33918_FENBERG, MARTIN_20030403

_ CAMA / F-1 DREDGE & FILL
GENERAL PERMIT
❑New -Modification ❑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 I SA NCAC
Applicant Name
Address
City_ _ State ZIP
Phone # ( ) Fax # ( )
Authorized Agent 1}, W)rA
Affected ❑ CW ❑ EW E3 PTA ❑ ES ❑ PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS: ❑ FC:
ORW: yes / no PNA yes / no Crit. Hab. yes / no
Previous permit #
Date previous permit issuec
Cl Rules attached.
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision_ -
City -_-_-- _ ZIP
i
Phone # ( )_ - River Basin
Adj. Wtr. Body__-_ _ (nit [man /unkn)
Closest Maj. Wtr. Body ____. ;
M.
I
IPA
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Agent or App cant Printed Nam
Signature * Please read compliance statement on back of permit"
Applicatioh Fee(s) Check #
Permit Officer's Signature
Issuing Date Expiratior0bate
Local Planning Jurisdiction Rover File Name
is ,

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, certifythatthis project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
❑ T r- Pamlico River Basin Buffer Rules El Other:
`❑Meuse 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 / I-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

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ADJECENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILING/BOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to M , K 14rA w
(Nnme orprnperty nwner) /
Property lacated at / I I S' L4 H f -e
(Lnt, Block, Road, ect )
On 3t It _C f�• if In �a.�•ti C o
— — (W.1lerhndy) (Ibwn and/nr County)
, N.C.
He has decrided to tile, 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 piling/boatlift/boathouse
must be set back minimum distance of fiReen feet (15') from my area of riparian access unless
waived by me.
I do not wish to waive yhe setback requirement.
_ I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
( To be filled in by individual proposing development)
C,
i
f- — —
Signafu
Print or ypc Name /�
_�� /� %1/
Telephone Number
J—P--3
Date
Foley & Foley Contractors

ADJECENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILING/BOATLIFT/BOA-FIIOUSE)
i hereby certify that i own property adjacent to�.-�''� r�r"e.'5
(Name or propel ly owner)
Property lacated at1 A S a K S tT'
(Lot, Block, Rond, ect )
3.. i t Cct �e k in I�4 ,h ( t ( v _, N.C.
(IVnlerhody) gown and/or County)
He has decrided 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 piling/boatlift/boathouse
must be set back minimum distance of fifiteen feet (15') from my area of riparian access unless
waived by me.
I do not wish to waive yhe setback requirement.
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
( To be filled in by individual proposing development)
r
Sigi attire
J;!�IqAf Al4kTllu
Print or Type Name p
Telephone Number
L,�2--
Date
Foley & Foley Contractors

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to 114ar"T-f1411 1 et n is
(Name of Property Owner)
property located at S e A
(Lot, Block, Road, etc.)
on 6 C r 2 i. , in ru r� i < c " I N.C.
(Waterbody) (`Yawn 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.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development)
4f-1P"s)'O
Print or Type Name
- -7
Telephone Number
Date: & —/ r n R 1
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
hereby certify that I own property adjacent to fA A` r J, 'n e7 40 `S s
(Name of Property Owner)
property located at / (( u h S P T
r (Lot, Block, Road, etc.)
on Q` r t -e in a1 M 1 r C v , 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.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development)
Signatures
Print or Type Name
Telephone Number
Date: �U3
—29—
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