43668_FINK, GLENN_20060105

—
CAM / fJ DR DGE & FILL
EN PERMIT
CJNew G'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
Previous permit #
Date previous permit issu d
Applicant Name ' ! ��� N/t Project Location: County
Address__ y -�. t.: r= / 1 r Street Address/ State Road/ Lot #(s)
City %Y ti State ZIP -
Phone # ' 19 ` Fax # Subdivision
Authorized Agent /.,.' :y,,'j. City__ ZIPS
CW ❑ EW ❑ PTA )a ES ❑ PTS Phone # () 5 i River Bas
Affected - OEA ElHHF ❑ IH El USA El NIA AEC(s): Adj. Wtr. Body /� (nat 1man /unkn)
PWS: ❑ FC:
ORW: yes / no PNA yes J no,, Crit. Hab. yes { no
Closest Maj. Wtr. Body
Type of Project/ Activity
Pier (dock) length
Platform(s)
Finger piers)
-- t
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
U
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
Signature ** Please read compliance statement on back of permit
Application Fee(s) Check #
(Scale: )
See note on back regarding River Basin rules.
Permit Officer's Signature
Issuing Date Ira I tam
L �3�d
Local i eame Planning Jurisdiction

10
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, certify that 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/ 1-888-4RCOAST
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/OS

JUL-28-2005 FRI 11:04 AN NO DIV OF CQR51'AL 11 W FAX K 4 P. 07
AOJACFIT xtlY'ARIAN PROPERTY OWNM S':`AraUaENi
(FOX A PIERAWOORM P1taiVGS/BOA4'UFT1BoAMoUSE)
I hemby certify that I own property adjacxmt to _ A�
(Nam of Propeviy Owncrl
prowty krule t at
Block, Road, etc.)
on , in , N.C.
(Wsrtrrlrodyj (Town and/or Coanty)
tia bas &=rWMd to me, as shown below, tba da t4utI t he is pg Vpoft at that loMioa,
and, I have no vt>jeWWU to his Propa>ai. I uodetstand that a pWfmooring
ptlinguUndifi/bouthom am# Us, set bask a minimum distance of fifteen fat (13') from my area
of riparian avts UAICSS waivtxl by me.
l dst_. d wish to wive the setback requirement.
I dQ wish to waive drat selbhck requirement.
MIS
DESCRWrION AND/OR DRAtti ING OF PROP65ED DEV F.I.OPai A
(lit bejUl ed in by individual proposing dcvclopntent)
;
�.�v
may_+ � vF•���y�lT ,�.►--�
-- ---- . .-.
- - ---- - -- .....................r..._...
sigrt5�cure � ..
Print or Tyjx: NOW
�sz_- & 3_1
Telephone Number
Date: 0 b
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I I -In M
R:?,A)a X110#0 if -
.3A 04 Fi-
ata!�
ICQ{l wil Well

JUL-29-2005 FRI 11:04 AN HC DIV OF COASTAL HGHKT FAX K 4 P. 07
ADJACR1' T RMARTAN PROPERTY OWNER STMI MENT
(FOR A PIF,RMOO)UNG Pll.IVVGS/BOArLJF 1BOA77lOUSE)
I hereby certify that I own property adjacent to _- 9—lat�u s
(iVarne of Property Owner)
promty loculed at-,,.,.(lez -(e..-
(Lot, block, Road, etc.)
onin - , N.C.
(walerbady) (Town and/or County)
Ire Karl d=nlW to me, as sttown hel0w, thv development he is proposing at that location,
and, I have no objections to his proposal. [ understand that a pier/mooring
Pitin$MIuCul Wboathouse mast b., set back a minimum distance of fifteen feet (151) from my area
Af r1prian MEXAM ualeas waived by me.
dAM wish to waive the setback requirement-
I do wish to waive that setback requirement.
..__..«...........r........._.------------- -------- ---------------------�------------ ------------------�.
DESCRTKION ANTWOR DRAWING OF PROPOSED DEVFI-OPMENT;
(re be Jilted ht by individual proposing de►vlopntent)
T.
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---
----------• - - _—F --
--_
`l r� ..._-• ----........ .».............. _.......
Signature
Print or Tylx: Name
5 � UT- D
Telephone Number.
Date:

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