53669_GRYB, BOB_20090604

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JCAMA / ❑ DREDGE & FILL
GENJEJRAL PERMIT Previous permit #
❑New edification �4'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 I SA NCAC
❑ Rules attached.
Applicant Name Project Location: County
Address Street Address/ State Road/ Lot #(s)
City State ZIP
Phone # O Fax # O Subdivision
Authorized Agent City ZIP
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Phone # (,) River Basin
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body (nat /man /unkn)
❑ 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)
Groi
Bulk
Basin
Othe
Shor
SAV:
Sand
Mo
Phot
Waivery
A building permit may be required by:
El See note on back regarding River Basin rules.
Notes/ Special Conditions
Finge - !--- — i
r pier(s) �
n length ---
number
i
head/ Ripraplength � +
avg distance offshore
max distance offshore
channel
cubic yards
I - �
ramp
- — - I
house/ 6oatlift
h Bulldozing
i i I i l
I
eline Length ii !
not sure yes no
bags: not sure yes no
ratorium:
n/a yes no
os: yes no
Attached: es
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit
Permit Officer's Signature
Issuing Date
Expiration Date
Application Fee(s)
Check #
Local Planning Jurisdiction
Rover File Name
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit
Permit Officer's Signature
Issuing Date
Expiration Date
Application Fee(s)
Check #
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 [)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
Mailing Address:
1638 Mail Service Center
Raleigh, NC 27699-1638
Location:
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
Fax:[phone]
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ 1-888ARCOAST
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

i�� �,����'�� ��

V,
MODIFIES
Modifications are made to active permits. A general permit is modified if the project proponent wishes to
alter the dimensions of the development authorized in the original general permit. A new development
activity can also be added to the original general permit if it could be authorized by a general permit rule
currently used in the original general permit.
Modifications to a general permit should only occur when the spacing, dimensions or other parameters of
the already authorized action need to be changed. Modifications SHOULD NOT change or add general
permit rules or fees.
If a development activity would require authorization from a general permit rule not used in the original
general permit, then the field representative would most likely write a new general permit for that activity.
This is because a new fee would be required for the new rule and subsequently the expiration date would be
different.
There is no fee charged to modify a general permit.
The following data items might need to be changed to reflect the information on the modification:
"Permitted" development activities and/or dimensions
"Permitted impacts and/or dimensions (this is NOT AECs)
Field Representative
The project site location, and applicant name(s) should not change due to a modification.

Jun 02 09 0$07p Audrey ARNOLD
i
2`2j-7263018 P2
ADIACENJ RIPARIAN PROPERTY OWNER STATEMENT
I HERBY CERT THAT I OWy PROPERTY ADfACNET TO
(NAME. or rItOPERT OWNER)
PROPERT LOCATED AT` _ '? ��_
y� (LOT, BLOCK, ROAD,
E C.) �J
ON yt At,
(titJA £RBODY) (TOWN ANDJOR COUP
HE HAS DE CRIBED TO ME AS SHOWN BELOW, THE DEVELOPMEi` T ICE IS
PROPOSING AT T AT LOCATIION AND, I HAVE NO OBIEACTIONS TO HIS
PROPOSAL..
DESCM
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Telephone number
DATE L 9 = O

Jun 03 09 01:31p [phone] p,1
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Jun 03 09 01:31 p
Jun 02 ,OB 08 07p Audrey ARNOLD
[phone] p.2
252-725.3018 p2
AD7ACEN1� RIPARIAN PROPERTY OWNER STATEMENT
I HEUY CERTM THAT I OWN PROPERTY A.DIAC-i T-r TO
(NAMS OF Pk, PEii
i
PROPER LOCATED AT dj+
(LOT, BLOCK, ROAD, E C.)
(W ERBODY) - OWN ANDIOR COUNTY)
ftE HAS Di~ CRMED TO ME AS SHOWN BELOW, THE DEVELOPMENT T HE IS
PROPOSING AT T AT LOCATIXON AND, I HAVE NO OBJEACTIONS TO HIS
PROPOSAL..
DESCW ION ANUOR DRAWING OF PROPOSED
DX\T1rr0P T cro 0E FILLED IN SY INDIvIDUM, PKo,'OSING DEvj LOpMENT)
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pnnt or type name
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Telephone number
DATE ._"_---