40764_DICK, PATRICK_20060607

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LCA-MA / C DREDGE & FILL
GENERAL PERMIT
LINeW ]Modification .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_
i i .
Previous permit #
Date previous permit issued
Applicant Name i ; �..; ��i j Project Location: County_
Address y j (l Street Address/ State Road/ Lot #(s)
Rules attached.
City State ZIP "-> �' --
�—
Phone # ( ) ? ? - i _ k' Fax # ( ) Subdivision
Authorized Agent �j ' ' City__ _ ZIP
Affected
C CW ❑ EW PTA G ES C PTS Phone # ( ) _ River Basin
-
AEC s : ❑ OEA ❑ HHF ❑ IH 1-1_ 1 UBA N/A Ad'. Wtr. Body - (nat /man /unkn)
❑ PWS: —FC:
ORW: yes / no PNA yes / no Crit. Hab. yes / no Closest Maj. Win Body
Type of Project/ Activity
Pier (dock) lengthy
Platform(s)T
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
r�
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 **''�/y
f `f 4 G9l Z
Application Fee(s) Check #
(Scale: )
..- "- -
_ See note on back regarding River Basin rules.
Permit Officer'sSie
IssuinggDate
Local Planningjurisdiction
Expiration Date
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:
L_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

SKETCH ADDENDUM
Borrower/Client
Pro e ty Address
City County State
Zip Code
Lender
LA
Z
5-
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FW-73A
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© 1980 Forms and Worms Inc., 315 Whitney Ave., New Haven, CT 06511 All Rights Reserved 1 (800) 24 -4545

�LAND MARINE CONSTRUCTION, L'L'C5"-%%,v
.CUSTOM DOCKS& DECKS
SEAWALLS, BOATLITTSROCK GROINS,
WOOD VINYL &COMPOSITES
FREE ESTIMATES
THOAIAS LA W!RFNCE OFFICE (252}728-3419
1286 ISLAND ROAD CELL {252) 725--32
HARKERS ISLAND N.C.28531 CELL {252}241-1394
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to'j-t- V f ek f C.4 's
(Name of Property Owner)
property located at / ? a .5A
(Lot,/Block, Road, etc.)
on (�qr �.c, A.> , in Je,-.e , N.C.
(Waterbody) (Town an&4 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 DRANVING OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development)
Sizr4ture
L (Ae4c'�-
Print or Type Name
hone K umber
Date:

CERTIFIED MAIL — RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGE-N ENT
ADJACE-NT RIPARIA..'N PROPERTY OWNER NOTIFICATIONAVAIN7,R
FORM
'Name of individual applying for permit:��f�e�
Address of property: // 9� _ —
(liot or street 4, street or road)
(City & county)
I hereby certify that I own property adjacent to the above referenced property. The
individual applying for this pert i't has described to me (as showrr-ori the attached
drawing) the development they are proposing. A description or drawing, with
dimensions, should be provided with this letter.
✓ I have no objections to this proposal.
If you have objections to what is being proposed, please a.Con of Cda50�"4e
Management, 400 Commerce Ave., Morehead City, NC 28557 or call (252) 80&-2808
within 10 days of receipt of this notice. :Vo response is considered the same as no
objection if you have been nolif ed by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift or sandbags
must be set back a minimum distance of 15' from my area of riparian access unle,s
waived by me. (If you wish to waive the setback, you must initial the appropriate blank
below.)
I do wish to waive the 15' setback requirement.
A, 1- A.��I do not wish to waive the 15' setback requirement.
- /.3110( ,�
Signature or / Date
AIA e-4
4 �q 1 l 0 �
Print Name
zz� 31 l
Telephone Number With :a.rea Code
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From:
Re: Authorization Letter
I ?Air 9 c' G � � C� authorize
lju�� - -, TogwEED
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Morehead City DCM
—Ek61n..a S � A --�> he t C,�to act as my agent for the sole purpose of
obtaining/signing permits to rform work at
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Sincerely,^'A,� /( J
Signature
Print Name�f}-�

ISLAND MARINE CONSTRUCTION LLC
1286 ISLAND RD
HARKERS ISLAND, NC 28531
PHONE: [phone]
PAY TO THE
ORDER OF -
WACHOVIA
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Wacho,via Bank, N.A.
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66-21/530
BRANCH 17181
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ISLAND MARINE CONSTRUCTION LLC 2005
1286 ISLAND RD 66-21/530
HARKERS ISLAND, NC 28531 BRANCH 77585
PHONE: [phone]
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PAY TO THE
ORDER OF $ o co
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WACHOVIA
Wachovia Bank, N.A.
wachovia.c#m
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