44518_DAVIDSON, ANDREW_20060306

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GENERAL PERMIT
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Previous permit #
New ❑Modification E)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
Project Location:
County___
Address . `f`0 2 �61�� g�;� � �f��'<� Z r .
Street Address/ State Road/ Lot #(s)
city AJ State ZIP
Phone # O ..�,`;�'�,vl,o Fax # (�)
Subdivision
Authorized Agent
City_
, ZIP
❑ CW J EW ❑ PTA ES ❑ PTS
Affected
Phone #
Z Ai. River Basin
_
-
-
AEC s : L l OEA I HHF ❑ IH I-' UBA h N/A
Ad'. .
I Wtr. Body
'
(nat-/man /un n
❑ PWS: ❑FC:
ORW: yes / no PNA yes / no Crit. Hab. yes / no
Closest Maj. Wtr. Body —-
Type of Project/ Activity
(Scale: )
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 t ' ts!f /I L" �—
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
Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit
Application Fee(s) Check #
Lr Lit t-1t':
See note on back regarding River Basin rules.
)., V 1 in".. �
Permit Officer's Signature
Issuing Date Expiration Date
1- 0306 ,31
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 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
202-808-2808/ 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

G
ADJACENT RIPARIAN PROPERTY O«R STATEME" NT
(FOR A PIER/AlOORING PILINGSIBOATLIFTIBOATIIOUSE)
I hereby certify that I own property adjacent to ire) ,g1/1Gtsa 's
Wame of Property Owner)
property located at a D,�, doT 11 b61- 15-1
/. i
(Lot, Block, Road, etc.) '
on 0IG .pl� (n Aa , in eu) ,. N.C.
(Waterbody) (Town andlor 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/boatlift/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.
I do wish to waive that setback requirement.
DESCRIPTION AINTD/OR DRANi'L'qG OF PROPOSED DEVELOP,1'IFAM
(To be filled in by individual proposing development)
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Signatur
Print or Type Name
Telep nc Number

02/22/2009 10:55 FAIL 302 3284922 H&V Service, Inc. 001
Feb 20'06 05:I3p Bob e, Missy Baskery11 252-249-3537 P-2
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I hereby certify that I own pnq=ty adpcm to - Is
plaane aff Propmy Ownw)
property locatedat Off' -
(Lot, Block, Road elc.)
in N C.
(Waterbody) (Town andlor County)
He bus desm--bed to mac, as 9MM9 Wow, die deVduFnk at Le- is proposog at drat
location, and, I have no objec6ous to his pmp� I vudeaumW that a piesimooing
Pl'lia must ba srt back a mk mum distance of finnan Poet (i51 fiogm my aura Of riparian asks unless waji;W by Mr-_
Vf I do not wish to waive the setback requirement.
I do wish to waive that setback raqui ent_
DESL'It MON ANZWOR DRALVV G OF
ri'o be JUW :ra by indirUs al pi
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Print or Type Name
Telt!Aone Number

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