33635_DAGUTIS, PETE & SCHALENE_20030226

DCAMA / ❑ DREDGE & FILL
$Ey
�1
'� GENERAL PERMIT
f 7-
Previous peri4i #
❑New ❑Modification ❑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 0 CW ❑ EW ❑ PTA DES ❑ PTS
Phone # ( ) River Basin
AEC(s): 0 OEA 0 HHF ❑ IH O UBA ❑ N/A
Adj. Wtr. Body (nat /man /unkn)
❑ PWS: ❑ FC:
ORW: yes / no PNA yes / no Crit. Hab,
yes / no Closest Maj. Win Body
Type of Project/ Activity
(Scale: )
Pier (dock) length
Platform(s)
Finger piers)
I
Groin length I —
I 1c44L I)
number I — ----
I
Bulkhead/ RiPEA length
gt
avg distance offshore f
max distance offshore
1 I {{I I I
Basin, channel
I i
cubic yards
Boat ramp -
Boathouse/ Boatlift
Beach Bulldozing !
Other I ! r
Shoreline Length
SAM not sure yes no
i
Sandbags: not sure yes no f -
1 I
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 compliance statement on back of permit
Application Fee(s) Check #
- -- -- - —I - ------ I 11
E' See note on back regarding River Basin rules.
'Permit Officer's Sk6ature
700
Issuing Date Expiration Date
Local Planning)urisdiction 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 consistentwith the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
❑ Tar- Pamlico River Basin Buffer Rules ❑ Other:
aeuse 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 (910-395-3900) for more information on how to comply with thesebuffer rules.
Division of Coastal Management Offices
Central Office
Mailing Address:
1638 Mail Service Center
Raleigh, NC 27699-1638
Location:
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293 / 1-888ARCOAST
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)
Morehead City District
151-B Hwy. 24
Hestron Plaza II
Morehead City, NC 28557
202-808-2808
Fax: [phone]
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico Counties)
Washington District
943 Washington Square Mail
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
910-395-3900
Fax: [phone]
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)
www.nccoastalmanagement.net
Revised 10/05/01

6573
CHARLES T. JENNINGS 66-152/531 CC
DOROTHY L. JENNINGS 3
588 CREEK PLACE ROAD 252-249-0563 t -`.� v - O Date
ARAPAHOE, NC 28510
Pay To The
Order Of
i� .. _ �l ,- �✓ J , r c C> — = Dollars • �:« "
-TA_
Wachovia Bank, N.A.
6uybmi. NC 28515
NP
Memo
1:053LOIS291: 0786
2 20030i1' 65 3
q kAAL4XD 2000

Pamlico County Building Inspections
P.O. Box 776
Bayboro, N.C. 28515
(919)-745-3861
d,Aunt Riparian Property Owner Statement Epn#
�_ .. i.r GiC�%`L S _4s
I hereby certify that I own property adjacent to
Name of landowner proposing development
on J A #o C-`P-t O in/near Lot# t of Subdivision, if applicable
Community
Tax Parcel # (�; 2 t ci,`Z F-`P off SR t O
Complete description of how to locate this property:
This proposed project, aJ3-u �-, and the location has been described to me as
shown in the drawing below and I have no objections to the proposal.
For a Pier, check one of the Following:
_✓ I wish to waive the 15' minimum setback from my riparian access.
I do not wish to waive the 15' minimum setback requirement.
Draw the proposed structure in the space provided below. List the size of the structure and
measured distances from the adjacent property lines, other structures on the property, and the
road. Water etc.
A.Rer this form is completed by the landowner proposing the project, a copy is given to the adjacent landowners for their consent and
signatures. The forms are then returned, along with a building plan and other applicable required information, to the Building
Inspections Office for building permit application/processing.
C
Date
Signature Y^

Pamlico County Building Inspections
P.O. Box 776
Bayboro, N.C. 28515
(919)-745-3861
pro rtv Owner StAtP nt Epn#_________
I hereby certify that I own property adjacent to
Name of landowner proposing development
on J A M L 0-10 in/near Lot#___ I__ of Subdivision, if applicable
Community
Tax Parcel # q- 2 t G Q— off SR t o .
Complete description of how to locate this o crop t � —
n , ,�71 and the location has been described to me as
This proposed project, a ave no objections to the proposal.
shown in the drawing below and I h
For a Pier, check one of the Following:
✓ I wish to waive the 15' minimum setback from my riparian access.
I do not wish to waive the 15' minimum setback requirement.
and
Draw the proposed structure in the space provided better structures on the property,rand he
measured distances from the adjacent property fines, oth
road, water, etc.
"41CiS
Act15 0.1{ E S� Al
A�tUitS P,4reIcA
pit opaS8'.0
QL)'-W-4eA t> z�o�
Aftthis form is completed by the landowner proposing the project, a copy is given to the adjacent landowners for then consent and
er
signatures. The forms arc then returned, along with a building plan and other applicable required information, to the Building
Inspections Office for building permit application/proce`r' ng.
Date 1 f c 2
Signature,