53698_FALK, CAROLYN_20050528

El CAMA / F 1 DREDGE & FILL
GENERAL PERMIT Previous permit #
C�7New ❑Modification ❑Complete Reissue ❑WPartial eissue 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 ~%�t _
ules attached.
Applicant Name
1 f!
r. `ram e^, C C ! u aP--
Address
I
r' r-p r
City
}
mc)vm tateZIP
n�
7
Phone #
-7L*ax'11
Authorized Agent4__}!r�
_
El CW
�7 EW PTA El ES ❑ PTS
Affected
❑ OEA
AEC(s):
❑ HHF ❑ IH ❑ UBA ❑ N/A
PWS:
❑ FC:
ORW: yes / ffio' PNA yes /j na Crit.Hab. 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 Boatli I Z x I-Z, "
Beach Bulldozing
Other
Shoreline Length V>
SAV: not sure yes no
Sandbags: not sure yes n
Moratorium: n/a yes n
Photos: yes
Waiver Attached: yes n
A building permit may be required by:
Notes/. Special Conditions V n vi 1 yip .n/
jgen `'or Applicant Printed Name
Signature'-- ", Please read compliance statement on back of permit"
Application Fee(s) Check #
Project Location: County C) 011„
Street Address/ State Road/ Lot #(s)
t;
Subdivision f
1
City G�- ZIP
Phone # (^ ) 3s. t River Basin ,-i? 6h
Adj. Wtr. Body AT LEI1" n nat /man /unkn)
1
Closest Maj. Wtr. Body +� tl
_1
(Scale:
E See note on back regarding River Basin rules.
<h&Ir," y 17g)-•<'
Issuing Date Explratioh Date
Local Planning) u-risdiction Rover File Name

M
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
Raleigh Office
Morehead City Headquarters
Mailing Address:
400 Commerce Ave
1638 Mail Service Center
Morehead City, NC 28557
Raleigh, NC 27699-1638
252-808-2808/ 1-888-4RCOAST
Location:
Fax: [phone]
2728 Capital Blvd.
(Serves: Carteret, Craven, Onslow -above
Raleigh, NC 27604
New River Inlet- and Pamlico Counties)
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)
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 08/09/06

FROM :,NK FALK PHONE NO. May. 27 2009 01:27PM P2
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIE,"0O.RING- PILI.NGSIBOATLIFTIROATUOUSE)
I hereby certify that I own property adjacent to 00.r01Y,\ 'i l4 I Ifr ( r,yr,".n IS
('Name of Property Owner)
property located at 5C�i gynJfv�- �-Cne
(Lot, Stock, Road, etc.)
on , k� ��s A j 1J�ake��,,a�/ , in , ,�a., �crGZ (C-, fc C����,/ , N.C.
(Waterbody) (Town and/or County) `�—
Applicant's phone #: Z,52-. W4 � " 70 c-> Mailing Address:
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 / boadift / boathouse
must be set back a minimum distance of fifteen feet (15') from my area of riparian access unless
waived,'by me. (If you wish to waive the setback, you must initial the appropriate blank
below
I do not wish to waive
I do wish to waive that setback requirement.
OFR&O-PQSED DEVELOPMENT
(To be filed in by individual proposing development)
0
Q
p� 1
--------------------------•---------------- 1
---------------------------- ------------
(Information for property Owner Applying (Riparian Property Owner Information)
for permit)
Mailing Address S1 tore
Ro6-'y rAcjn+, Nc - �',� r,55 �31Z1fNMI SCQ r�
City/State/Zip Print or Type Name
-Zr:>'z- 0L3--7(!;�SS A 1:: - - 4 ro 2 -2 *42- q25,?
Tel�oebe Telephone Number
z I`
Sign . a Date

AF
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Michael F. Easley, Govemor James H. Gregson, Director William G. Ross Jr., Secretary
Date fpm�( 2(�09
Name of Property Owner Applying for Permit:
co,cl Y^ ( AI V-
Mailing Address:
�ScC —It. ve,,y La.-,P.,
Qc0k Acv�fi P�)C 273c3
I certify that I have authorized (agent) & I i X A)c,"' -5 to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) scot 1.' •4+
at (my property located at) Sot( SYn%d'^' 'ZBSSzf
This certification is valid thru (date) (o--4- C9
Property Owner Signature
5' 2-7-C9
Date
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: [phone] FAX: [phone] Internet: www.nccoastalmanagement.net
An Equal Opportunity 1 Affirmative Action Employer — 50% Recycled 110% Post Consumer Paper

NORRIS MARINE CONSTRUCTION & LANDSCAPING
BILLY M. NORRIS, OWNER LLC
B 252-393-8646 H 252-393-8810
377 NORRIS LANDING RD.
SWANSBORO, NC 28584
PAY
TO THE (� J
ORDER OF
FOR
�f First Citizens
Bank
firstcitizens.com
II4008 19 211'
x_
8192
DATE 66-30/531
342
I:053 100300i:00341 2292 2 1u'
r
D O
L L A R S