43619_KELLER,NELSON_20051221

C'CAMA / L DREDGE & FILL
GENERAL PERMIT
F New iModification ,Complete Reissue uPartial 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
Previous permit #
Date previous permit issued
F-1 Rules attached.
Applicant Name J'/ P /' C-` Project Location: County
Ad ress ttjj
City t7 '' ' ! State.,' < ZIP
Phone # ( ) : J `..t Fax # (�)
Authorized Agent'
Affected 1 CW 0'115W E "PTA ❑ ES ElPTS
AEC(s): ❑. OEA ElHHF ElIH ❑ USA ❑ N/A
❑ PWS: ❑FC:
ORW: yes / no PNA yes / no Crit. Hab. yes / no
Type of Project/ Activity
Pier (dock) length
Platform(s)k 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
7
Shoreline Length
SAM not sure
yes
/o -- --.- -- -------=--
Sandbags: not sure
yes
n
Moratorium: n/a
yes
n G'
Photos:
yes
irna�
W ; A h d
giver ttac a yes no - --- ---
A building permit may be required by:
Notes/ Special Conditions
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit
o
Application Fee(s) Check #
Street Ad ress/ State Road/ Lot (s)
Subdivision
City_ --
Phone #
Adj. Wtr. Body___
Closest Maj. Wtr. Body
ZIP
River Basin
(na�man JunL
(Scale: )
❑ See note on back regarding River Basin rules.
Permit Officer's Signature
Issuing Date
Local Planning Jurisdiction
Expiration Date
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:
LTar- Pamlico River Basin Buffer Rules Other:
[J 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/ l-888-4RCOAST
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

I hereby certify that I (ter property adjacent to II ELLI�
+7fume of Property Uwner
3
(Lot, Block, mod,
RrQ?c ► M LK_ m �' r� N. C-
' (Watutod y) osru axdlctr C sst_v)
Ile teas descrffx�d to = its ificmn below, the develol runt he is proposing at tip Dian,
and, I have no objecdc= to hi.3 pv:WsaL
DESCRIPTION AMI/O1K DRAWING OF' P1kC)1 OSED DEVELOR T
f� (To be fBed ; ►r. by individual propada g devsjopmejzt)
3-S
rlu-�
I5't
r
Print or Type Same
`r - -5 C 4 C `746
Tel hcr•ie Number
90 39Vd onaiSN00 A33a0 GOdE ESZbSVLZSZ 8Z:Li S00Z/6T/Zi

I hereby ft- rffy that I VIM Pr0pCM Adjacent to
0'"ne of PraPerty Ownet-) r�
11104 Block, Road, etc.} .
(Wa�xbody) ovn an d1or O nty)
He has d&%v to me a: ,hOwn below, the develo4: rment to is proPesing at that location,
and, I have no objection to his .proposal.
�AR!�40'
DESCRIPTION AND/(I;Ip, DpAWING Oj` PRt:►:PpSIEp DEVELOPMENT
4% (To b,e, fia&F Jn by indry =I prvpam:zg ,dsvel'opmerrt)
c
SSW
a1
Sigm4i
flint Qp ype Name
Te?epha ie Number
Date;
L0 3Jdd OndiSNOO A33dO GVOdE ESZVSVLZSZ BT:TT 900Z/6T/ZT

3785
BROAD CREEK CONSTRUCTION 66-112/531
PH. 252-745-4252 �� 01901
11 CREEMEW CT
MERRITT, NC 28556-9572
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BRANCH BANIDND AND TRUST COMPANY
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