34501_GOWER, JERRY_20030624

Cs7CAMA / ❑ DREDGE & FILL '
GENERAL PERMIT Previous permit#
PNew ❑Modification El 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
[J Rules attached.
Applicant Name i i" t I-4WFe Project Location: County ("17 �{rI,-t-
Address ? `f
City W� at. f State NC ZIP 2 S91
Phone # Fax # ( )
Authorized Agent f. AA t
Affected ❑ CW ❑ EW 0 PTA ❑ ES ❑ PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS: ❑ FC:
ORW: yes / no PNA yes /.,no; Crit. Hab. yes / no
Street Address/ State Road/ Lot #(s)
7
Subdivision 3 t w l /4 f 1 fv Aw ' ' c`'
City ZIP
Phone # ( ) River Basin VVj I�,s'
Adj. Wtr. Body /wY r / C y 'at)/man /unkn)
Closest Maj. Wtr. Body i�cf u � i `'V k c]
Type of Project/ Activity Fr` pt 'reji Qtlf fr �r�6 x 3 ! r : ry+o! rl 1 Mi pv"• wo
1 nlo' -11, 19'IT ? '�• Nf AC.-IfG.
Pier (dock) length 31
I
Platform(s) ( f k X? t t _ . _ - tl . ._ ._
Finger pier(s) (� E
Groin length
number --
1....-..
Bulkhead/ Riprap length � I
avg distance offshore .
max distance offshore 1......... i _'{
Basin, channel I T
- --
__.
cubic yards_
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
o /r.) 4
(Scale: A Il E )
Shoreline Length f
SAM not sure yes
Sandbags: not sure yes
_ i .
Moratorium; n/a yes
Photos: yes io _
Waiver Attached: no
A building permit may be required by: (G ! 4C ► ❑ See note on back regarding River Basin rules.
Notes/Special Conditions G 7Ar Pjifxrrd r f. .4tu4% titi P.Y`%(.,.d r•fC•,- 7"Aa.. -7C
b.��;•cl..}} MQ�/�L r!I(P. 4`J �f /
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AJdnt or Apglicant ri ted ame
Sinature r Please read compliance statement on back of permit"
g P
4foG. C 4 �013
Application Fee(s) Check #
` ✓ ` G ;A Y (�/ f- 611 i i /1�/. c! f 7 !G r,i/A•
r� -c
Permit Officer's Signature
t :�1 c.2 9 ly 3
Issuing Date Expiration Date
r., it, f �_ t it) rF z y /34
Local Planningjurisdiction 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 ])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 (252-946-6481) 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
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

JERKY GOWER CONSTRUCTION CO, INC.
PH 365-9767
7324 SIEMENS RD
WENDELL, NC 27591
Pay to the
Order of_
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FIRST CITI7.IJNS N stDCo pa Y
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10 ADJACENT RLPARL- .N PROPERTY OWNER STATENLEN—f
(FOR A PIER/MOORING PILINGSIBOATLIFTIBOATNOUSF)
I hereby cendfy that I own property adjacent to 's
(Name of Property Owner)
prope-,y located at 11D� — - / <�-
(Lot; Block,
on /� �� , in —
(Waterbody)
Kno-
Road, etc.0
06q:�q2 F-L
(Town and/or Countv)
✓61
0,,
He has desc-ibed to me, as shlown below, the deve'.opmer« he is propos ---- ac that location,
and, I have no objections to his proposal. I unde=—d tha: a pie:/moorinE
pdLn,gsi Nadift/boathouse must be se; back a minimum distance o:' Fi peen fee : from my are_
of access unless waived by me.
I do nnt wish to waive the setback requireme—nc.
I ,dn wish to waive C.at setbac'.< rcuiremenc.
DESCPJPTION AN-D/OR DRAWING OF PROPOSED DEVELOP`IE`-I":
(To be felled in by individual proposin; development)
0
i2nature
Print or Type N-1.7. e
Telephone Number
Date: .5 -3 - o

06/09/2003 12:28 FAX [phone] COWER CONST INC
Jun 09 03 OSt46a titan builders (SIS)366-1054
ADJACENT RIPARIAN PROPMTY OWNER STATEMENT'
(FOR A PIERIMOOVIK; PILINGS/BOA7UMBOAMOUSE)
i hereby certily that I own property adjacent to
(Name of Prop y Own")
PAY located at d /� f B
J�� , ;W'.44LAt. I11dCK, KM3,,,,etC..)) I I'�'
on �W
aterbody) (Town pnd/or County)
He has described to me, as shown below, the dzvdopment he is proposing at that location,
ttnd, I have no objections to his proposal. I under5tand that A piertmooring
pilftslboathftlboamotm must be set back a minimum distance of fifteen foes (15') from my stet
of riparian access unitss waived by me_
i do not wish m waive the setback requirrntent.
I fiII wish to waive that setback requiren[tnt_
Y MCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT.,
(To be Jslfed in by indiridao(pmposfsg deretopment)
Signs
Print o Type Name
i9-3'6�-I'Ie3
Telcphone NgmMr
pate. ,/ - 9-o3
- - win ►rre ear ara "-T ryIfir, ranz/eaiea
MAY-21-2003 WED 12:39PM ID_ PACE:1