44221_HERR, ALAN_20060202

CAMA / D DREDGE & FILL t
GENERAL PERMIT
r INew --]Modification ❑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_
A 1' N ' `` " - P L C
pp scant ame r
Address
City l:y State ` ZIP
Phone # (��) ' -7 "C ' Fax # ( )
Authorized Agent
Affected CW 9EW 9 PTA P-ES 0 PTS
AEC(s): OEA ' 7 HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS: ❑ FC:
ORW: yes / no PNA yes / no,) Crit. Hab. yes / no
Type of Project/ Activity
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 Length -" ) 1 )
SAV: not sure yes `no
Sandbags: not sure yes (no
Moratorium: n/a yes i no
Photos: yes no
Waiver Attached: yes no
A building permit may be required by:
Notes/ Special Conditions
Previous permit #_
Date previous permit
rolect ocation. ounty
Street Address/ State Road/ Lot #(s)
Subdivision
CityIJ ZIP 4-1-
Phone # () River Basin
Adj. Wtr. Body t "r ' ` Gf �Wai /man /unkn)
Closest Maj. Wtr. Body. —J=
(Scale: / )
f � /
3f! n f �-
-� ` ❑See note on back regarding River Basin rules.
)
Lw /=4 fu I-_j I ; ?
Agent or Applicant Printed Name
Signatur "Please read compliance statement on back of permit"
Application Fee(s) Check #
Permit Officer's Signature
Issuing Date Expiration Date J
Local PlanningJurisdiction ! 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:
F Jar - Pamlico River Basin Buffer Rules F_l Other:
Ll 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)
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,
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 (, -)Rk L ES Wk 10212' 's
(Name of Property Owner)
property located at 1 `7 9 `1"�lU iC M�++J 2D ,
(Lot, Block, Road, etc.)
on a 00S LRE- k, , in A,4k,-TD-6&'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.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development)
�x/5-r/�6, 'P/EP I--1
3�K5 00i 3o' Dp
SOOZE(,I-E
pp Js
Signature
Print or Type Name
Telephone Number
Date: "I'aa10

CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER
FORM
Name of individual applying for the permit:
Address of property: 17 <3 I d USG A', � 1� Jb .
(Lot or street#, street of road)
(City & County)
I hereby certify the I own property adjacent to the above referenced property. The
Individual applying for this permit has described to me (as shown on the attached
drawing) the development they are proposing. A description or drawing, with
dimensions, should be provided whit this letter.
)_I have no objections to this proposal
If you have objections to what is being proposed, please write the Division of Coastal
Management, 400 Commerce Ave., Morehead City, NC 28557 or call [phone]
within 10 days of receipt of the notice. No response is considered the same as no
objection if you have been notified by Certified Mail.
Waiver Section
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift or
sandbags must be set back a minimum distance of 15' From my area of riparian
access unless waived by me. (If you wish to waive the setback, you must initial the
appropriate blank below.)
I do wish to waive the 15' setback requirement
I do not wish to waive the 15" setback requirements
Signature Date
� "e' t .rz. \ . L� M S
Print Name
Telephone number with area code

CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAlVER
FORM
Name of individual applying for the permit:
Address of property: ( % j ) �//� M 4 fj P-B i
(Lot or street#, street or road)
3EAUF'oR_1 ICAu-'�5k&T gilt;
(city & county)
I hereby certify the I own property adjacent to the above referenced property. The
Individual applying for this permit has described to me (as shown on the attached
drawing) the development they are proposing. A description or drawing, with
dimensions, should be provided whit this letter.
--U/—I have no objections to this proposal
If you have objections to what is being proposed, please write the Division of Coastal
Management, 400 Commerce Ave., Morehead City, NC 28557 or call [phone]
within 10 days of receipt of the notice. No response is considered the same as no
objection if you have been notified by Certified Mail.
Waiver Section
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift or
sandbags must be set back a minimum distance of 15' From my area of riparian
access unless waived by me. (If you wish to waive the setback, you must initial the
appropriate blank below.)
I do wish to waive the 15' setback requirement
Ce vl'*'- I do not wish to waive the 15" setback requirements
o112-o "'Vo1^
gn re Date
Print Name
s'rZ-j
Telephone number with area code

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to ( P A►2-LE S A. f- ER-p. 's
(Name of Property Owner)
property located at 1-7? T 14 u 2 p4 o f (Z G
(Lot, Block, Road, etc.)
on F, ;J ,in t3ttf30r6P-'r / C, 0 0,1',E a9:'f CO3 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.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development)
i� 00k 5
'PUT Pnc e-S o N o d O�
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-rrmt or i ype iN ame
Telephone Number
Date: / 0V 2-e9

CHARLES
4901 MISTY
OF? W,41VJD4 J.
HERF?
,A, -ry O'W D�
EIGH, NO- 847-933
27613
PAY To THE
ORDER OF
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7 A-/,
PO. Fe
.0. ' Federal Credit
BOX 58429,
www. PALEIGH IVC Union f
c0astalfcij 0 27658
MEMO P, rg
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66-75491253,
DATE 2033
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