Project Location: CountyAddress�f i} �_ r Street Address/ State Road/ Lot #(s)
] --- -
City�/�''y _— State
Phone # (l/0)t�0 —yrp�'Fax # ( ) Subdivision _
Authorized Agent City_ S O ZIP
Affected � �TA El ES ElPTS Phone # ( ) River Basin
AEC(s): -i oEA ElHHF ElIH ❑ UBA ❑ N/A Adj. Wtr. Body �l �f oi-ek - a an_ unkn)
DiPWS: ❑ FC:
ORW: yes n PNA 40/ np Crit. Hab. yes / no
Type of Project/ Activity G / do
Closest Maj. Wtr. Body _- e OL40t
16 X u 0
0.
Pier (dock) length /49YX&_
Platform(s) /0 X /lL.J —
-
Finger pier(s)
Groin length — - -- —
number _. - -- --
I I
i
Bulkhead/ R prap length j I
—i----1- } —I—
avg distance offshore
max distance offshore
Basin, channel --' - —
00
—*
Shoreline Length
SAM not sure
yes
Sandbags: not sure
yes
Moratorium: n/a
yes
Photos:
yes
Waiver Attached:
yes
no
A building permit may be re
fired by
Notes/ Special Conditions
Agent or Applicant Printed Name
wmw�--P--v
mum om
VnA FA of, 6 1 1 "A VAq
lip
(Scale: T-S )
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�I?> ❑ See note on back regarding River Basin rules.
Signature ** Please read compliance statement on back of permit ** Issuing
/19A -• u/4'C'
�/l d'l"xpir ion Date
Tip t,n o d A

MCDENK
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Michael F. Easley, Governor Charles S. Jones, Director William G. Ross Jr., Secretary
June 5, 2006
SUSAN HAYS
226 WILD OAK DR
SWANSBORO, NC 285854
Dear Ms. Hays:
Attached is General Permit #45723C- to construct a 104' X 6' pier to a 20' x 10' platform and a
13' x 13' boatlift at 226 Wild Oak Dr, Swansbobo, NC
In order to validate this permit, please sign the permit as indicated. Retain the white copy for
your files and return the signed yellow and pink copies to us in the enclosed, self-addressed
envelope. If the signed permit copies are not returned to this office before the initiation of
development, you will be working without authorization and will be subject to a Notice of
Violation and subsequent civil penalties.
We appreciate your early attention to this matter.
Sincerely,
" "
Ryan Davenport
Field Representative
lsb
Enclosures
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: [phone] FAX: [phone] Internet: www.nccoastalmanagement.net
An Equal Opportunity 1 Affirmative Action Employer— 50% Recycled 110% Post Consumer Paper

susAiv R. HAYEs . ;1 rs , t� �a r� r f r.r ,„;, 4695
ROBERT L HAYES
PEL (910) 3 6-7655 ash
286 WILD OAK DRIVE 66 7497/2560
DATE
SWANSBORO NC 8858� µ , '
PAY TO TH
ORDER OF l j(—, J\J (� "�►
NAVY
FEDERAL
CREW UNION
FOR ���, I �/�
�. 2560 749?41.469 5@11 L 506.39 i ?❑ 311100 L
DOLLARS 8
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSIBOATLIFT/BOATHOUSE)
I hereby certify that I own 's
Property adjacent to Nzn of Property Owner)
property located at
(Lot, Block, Road, etc.)
n 0�,S �. fr-e.Q,�s. , in N.C.
SI�tIG,�btNCj ,
o (Town and/or County)
(Waterbody)
He has described to me, as shown below the development he is proposing at that location,
ier/moor
and,
I have no objections to his proposal. I understand that a ping
pilings/boatliftJboathouse must be set back a minimum distance of fifteen feet (15') from my area
of riparian access unless waived by me.
I ssnat wish to waive the setback requirement.
l `�ish to waive that setback requirement.
_________ - -----------------------------------------
DESCRIPTION AND/OR DRANYING OF PROPOSED DEVELOPMENT:
(To be filled it, byindiridual proposing development)
---------
------ - - - --
--------------
-
Sl'gnature � b
Print orType Name eItzabz Gibson
0�10
Telephone Number

ADJACENT RIPARIAN PROPERTY OLWNE STIFTIBOA STATEMENT
(FOR A PIERIMOORING PILINGSIBOA
I hereby certify that I own property adjacent to
(Name of Property Owner)
property Located at a�� t iC 0C.-
(Lot, Block, Road) etc.)
- , N.C.
on�1 a l�S (,,��,j� , in Sdd'L�
r� � -
(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 slat wish to waive the setback requirement.
I �00 wish to ,�,aive that setback requirement.
- --------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by iruliridual proposing development)
----------------
---------------------------
---------------------
�gn� ure
R4e4 � A-1 4 Nnll 3ar�o
Print or Type Name
n 04> j
Telephone Number

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