33647_DOREMUS, RICHARD & NANCY_20030317

C'CAMA / DREDGE & FILL
4
GtNERAL PERMIT
Previous permit'
-JNew !—Modification i-Complete Reissue -Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources I
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
,� � Rules attached.
Applicant Name_ ` ;�y r' N�nc Ll kfE- fN�.1Project Location: County i
Address —/ S tc.)W ll11 Street Address/ State Road/ Lot #(s) )
City_ ; � c k oil J�Iorf, - State !JC ZIP,
Phone # ( (�J Fax # (_ )
Authorized Agent
Affected CW ❑ EW ❑ PTA ❑ ES ❑ PTS
AEC(s): -' OEA ❑ HHF ❑ IH ❑ USA ❑ N/A
PWS: ❑ FC:
ORW: yes / no PNA yes / no Crit. Hab. yes / no
Type of Project/ Activity
Pier (dock) length
Platform(s)_
Finger pier(s)
Groin length
number
Bulkhead/ Ripi
avg dista
max disc.
Basin, channel
cubic yw
Boat ramp _
Boathouse/ Bc
Beach Bulldoz
Other
Shoreline Len;
SAM nc
Sandbags: nc
Moratorium:
Photos:
Waiver Attach j j
A building permit may be required by: A kmjl JhC)irg C
Notes/ Special Conditions ACIA" l .{y, Limo .skure� �- t�Q• t
`^ t 1, , 1
-E\ �,fk-{+ . �^r\rI1.. YJP n�1Xr`I --H V11
Subdivision
City ZIP
Phone # ( )_ __ River Basin �, ,Jr ( J%t k
Adj. Wtr. Body "r't . Y r �c (/ _ (nat /man\ /unkn)
Closest Maj. Wtr. Body
(Scale: i�
❑ See note on back regarding River Basin rules.
, 012C r► I 1 4'C
Agent or pli t:Pr7ne a e �PermitOfficer'sSignature
/ , 7
-VJI'l
Signature Please read compliance statement on back of permit Issuing Date Expiration Date
Application Fde(s) Check # Local Planningf 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 I) 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, certifythat this project is consistentwith 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 (252-946-648 [)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 / 1-888-4RCOAST
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 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.nccoastalmanagement.net
Revised 10/05/01

K. RICHARD DOREMUS, JR. BB$T
(� NANCY H. DOREMUS MOREHEAO CITY, NC 28557 1977
dW, 145 L1.0 O111 .Y DRIVE 66-7121537
I INI: KNOI.I. SHORES, NC 28572
[phone]
C✓ 03/17/2003
NCDENR $ **100.00
One Hundred and 00/100#kki*k****#***#R#i**k***#}i#k******i*ilk***##i*k#k**ii#i**#}#f##i#*}}# /'1w/11j
8 Secumy lealures
included.
Dela,is on back.
".1116 CAMA Permit- boat lift 6FP"Z,--T(o4L7
1:0S310112If: S212383840ii' 15
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ADJACENT RIPARL-kN PROPERTY OWNER STATE-NIEiNT
(FOR A PIER/MOORING PILINGSIBOATZ.IFTIBOATHOC'SE)
I hereby certify that I own property adjacent to tCNA J ± AlA y �Q2crn'�t s 's
(Name of Property Owner)
prope.y located at A/ 5 �- �Qi o�� Jed i�»✓� l��'b� S / r�f�c ,
(Lot; Block, Road, etc_)
on -Pf�S C19NAl- in N.C.
(Waterbody) (Town and/or Countv)
He has described to me, as shown below, the development he is proposi-_ a_ that location,
and, I have no objections to his proposal. I understand char a pier; mooring
piiingoa hft/boathouse must be se -.back a minimum distance of f iteea fee.: ( "om my ') frar
s bea
of riaa:-ian access unless waived by me.
I n 6A wish to wthe setback requirement.
I wish to waiv
_ e t�at setback recuirement.
DESCRIPTION AND/OR DRAWLNG OF PROPOSED DEVELOPNIE`T:
(To be filled in by individual proposing, development)
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Print or Type Name
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Teleohone Number

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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFFIICCATION/WAIVER FORM
�►ci-//�72 �J �._'J�(�En4uS
Name of Individual applying for Permit:
Address of Property: I yS t U 13 L-OL [. Y �:D 2
(Lot or Street #, Street or Road, City & County)
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions, should be provided with this
letter.
I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coastal
Management, Hestron Plaza II, 151-B, Hwy. 24, Morehead City, NC, 28557 or call (252) 808-
2808 within 10 days of receipt of this notice. No response is considered the same as no objection
if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat hous lift r sandbags must be
set back a minimum distance of 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 wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
Signature Date
L. S'C14LI mPc/z
Print Name
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Telephone Number With Area Code

UNITED STATES POSTAL SERVICE [postage
irst-Class Mall
& Fees PaidSPS
111111 ermit No. G-10
• Sender: Please print your name, address, and ZIP+4 in this box •
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■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
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A. Signature
B. Reclyied by (Prirfted Name) , V j C. Date of
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D. Is delivery address different from item 1? Ye
If YES, enter delivery address below: Z.Ntf
3. ice Type
Certified Mail ❑ Express Mail
egistered ❑ Return Receipt for Merchandise
❑ insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number 7002 0860 0003 9498 4161
(Transfer from service labs. — -
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PS Form 3811, August 2001 Domestic Return Receipt 102595-02-M-0835

U.S. Postal Service
CERTIFIED MAIL RECEIPT
(Domestic Marl only; No Insurance Coverage Provided)
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Postage
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Certified Fee
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Return Receipt Fee
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(Endorsement Required
Restricted Delivery Fee
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Total Postage & Fees
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ATLANTIC BEACH C1a�i0
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TOTAL 5.00
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