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CAMA / ❑ DREDGE & FILL
GE.NERAL PERMIT
Previous permit #
]New ❑Modification ❑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
f E. Rules attached.
Applicant Name _ �r F % Project Location: County d
Address Street Address/ State Road/ Lot #(s)
City_ State AIC ZIP r ' 3 ;` ( �' r'r / lJ
Phone # (_ /) %" ;1 i ��Fax # ( ) Subdivision
Authorized Agent � A%/ i` A, _J City_.___ _ _ ZIP -ti � 1 1 ✓
Affected i❑ CW Li EW [ "A ElES ❑ PTS Phone # (_-_ -) __ River Basin
❑ OEA ElHHF ElIH ❑ UBA El N/A
AEC(s): Adj. Wtr. Body _ (Tat /man /unkn�
1 PWS: ❑FC:
ORW: yes / no PNA yes / 19 Crit. Hab. yes / no Closest Maj. Wtr. Body
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
/ :
SAV: not sure
yes
no
Sandbags: not sure
yes
no
Moratorium: n/a
yes
no
Photos:
yes
no
Waiver Attached:
yes
no
A building permit may be required by:
Notes/ Special Conditions
(Scale: _,Al 7 � )
I
_ See note on back regarding River Basin rules.
Agent or Applicant Printed Name 2 4 200mit OtfiEer's Signature
,r
i > i l_,
Signature "Please read com�pliancestateme�nbk d city
xpirati n Date
ApplicationFee(s) Check# Local anningJurisdiction 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, certifythat this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
Tar- Pamlico River Basin Buffer Rules �_� Other:
I_ 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, INC 27699-1638
Location:
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
Fax:919-733-1495
Elizabeth City District
1367 U.S. 17 South
Elizabeth City, INC 27909
252-264-3901
Fax:252-264-3723
(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: 252-247-3330
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico Counties)
Washington District
943 Washington Square Mail
Washington, NC 27889
252-946-6481
Fax: 252-948-0478
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, INC 28405-3845
910-796-7215
Fax:910-395-3964
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)
Revised 06/29/05
n.r-cu-:uuo io:ua prom-VDANVT 2622403243 T-434 P.002/002 F-796
r�DJACENT RIPAR1AN PROPERTY ONVIN 12 STATEMENT
' (FOR A PlER/r1lO0RING pii iNGs(soATLIFT/BOA THousE)
1 hercb), certify that I G%vn property adjeccnt to S� _ �-t�_r��¢.� •s
(Name of Pr
property located at.
MAR 2�
(Lot, Block, Road, etc.)
on r .....� ad C' DC
(1�'at l�odv) (Town and/or County)
He has described to nte, as shown below, the development he is proposing at that location,
and, I have no objections to his proposal. I understand chit epiartmoo�ngpilingi�boatlilt//boethousc
must be stt back R minimum distance of fifteen feet (IS') from my aroa of rip3rian eecess unless
waived by nic.
I d"- 9t %yish to waive the setback requirement,
I Ag wish to Nvisive that votback requirement.
...................._......._._._.......---........ __......................... ............................
.._---
DESC'WPTION' AND/OR DRAWING OF PROPOSED DEVELMAIENM
(To bm Idled In by Individual proposilq develoDarelrr')
c
200/Z00'd OL09#
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tgnature
et.� Q
N2i0H TZ6Z£596T6 £5:Z0 900Z,OZ-dVX
03/20,!2006 12:28 804-272-5843
Nor-20-2006 00;66 From-BBANDT
JOHN J JOHNSON PAGE 02
2622409248 T-420 P-002/002 F-770
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A FfENUOORING PIZ INGSIB OA TL IFTIB OA THOUSE)1
t hereby certify that I own property adjacent to
0' rz
(Name of Properly O►vn%)
,� qR property located at 2 z
��� a,�..L,� t, �006
(Lot, Block, Road, etc.) @hea
� C.
.�..,,_A N.. oC4
(wet body) (Twwn and/or County)
He haj- described to me, as sho«'n below, the development he is proposing at that location,
and, Thave no objections to his propwal, I understand that a picr/mooring pilingsUatlift/boathouse
must be set back It minirnutJJ distance of fifteen feet (15') from my arcs of riparian access unless
Nvaived by mz.
I da not wish to waive the setback rcquir=cnt.
I do wish to waive that setback requirement.
DESC RIPTION ANWOR DRAWING OF PROPOSED DEVELOP;NIENT:
(To be fillet! in by Individual proposing development)
<------' CFI >
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LARRY G. ARNOLD G23
P O Box 2277
Morehead City, NC 28557 66-21/530
3 BRANCH 77615
PE /Date
Pay to the
Order of ,' (/ \ /__*( $
_
Dollars = °°'•"' °"
WACHOVIA
Wachovia Bank, N.A.
wachovi
For /y �
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