44599_BATES, THOMAS_20060316

ICAI A / !-- DREDGE & FILL
GENERAL PERMIT
_
New (Modification F Complete Reissue ❑Partial 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
Applicant Name
Address
City
Phone # ( )
Authorized Agent
Affected ` I Cw
!OEA
AEC(s): _
PWS:
ORW: yes / no
State
Fax # ( )
EW F❑ PTA
HHF ❑ IH
❑ FC:
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
Shoreline Length
SAM 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
ZIP
❑ ES ❑ PTS
❑ U BA ❑ N/A
Crit. Hab. yes / no
Age6tbrlApplican PriAteame
Signature ** Please read compliance statefnent on back of permit
Application Fee(s) Check #
rib
Previous permit #
Date previous permit issued
I❑'Rules attached.
Project Location: County -___ _
Street Address/ State Road/ Lot #(s)
Subdivision
City _
Phone # ( _)
Adj. Wtr. Body_
Closest Mal. Wtr. Body
ZIP_
_ River Basin
-- _ (nat /man 1wnkn
(Scale: )
^` See note on back regarding River Basin rules.
..ter.{� / ` +➢ , 't'
Officer's Signature
Issuing Date Expiration Date
--5161 l
Local Planning Jurisdiction 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, certifythatthis project is consistentwith 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,
Orslow -below New River Inlet- and
Pender Counties)
Revised 06/29/05

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PAGE G
AMAC$f RWARIAN PROP== OWMM SrATEME '
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(watniy) (Tom J wVw County)
He w daxnbad a aaa, u 3ismt1 baler, to dheisraNat ht is prop wt at tut
ivcatwr, aad, I Iowa no objecbm to bb pevpoaal. I mdentad that a pieUmoalvt
pAini5/boatlihlboat w4m rout be =I back a dwame of fjwen fw (IS') fide toy un
of riparian wcm Wam wOivod by ore.
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENr
(FOR A PIBRIMOORING P&INGSIBOATL.IMBOATHOUSE)
I hereby certify that I own property adjacent to 7�& M,4 ,513,4 T6--5 's
(Name of Property Owner)
property located at 02 8 C- �. Cz� .I —A)
j (Lot, Block, Road, etc.)
OR J �C K C ���� in ,Ig41 /l �U T/r , 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. I understand that a pier/mooring
pilings/boatiift/boathouse must be set back a minimum distance of fifteen feet (15') from my area
of riparian access unless waived by me.
I do not wish to waive the setback requirement.
�J I .o wish to waive that setback requirement.
--------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMIIVT:
(To be filled in by individual proposing development)
-----------1--- A-1---------------------------------------------------
Signature
1 w�5
Print or T Name
C1igt S 9)-317�
/ telephone Number

SPRING CREEK CONSTRUCTION
Ph 252-249-1819
2398 WhortonsvWe Rd
Merritt, NC 28556
WA,cHovirA
Wachovia Bank, N.A.
FOR
10.0 5 3000 2 L 91: 200 7& 3000
2270
66-21/530
W BRANCH 77512
DATE
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