53096_JOHNSON, JUDY & MARTIN_20090125

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❑CAMA / ❑ DREDGE & FILL "�7?''
-. GENERAL PERMIT Previo spermit#
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❑New LJModification ❑P
Com lete Reissue ❑Partial Reissue V\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
El Rules attached.
Applicant Name Project Location: County
Address Street Address/ State Road/ Lot #(s)
City State ZIP
Phone # ( ) ' �� `� Fax # O Subdivision
Authorized Agent — - - City ZIP
Affected ❑ CW M EW Ll PTA C ES ❑ PTS Phone # ( ) River Basin `
AEC(s): J OEA El HHF El IH ❑ UBA ❑ N/A Adj. Wtr. Body Lnt /man /unkn
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❑ PWS: ❑ FC:
ORW: yes / no PNA yes / no Crit.Hab. yes / no Closest Maj. Wtr. Body
Type of Project/ Activity
Pier (dock) length,
Platform(s) _
—
Finger pier(s)
Groin length
—
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore__L
_ r
\_J A
-f— — x `
Basin, channel
cubic yards
Boat ramp
I
Boathouse/ Boatlift
—
Beach Bulldozing
Other
Shoreline Length
SAV: 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 Name
Signature Please read complixdce st�ement on back of permit
Application Fee(s) Check #
(Scale:
---i_,
i
See note on back regarding River Basin rules.
Permit Officer's Signature
Issuing Date ExpirationDate
1 �
iiy .li r
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 ❑ 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/ 1-888-4RCOAST
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

JAN-08-2009 15:21 From:DCM MHDCTY
To:912525277986 Page:1"1
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A P/EWMOOR(NG ! ILINGSIBOA'l'LIFTIBOATIIOUSE)
I _ _
I hereby certify that I own property adjacent to-JQ,—
(NA a of Property Owner)
property located at
6
Block, Road, etc.)
iiilo r t� G c>—' \ c_ " ,
on S� c,�S� s N-C"
�--� - - - Town and/or County)
(Waterbody) (
I
C
II ii ��
Applicant's phone`t �1�-Mailing Address: I�"� �`
I
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 underlstand 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 thelsetback, you must initial the appropriate blank
below.)
= I do not wish to waive
T do wish to waive that setbacklrequirement.
-------------------------------------------------- =-------------------------------------- =-----------------------
l)ESCR1PTION ,AND/OR DRAWING OF PROPOSED DEVELOPN Mi NT:
(To be filled in by individual proposing development),
r�� r✓%',E p�C� /_' v�'ljr
SIC)
--------------------------------------------------------
(Ynformatioai for Property Owner Applying
1for Permit)
`�` \
Mail i Address
�.
City/State/Zip
Telephone Number
ignaturc Date
y ° 4-li �l
--- --------------------------------------
(Riparian Property Owner Information)
�7
ignature
Print or -type Name
71--/,5 Vic. -
Telephone Number
Date

MICKEY OR JUDY JOHNSON
3718
DL 1683484 PH 523-4292
2285 ELIJAH LOFTIN RD. C 4 Date 66-30/535
r KINSTON, NC 28504
y. Pay to the
Order of s.
Dollars
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