56964_HAMANN, MARY_20101117

❑CAMA / ❑DREDGE &PILL
GENERAL PERMIT Previous permit # j
LJNew [Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued 7i
As authorized by the State of North Carolina, Department of Environment and Natural Resources
and the Coastal Resources Commission inqanea of environmental concern pursuant to I SA NCAC
❑ Rules attached.
Applicant Name maw Project Location: County
Address Street Address/ State Road/ Lot #(s)
Y
City State ZIP
Phone # (__) Fax # (, )
Authorized Agent
Affected ❑ CW ❑ EW ❑ PTA
AEC(s): ❑ OEA ❑ HHF ❑ IH
❑ PWS: ❑FC:
ORW: yes / no PNA yes / no
Subdivision
City
ZIP
❑ ES ❑ PTS Phone # O River Basin
❑ UBA ❑ N/A
Adj. Wtr. Body [nat /man /unkn)
Crit.Hab. yes / no Closest Maj. Wtr. Body
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Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit
Permit Officer's Signature
r
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 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
❑ Neuse River Basin Buffer Rules
❑ Other:
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/ 1-888-4RCOAST
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

Applicant:
Date:
Describe below the HABITAT disturbances for the application. All values should match the name, and u its 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
ternimpacts)
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount
Dredge ❑ Fill ❑ Both ❑ Otheri�j
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 ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FORA PIER/MOORINGPILINGSIBOATLIFTIBOATHOUSE)
I hereby certify that I own property adjacent to S u-r 5 A0 +s i ©)J S
(Name of Property Owner)
property located at J 71 o C6 z4- nJ Tf2' C 1-u 8 "� o A
(Lot, Block, Road, etc.)
on NClafP61z7 "AWE2 , in CP a-rE 2E7 Diu AJT,N.C.
(Waterbody) (Town and/or County)
Applicant's phone #: )(6/ f Mailing Address: %/� CQctalT�1/ � � ➢
)''I eE'wC-42) CITV
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 / boatlift / 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.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
n/EW P d 12 T R I %(FR
..,F r:
-ft, 16x'o
PAOPOLCD
LjFT
!-� --------------------
(Information for Property Owner Applying (Riparian Property Owner Information)
for Permit)
/J o co u ff-rA y C j- u B PhD
Mailing Address
/>'1D2ENE"A7 6TV , ArC -� kEyz
City/State/Zip
- ,x-22-L—fz,iy'
Telephone Number
Signature
Date
Signature
,SLLE SRr-3)SToA%
Print or Type Name
Telephone Number
.ate
Date
NOV 15 20,0

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGS/BOATLIFTBOATHOUSE)
CSC.
I hereby certify that I own property adjacent to -RCc 5 S �uSS,- L 's
(Name of Property Owner)
property located at .17-16 C'ouA/-7-2y C" B W o A -b
(Lot, Block, Road, etc.)
onrS%P[JfZ.7 �� fE'Z , in ��r� fL ; c�2 t T �d+� nf-r�/ , N. C.
(Waterbody) (Town and/or County)
Applicant's phone #: Mailing Address: / 7/d
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 / boatlift / 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.
---------------------------------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
/Vt= W PD rz-r J% v E 2
741
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----------------------------------------------------------------------------------------
(Information for Property Owner Applying
for Permit)
Z %/ D Z V u.,XJTFz y 1r1 13 'X1 Z�>
Mailing Address
Cry , ,AUc, 2 aYK7
City/State/Zip
Telephone Number
Signature
Date
(Riparian Property Owner Information)
Si ture
-f U s s 'XL) SS F<.-
Print or Type Name
�J-Z - 247- Z9yz
Telephone Number
Ream
NOVat-5 2010
It�'flt�?l�,vpC�

Mr. Francis C. Hamann nisi 4255
1710 Country Club Rd
Morehead City, NC 28557
��ss ,�% . / DATE
ORDER OFPAY TO -
DOLLARS e
Lnok for: Micro Print signature line. gray ry pe and linmork. First Citizens Bank logo on back. If not prescn!. do not cash.
First Citizens
B nkizens.com Qg4
FOR
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