34748_GROTHER, RON_20030827

'-
_ ',71CAMA / DREDGE & FILL
GENERAL PERMIT
❑New []Modification ❑Complete Reissue —]Partial Reissue
Previous pit #
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 15A NCAC
❑ Rules attached.
Applicant Name_
Address
City t } ??c StateW ZIP
Phone # ( ) iq, -- . Fax # ( )
Authorized Agent
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS: ❑FC:
ORW: yes / no PNA yes /(no Crit. Hab. yes / no
Type of Project/ Activity
Pier (dock) lei
Platform(s)_
Finger pier(s)
Groin length
number
Bulkhead/ Rip
avg dista
max dist
Basin, channel
cubic yai
Boat ramp _
Boathouse/ B;
Beach Bulld02
Other
Shoreline Len
SAM n<
Sandbags: n<
Moratorium:
Photos:
Waiver Attacl
A building permit may be required by:
Notes/ Special Conditions
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit
�-�-- .14
Application Fee(s) Check #
-,WTI F'R"'
Project Location: County ('; wl
Street Address/ State Road/ Lot #(s) ( i,)(. rT-
Subdivision
City ; T f i_� `.I (: 7 ZIP
Phone #)River Basin
Adj. Wtr. Body / I.. �r 1 ` na man unkn
Closest Maj. Wtr. Body
(Scale:
E See note on back regarding River Basin rules.
4' n I- YN-, k,
! h it
Permit Officer' Signature
r�� I '•�' f
Issuin Date Ei piration,Date
Local Planning Jurisdiction Rover File Name
a

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:
❑ 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
151-13 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

PAY
TO THE
ORDER
- - --
-..
ncrd datum rnl. Str 6a k-(o_r -..r a
BLUE WATER MARINE CONSTRUCTION, INC.
P.O. BOX 93
MOREHEAD CffY, NC 28557
N
1 �
i N�or�
2344
66-112/531
02301
DATE JX
DOLLARS
on
BUT
BRANCH BANKING AND TRUST COMPANY
MOREHEAD CORT LCARO
GT7
FOR-------
u'002344►i' i:OS3LOLL20:S2L4986S92112

ADJACENT RIPARLAN PROPERTY OWNER STATENLE�T
(FOR A PIER/MOORING PILINGS/BOATLIFT/BOATHOUSF)
I hereby eer&y that I own property adjacent to IJ,► �.i� (�2o'jH ,s
(Name of Property Omer)
property located at rl;D Lo f 0, l2 T w,>yT- No = I +I— ,
(Lot, Block, Road, etc_)
on _TA YLol2h GI2erLrY. in N.C.
(Waterbody) (Town and/or County)
He has described to me, as shown below, the development he is proposi-__ a_ t` at location,
and, I have no objections to his proposal. I undersea :d tha_ a pier/mooring
piiirgE, aoatiin/boathouse must be set back a minimum distance of Fl�etn fee": (i5') Fom my area
of rip=ian access unless waived by me.
VqJ I Owish to waivC the setback requirement. 0 OTNC VIEST Si PE Of- LoT-12
Sin •ish to waive t; at setback recuirement. p ►J TH 0v L r
------------
DESCRIPTION AN_D/OR DRAWS G OF PROPOSED DEVELOME\-I':
C_4r_-T EIrI04Sro,rl (To be,filled in by irzdMdual proposin; development)
Dp l,of fRo(��2 ' L�+��--1 j�►/�iNTfUttJJ ljcv
WIE�S T 171 Oe ►,vT i Z N10 ai I P� E X t SC I ►J
P�agT 5��nh�Jo-
l
ES-
LOT 12 W SST E>'r�� So rJ �t�t cl►2 r��iLs� S 1�Jv��l1
o � o� ��2v�9��t; 'AT �.
F�� LIDIT?]
aC
QiQE�A•T 0ni q23
� T
-------- —------- --- -------- --------t2 ---------
Lon, To
0e L-O i _ 12- A"f
2!��
Signature
S
Print or Type Name —
('0
Te!ep one Numb, :