33678_DAVIS, MICHAEL S_20030411

L' CAMA DREDGE & FILL
GENERAL PERMIT
� New JModification 'Complete Reissue `]Partial Reissue
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
Applicant Name ,',I (jio i j rt +tJ 1)dy, t
Address `Igio
ir-i
D,-vt
City �'w �'C ►�
State Al<
ZIP
Phone # (- �1) c S� l
Fc # (Zsz) l
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Authorized Agent
El CW
O EW
❑ PTA ❑ ES
❑ PTS
Affected
AEC(s): OEA
❑ HHF
fJ IH ❑ UBA
❑ N/A
❑ PWS:
❑FC:
ORW: yes / no
PNA
yes / no Crit.
Hab. yes / nc
Previous permit #
Date previous permit issued
7F/
LE Rules attached.
Project Location: County r`�r: i,,, t
Street Address/ State Road/ Lot #(s)
IS'( JV"I' t P. i~c
Subdivision
City /= /s., 4 / ZIP , es" V
Phone # O River Basin
Adj. Wtr. Body 54 w . / PY) Y'4 �r d fife t '/man /unkn)
Closest Maj. Wtr. Body
Type of Project/ Activity k[:
or UJAI C=f• r� �ac� �/tJ it
dri r s,
td h �o
w lti
L�ffi.
(Scale:ty
OE:
Pier (dock) length 'Z iLfxE
Platform(s)
Finge
Groin
Bulk
Basin
Boat
Boat
Beach
Other —
Shoreline
SAV:
Sand
Moratorium:
Photos:
Waiver Attached. yes no -- --
A building permit may be required by: 6a , 4t r e
Notes/ Special Conditions • • A r •
r4,1, rti: u
jj —
1 �� . i �JF1 fE h (I l � •
❑See note
A i• ,� � s
regarding
on back re
-' • �/ / v ,
ardin River Basin
.
rules.
/
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/
1J. 4:J T�, � �r r _ S R t V
,! �'! : - ,,
, :.�.
length
number
head/ Riprap length
avg distance offshore
max distance offshore
channel
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t
cubic yards
Agent or Applicant Printed Name
% i^fLt
Permit Officer's Signature
7 of f
Signature Please read compliance statement on back of permit 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:
E Tar - Pamlico River Basin Buffer Rules L _] 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 (910-395-3900) for more information on how to comply with thesebuffer rules.
Division of Coastal Management Offices
Central Office Elizabeth City District
Mailing Address: 1367 U.S. 17 South
1638 Mail Service Center Elizabeth City, NC 27909
Raleigh, NC 27699-1638 252-264-3901
Location:
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293 / 1-888ARCOAST
Fax: [phone]
Fax: [phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Morehead City District
l 51-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 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
910-395-3900
Fax: [phone]
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)
www.nccoastaimanagement.net
Revised 10/05/01

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERI UNCO VERED BOAT LIFT
I hereby certify that I own property adjacent to is
(Name of Property Owner)
property located at tk -'36RYt
(Lot, Block, Road, etc.)
on a , in ��� �-��. (.Cq-�Ao- Qa���� , N.C.
(Waterbody) (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. I understand that a pier/uncovered boat lift must be set
back a minimum distance of fifteen feet (15') from my area of riparian access unless waived by
me.
I do not wish to waive the setback requirement.
I dQ wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
Print or Type Name
Zsz 3 r3-
Telephone Number
Date: /f'j-- ZZ' 2"3
-30—

I
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� �'a��.t,�k
F.
t - �a�S ,

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/UNCOVERED BOAT LIFT)
I hereby certify that I own property adjacent to �'"i.c�,t;�� j��'i���� is
(Name of Property Owner)
property located at
i SC) —�NRYt
(Lot, Block, Road, etc.)
on �c�C ��� , in -�R � ' �,,�ti GOAD. Qai,��) , N.C.
(Waterbody) (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. I understand that a pier/uncovered boat lift must be set
back a minimum distance of fifteen feet (15') from my area of riparian access unless waived by
me.
I do not wish to waive the setback requirement.
;N'T I dQ wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
Signatur
Print or Type Name
ci ( � 2 4- � 3
Telephone Number
Date: I c-S
—30—