41154_MEYERS, KIM_20050413

s [__iCAMA / '-' DREDGE & FILL
GGENERAL PERMIT Previous permit
_#
1New Modification -]Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources 6 .�
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
D Rules attached.
Applicant Name y Project Location: County_ --
Address I j
Street Address/ State Road/ Lot
Cityi�,✓?-JSiae '/-ZIP
Phone # (��) �� 6 } 3 Fax # ( ) Subdivision _
Authorized Agent F� 1s p' _ 1l. _ f " City-- -- �� r ZIP _.
Affected -' CW fftIEw 0-PTA EES ❑ PTS Phone # ( ) _ River Basin
l OEA ❑ HHF ElIH ❑ UBA ❑ N/A / /
AEC(s}: Adj. Wtr. Body__- nat man unkn)
IJ 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/ iiiprap length
avg distance offshore
max distance offshore "
Basin, channel
cubic yards 1 _
Boat ramp
' 7 Y
�.
Boathouse/ Boatlift 7f
Beach Bulldozing
Other_ — --_
---y4---cy
Shoreline Length
i
SAM not sure yes
Sandbags: not sure yes n
1
Moratorium: n/a yes >o
Photos: yes no,)
Waiver Attached: 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
Application Fee(s) Check #
i
(Scale:
See note on back regarding River Basin rules.
Permit Offic r'sSignature
l
Issuing Date Expiration Dat
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
landowners).
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:
j 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 (910-395-3900) for more information on how to comply with thesebuffer 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 / 1-888-4RCOAST
Fax: [phone]
Fax: [phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Morehead City District
151-B Hwy. 24
Hestron Plaza II
Morehead City, NC 28557
202-808-2808
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
910-395-3900
Fax: [phone]
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)
www.nccoastalmanagement.net
Revised 10/05/01

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
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I hereby certify that I own property adjacent to
Z88o is property
located at 122- la�2gaiZt� �� f_1DJ2IJd5_ on
(lot, Block, Road, etc.)
"'P/A./,F J:�',440te. Sc402c�-g , N-C_
(Water Body) (Town and/or County) zesiz-
He has described to me as indicated below the development
he is proposing at that location and I have no objections
to his proposal. I understand that a pier, pilings and
dredging must be set back a minumum distance of fifteen feet
(15') from my area of riparian access unless waived by me.
I do not wish to waive that setback requirement_
t/ I do wish to waive that setback requirement.
Description and/or drawing of proposed develo mp ent:
(To be f-illed in by individual proposing development_)
-IkfSTALL_A-nos! OF n'o (-,w,r-r or- NECJ ui JY- S4r1gu)44L 12Ewz-4eLri+1F4-1-,
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14.ST AIL N6W 13o4 r
mA ll N 1-64 ANeC •i7eCDge 1304T u G f ^ Vj A 13 W x 30
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Signature
Print Name

:The Page Group, Inc. FAX NO. :910 293 4342 Mar. 15 2005 06:50PM P 2
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Mar 18 05 08:29a � P.
4I t �vnrers -
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT logs Puw L,AWnF Ve.
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I hereby certify that I own property adjacent to
3�6'7b7-Z88o .s property
Alocated at l2- o n
(iot, g10Ck, Road, etc.)
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N.C.
(Water Body) (Town and or County) ZrTS�2.
xe has described to rre as indicated below the development
he is proposing at that location and I have no objections
to his proposal. I understand that a pier, pilings and
dredging must be set back a minumum distance of fifteen feet
(15,) from my area of riparian aCCess unless waived by me.
do not wish to waive that setback requirement.
_ do wish to waive that setback requirement-
ri tion and/or drawin of ro sed develo ment:
Dcsc
(To be filled in by individual proposing development.)
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MUD BUCKET DREDGING, INC.
ATLANTIC BEACH CAUSEWAY NCOL.8039839
PO BOX 3355 PH(252)726-2191
ATLANTIC BEACH, NC 28512
4217
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Anarni 8cach, N.C. 28512 "many
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