55768_GIBSON, MARTYA_20100528

El CAMA / ❑ DREDGE & FILL IVti l� �/ xD/6z�
GENERAL PERMIT Previous permit#
'�CNe4 ❑Modification ❑Complete Reissue El 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 i 7 o (.
I
X Rules attached.
Applicant Name , c r- A �I �Y.A
Address ()12
City J' I�Q State fi.C._. ZIP j
Phone # (''1 ) (,2t; - JCD� Fax # ( )
Authorized Agent c r, c G i l l y
Affected ❑ CW ❑ EW I KPTA ❑ ES ❑ PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
O PWS: ❑FC:
ORW: , es -/ no PNA yes / nod Crit.Hab. yes / no
Type of Project/ Activity 1 )t^,c jC ? X fPn s , c A
Pier (dock) length -3'K �
Platform(s) f � (
, P &
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 \QyJ S }.t1
Shoreline Length i '
SAV: not sure yes no
Sandbags: not sure yes n
Moratorium: n/a yes
Photos: yes o
Waiver Attached: yes
A building permit may be required by:
Notes/ Special Conditions
F
Age) or Applicant Printed Name
t
Signature Please read compliance statement on back of permit
�= L42,00
Application Fee(s) Check #
� Project Location: County��-toi-
Street Address/ State Road/ Lot #(s)„
Subdivision City j`Ict �wy y -Ti i))
cncj ZIP
Phone # (Z5Z) '42-1,774, River Basin
Adj. Wtr. Body a r - r n at man unkn
Closest Maj. Wtr. Body
�J (Scale: '! )
❑ See note on jback regarding River Basin rules.
[lic,t.I/J, Shall ^c '?PJ n,ry�
rermit utticer&aignatu re
5 k6l I d i
Issuing ate I Ex irati n Date
t
Local Planning Jurisdiction IRover 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, 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/ 1-888ARCOAST
Location: Fax: [phone]
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
Fax:[phone]
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico Counties)
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

Eric Ellis
' Marine Construction
DOCKS • SEAWALLS • BOAT LIFTS
DECKS & REPAIRS
Phone & Fax: [phone]
Cell: 252.342.6775
205 Nottingham Lane
Morehead City, NC 28557
oreheoct Cify
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSIBOA TLIFTIB OA THO USE)
I hereby certify that I own property adjacent to ;r,/ �P CAS c> �J 's
(Name of Property Owner)
/ / � J 4d RECEIVED
property located at -a`� / `.J( - '
(Lot, Block, Road, etc.) / MAY 2 7 2010
Oil Y--''q4/�' In / r'� '-�/ %J �9o�sjp city peM
(Waterbody) (Town and/or County)
Applicant's plione #: / Mailing Address: ZZ.; i'- `o�cf', ��
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 / buatbouse
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.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To befilled in by individual proposing development)
(Information for Property Owner Applying
for Permit)
Mailing Address
City/State/Zip
Telephone Number
Signature Date
.-------------------------------------------------------
(Riparian Property Owner Information)
Signature
Print or Type Name
Telephone Number
Date
TOO in
0I2Id SLL9 9ZL ZSZ XVd ZZ:60 0TOZ/9T/90

Eric Ellis
Marine Construction
DOCKS • SEAWALLS •BOAT LIFTS
DECKS & REPAIRS
Phone &fit 252.726.6775
Cell: 252.342.6775
205 Nottingham Lane
Morehead City, NC 28557
Jr:'
VI
O 7
x /6
iUC' L1
9r hl C1ra�
7.00In DIHFI 5LL9 9ZL Z5Z YVA ZZ:60 OTOZ/8T/90

• '. ADJACENT RIPARIAN PROPERTYOIYNER STATE:1IE17'
(FOR A PIER IfOORIIYC PILrivOs/BOA TLIFTIBOA THO us£)
I hereby certify that I own property adjacent t4La
Property located at i
(Name of Property 0-mner)
(Lot, Block, Road, etc.)
on
in z-� ,
(Waterbody) , N.C.
(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. 1 understand that a pier/mooring pilines'boatiihboathouse
must be set back a minimum distance of fifteen feet (i5') from my area of riparian access unless
waived b3e.
I do not wish to waive the setback requirement.
I do N-vish to ivaive that setback requirement.
DESCRIPTION'AI D/OR DRAWING OF PROPOSED -DEVEL.OPME�'`Z"r E
�EI©----
(Tv be filled in by litdit,idurrl proposing der�elopple110
® MAY 2 7 2010
�cA '% b /� L Morehead QtY DCM

s
ERIC S. ELLIS
JASA M. ELLIS 4200
205 NOTnNGHAM LN. 252-72"775
MOREHEAD CITY, NC 28557 ?elm66-30/531
Date 133
Pay to the jf /� �
Order of V / V $ 20c,
o
`vrFilrst
Dollars.
°Bac41aFA CitizensfB tc�izens.c°� L,-.
For V
1:0 5 3 L00 3001:00 L 3 L 7448 78011' 04 200

NC Division of Coastal Mgt. Habitat Impact Computer Sheet
Applicant: Marlyn Gibson
Date: 5/28/10
Permit #: 55768C
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
found in your Habitat code sheet.
Habitat Name
DISTURB TYPE
Choose One
TOTAL Sq. Ft.
(Applied for.
Disturbance total
includes any
anticipated
restoration or
temp impacts
FINAL Sq. Ft.
(Anticipated final
disturbance.
Excludes any
restoration
and/or temp
impact amount)
TOTAL Feet
(Applied for.
Disturbance
total includes
any anticipated
restoration or
temp impacts)
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount
Open Water
Dredge 0 Fill ❑ Both ❑ Other Mx
1209
1209
Shallow Bottom
Dredge ❑ Fill ❑ Both ❑ Other 0
457
457
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑