45293_HOSSFIELD, STEVE_20060525

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1JCAMA / ❑ DREDGE & FILL
GENERAL PERMIT
❑New I] 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_
Applicant Name
Address
City State ZIP
Phone # ( ) Fax # O
Authorized Agent
❑ Cw ❑ Ew ❑ PTA
Affected
AEC(s):
❑ OEA ❑ HHF ❑ IH
❑ PWS: ❑ FC:
ORW:
yes / no PNA yes / no
Type of Project/ Activity
Pier (dock) length_
Platform(s)
Finger piers)
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
SAM not sure yes
--
Sandbags: not sure yes
no
Moratorium: n/a yes
no
Photos: yes
no
Waiver Attached: yes
i�
A building permit may be required by:
Notes/ Special Conditions
❑ ES ❑ PTS
❑ UBA ❑ N/A
Crit. Hab. yes / no
Previous permit #_
Date previous permit
❑ RL
Project Location: County L�
Street Address/ State Road/ Lot #(s)
Subdivision I— �
City ZIP
Phone # ( ) River Basin
Adj. Wtr. Body_ (nat /man /unkn�
Closest Maj. Wtr. Body
(Scale: )
E See note on back regarding River Basin rules.
Agent or Applicant Printed Name
j i n i
Pe fficer's Signature
'*
Signature Please read compliance statement permitf-� Issuing Date
Expiration Date
ApplicationFee(s)
Check#
Local PlanhingJurisdiction
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 [)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 consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
Tar - Pamlico River Basin Buffer Rules �_I Other:
CI 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,
Onslow -below New River Inlet- and
Pender Counties)
Revised 06/29/05

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1 in. = 100.0 feet
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Maz 01 06 01 : 15p BLELCLIER 252 757107- p. 14
Adjacent Riparian Properq Owner StAlle-1 t
(FORA NFRAMOORING PIi,INGS/BOAi'LI T:BOATNOUSE)
l>wnrr
' 5
1 hcr: by cr ify ghat i o�vn nro adjacent :o 54 c%t_ e NssT (� -. -- —_-- —
dame of 'r�peny
J.��� Lu•rd•;rr.
i,�cate� athase
pri pert} roadd1c.
on �t�'•��:cvas;�ll 1i�atc;il',_+}• y__-- -___ --- --- ��otj•nzu3;orcounty
he has described to me. as shown betoW, Lhe dc,*,''iopmen hc.* k proposing at that la.:ation and I have
no obiections to his proposai.
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0 Rvi Wi5h LO W:IM'Z LiSc Set
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} l0 ��15i1t0'W""We the itiback, royw�en�2-li
Description andlor Drawing of Progused De%elopment
nt>
(To ix ti:.lea in by the in;lt,'iduat pro�,sin� dc�ctaprl
1, ,..''it:ICI•Z;6
% ianaturz
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Print or type name
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252- 728_ 3,3z
Adjacent Riparian Property Owner Statement
(FOR A PIERIMOORING P[LINGSIBOATLIFT/80ATHOUSE)
l hereby certify that 1 own property adjacent to Sl evt_. Uaisil ds{r _ 's
Name of i?ropaV 4wncr
ptvperty located at �+D t
Lot, biock, road, etc.
on Iniroconstal Waterway to Cartctct , W
Waterbody — Town amVor county
He has described to me, as shown below, the development he is proposing at that location and d have
no objections to his proposal,
X I do not wish to waive dhe setbuk requirement.
1 do wish to waive the sctback requirement.
Description andlor Drawtng of Proposed Development
(To be tilled in by the individual proposing development)
Sce Attuclivd,
Si to—
Y1
Pnnt or type name
Telephon nu ber
ate
Ke% n Lett
S1771 1,��Je.. Creak C�10r,
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IM Ss3 - Ygs'2
pef.'" tr, A F-,., ? 5-Z -- iYi- S6 3, '�-

U. F. S., LLC
101 DOLPHIN WAY
BEAUFORT, NC 28516
252-728-7576
PAY Memo:
TO THE One Hundred and 00/100 Dollars
ORDER
OF:
CAMA
rflm
WACHOVIA BANK, NA 66-152/531 MOREHEAD CITY, NC M557 2858
DATE
Nov 4, 2005 -
AMOUNT
$ *****$100.00
8 SECURITY FEATURES INCLUDED. DETAILS
u■0028581I" 1:0531015291: 546111 005441110
U. F. S., LLC
101 DOLPHIN WAY
BEAUFORT, NC 28516
252-728-7576
PAY Memo: Permit
TO THE One Hundred and 00/100 Dollars
ORDER
OF:
CAMA
WACHOVIA BANK, N.A.
MOREHEAD CITY, NC 28557
61466�11� LJ SECURITY FEATURES INCLUDED. DETAILS C
11500285011' i:053101529i: 546L 005441110
6fr152/531
2850
DATE
Nov 4, 2005
AMOUNT
$ *****$100.00