43532_AVERA, WILLIAM_20051103

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^� F ICAMA / ❑ DREDGE & FILL
GENERAL PERMIT Previous ermit#
❑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
❑ Rules attached.
Applicant Name I.:, Project Location: County
Address �F 7 '�� 1 Street Address/ State Road/ Lot #(s)
City !` State ZIP`
Phone # (') -, Fax # O Subdivision
Authorized Agent / ' City ZIP_
Affected ._' CW E EW Ey PTA
AEC(s): 71 OEA -I HHF ❑ IH
I-, PWS C
ORW: yes / no PNA yes no
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 j +
Shoreline Length 7 / 4 `
SAM not sure
Sandbags: not sure
Moratorium: n/a
Photos:
Waiver Attached:
yes no
yes t no}
yes
yes Gp)
yes I`nrgi
A building permit may be required by:
Notes/ Special Conditions
El ES ❑ PTS Phone # ( ) River Basin : !i/e
❑ UBA ❑ N/A Adj. Wtr. Body �� CAA` nat /man ./unkn
Crit. Hab. yes / no Closest Maj. Wtr. Body
bi
Agent or Applicant, Printed Name
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
(Scale:.%,
Z See note on back regarding River Basin rules.
Permit Officer's Signature
Issuing Date Expiration Date
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 [)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:
❑ 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

ADJACENT RIPARIAN PROPERTY.' 0WINTER STAME TENT
I hereby certify that I own property adjacent to
WILUAM AVErA is
(:Fame of Property 0,v�'ner)
property located at MEV[NS i70An s2
(Lot, Block, Road, etc.)) (
AMLICO N. C.
(VYaterbody) To vn and/or County)
He has described to me m shown belo,,v, the development heis proposing at that location,
and, I have no objections to his proposal.
DESCRIPTION ANYWOR DRAWING OF PROPOSED DENTLOPMEN'T
(To be filled in by inditi,idual proposing development)
-5'X / w 32/x6 T
SignaWl
Print or Type r�T�me
�-S1 7 �15 -- S c I/
Telephone Number
Date: /o — -7— OS
—29-

ADJACENT RXPAR AN PROPERTI' o ']' DER STAMMENT
I hereby certify that I_own property 26jacent to ALIAM AV£el&
LO
nel r s') f\e 'nrnof Prooertti- O wrier)
property lloc-ated at Vl��VIN S P 1?A � 2 --
(T.nt. Bloch, Road, etc.)
Sl l G , N.C.
(Waterbody) (L Gti� F1 2no/u: L,uutil.YJ
He has described to me as stioti�.'n belmv, the developmoent tie. is proposing at that location,
v n e, c �G V G' C� c.P ih u r i �-1
and, I have no objections to his pro osal. �, �1 , 4 o nod y
r� n .�. � e, r m i S S t u Y) �-h e but I i n o � it v a s?
re �a Mr._ �.�?� ,r , �„, MENU
Tn he filled in b indf'i'idual proposing erelopn' ent)
o n Did ALk, -,;i, A 9 r- e a A 4-a c. +h�v�,'�
�5 6 -Ux� WITR 52-)4,6
Sienacur
Awl
Print o. i yp:.
I�otio.le Numbs.
Late.

■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
' so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
A.
X ❑ Agent
❑ Addressee
B. Received by (Printe ame) C. Date of Delivery
SL _ r:�5
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
3. Service Type
❑ Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) El Yes
2. Article Number 7004 1350 0001 6537 7041
(Transfer from service label)
PS Form 3811, February 2004 Domestic Return Receipt 102595-02-tin-1540 i

UNITED STATES POSTAL SERVICE
3
First -Class Mail
Postage & Fees Paid
USPS
Permit No. G-10
• Sender: Please print your name, address, and ZIP+4 in this box •
I +I ccvkG �"'l *
�anrrsrsrrernt�rrrresiren:rri�r�

1.ER: COMPLETE THIS SECTION
■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
_0 NOJ
2K�i5
A. Signature
X 10V�.
0 Agent
0 Addressee
B. Received by ( Printed Name) C. Date of Delivery
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No l
3. Service Type
❑ Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise j
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number 7004 1350 0001 6537 7034
(transfer from service label)
+ PS Form 3811, February 2004 Domestic Return Receipt - 102595-02-M-1540

UNITED STATES POSTAL SERVICE
First -Class Mail
Postage & Fees Paid
USPS
Permit No. G-10
• Sender: Please print your name, address, and ZIP+4 in this box •
j4tk�'C &V- (hq &��tA dI'M
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1 Ions Island Rd 252-745-7877
P O Box 779
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