47253_MALL, DONALD_20060912

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D CAMA / C! DREDGE &FILL
GENERAL PERMIT
DNew CModification ElComplete Reissue CPartial Reissue
As authorized by the State of North Carolina, Department of Environment and Natural Resources
and the Coastal Resources Commission in an area of pnviironnmental concern pursuant to I SA NCAC
I l- N
/
s permit #
evious permit issued
❑ Rules attach
Applicant NameL"
Project Location: Coun(y
Address % r /
Street Address/ State Road/
Lot #(s)
City
State ZIP
Phone # .z ` 1 �l VJ�;Fax #
Subdivision
Authorized Agent
-
City l ' "
/ i` ZIP )--P,
❑ CW ❑ EW
aPTA DES ❑ PTS
Phone # ( )
River Basin yY P -. -J_-
Affected
❑ OEA [I HHF
AEC s :
El IH ❑ UBA El N/A
Ad). Wtr. Body
J,r'1I-L C.�-' `
nat /man /unkn)
❑ PWS:
❑FC:
Closest Maj. Wtr. Body
.�
ORW: yes / no PNA
yes)/ no Crit. Hab. yes / no
Type of Project/ Activity
Pier (dock) length _
Platform(s)
Finger piers) �
Groin length
number
Bulkhead/ Riprap length 1 !
avg distance offshore j
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
- : 40
(Scale:
EJ See note on back regarding River Basin rules.
Agent or Applicant Printed Name iC:� Permit Officer's Signature
}} nn r
Signature Please read compliance statement �V� (`y V Date Expiration Date
Application Fee(s) Check # 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:
❑ Tar - Pamlico River Basin Buffer Rules [_] Other:
❑ 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 Elizabeth City District
Mailing Address: 1367 U.S. 17 South
1638 Mail Service Center Elizabeth City, NC 27909
Raleigh, NC 27699-1638 252-264-3901
Location:
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
Fax:[phone]
Fax:[phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Morehead City District
400 Commerce Ave
Morehead City, NC 28557
202-808-28081 1-888-4RCOAST
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

ADJACENT RIPARIAN PROPERTY OWNER STATELMENT
I hereby certify that I own property adjacent to DOV'A , A �Ccy— 'S
(Name of Property Owner)
property located at 1 y 13 I c, ;ro Cvc C 6 ,
(Lot, Block, Road, etc.)
on �,[11 A4c,Ve,- Cyree-� C►V,,e,� in 6 VI ram- -A4- 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.
�Vo
DESCRIPTION AND/OR DRANVLVG OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development)
Signature IV
Print or Type Name
Telephone Number

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to -Dcq ;a �au 's
l' I II (Name of Property Owner)
property located at A-7 CC-t�
n (Lot, Block, Road, etc.)
on k�l�y� l �(P�k-�T►2t�� , in — Y I eYt. , 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 DRANUL G OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing de},elopment)
� � I
Signature
Print or Type Nam.-
,? V 2 - ? G Z-Z -
Telephone Number

.:r
KATHIE C BARROW 2451
Ph 252-249-2482 66-21/530
1413 Tosto Circle /r/ BRANCH 77648
Oriental, NC 28571Date
�% $ 11ad °v
Pay to the
Order of 4 `
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Ask Me About My Grandkids!
WACHOVIA
Wachovia Bank, N.A.
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For ' L—�� �� q 6 9 ii' 21.S L -
1:0 5 3000 2 L 9�: LO ? 20 9 7 6 ;]a