33937_GUTHRIE, BERNIE_20030428

CAMA / ❑ DREDGE & FILL ,�G�f3fi
GENERAL PERMIT
Previous perkt #
10 New CModification 7Complete 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
❑ Rules attached.
Applicant Name
Address
City P,' •' State ZIP
Phone # () % f 2 2c Fax # ( )
Authorized Agent
Affected ❑ CW ❑ EW [ l9 F A ❑ ES ❑ PTS
AEC(s): ❑ OEA Cl HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS: ❑FC:
ORW: yes / no PNA yes / no Crit. Hab. yes / no
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision
City ZIP
Phone # (_) River Basin
Adj. Wtr. Body i.. r`c�(_« .—�C>(1 r , nat'/man /unkn)
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Agent or Applicant Printed Name
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Signature P(ease+eaad compliance statement on back of permit
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Application Feels) Check #
Issuing Date
f Expiration Date
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 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, certifythat this project is consistentwith the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
Tar - Pamlico River Basin Buffer Rules �_J 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)
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax: [phone]
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Morehead City District Wilmington District
151-B Hwy. 24 127 Cardinal Drive Ext.
Hestron Plaza II Wilmington, NC 28405-3845
Morehead City, NC 28557 910-395-3900
202-808-2808 Fax:[phone]
Fax: [phone]
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico Counties)
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)
www.nccoastalmanagement.net
Revised 10/05/01

AF
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ISLAND PLUMBING
252-247-3611
PO BOX 564
SALTER PATH, NC 28575
DATE
FIRST CITIZENS 133
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ADJACENT RIPARLAN PROPERTY OWNER STATEN ENT
(FOR A PIER/MOORING PILINGSIBOA TLIFTIBOA THOUSE)
I hereby cerdfy that I own property adjacent to e L-tr+9r 's
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(Name of Property Omer)
prope. �y located at
(Waterbodv)
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t; Block, Road, etc.)
.Se, i wr iV.- F .
(Town and/or County)
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He has described to me, as shown below, the developmer« he is proposi-_ that location,
and, I have no objecdons to his proposal. I urde:sand t E: a pier/mooring
pilings;watlirdboathouse must be sc_back a minimum distance of f_lnetn fee: (15•) from my area
of nua-1an access unless waived by me.
I do not wish to wage the setback require:rle.lt.
I do v.'ish to waive t .at setback recuireme:it-
DESCRIPTIOti AN-D/OR DRAWLtiG OF PROPOSED DEVELOPNIEN-f:
(To be filled in by Individual proposzn,; developmenr)
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ADJACENT RJ PARL-�N PROPERTY O"NER STATEN EN- T
(FOR A PIER/MOORING PILINGSIBOATZIFTIBOATHOUSE)
I hereby certify that I own property adjacent to 'ern (P �ukrit 's
(Name of Property Owner)
propery located at H WV 6 b? ,
Lot, Block, Road, etc.)
on &y , in ISC Ikr PCJJA , N.C.
(Waterbody) (Town and/or County)
He has descnbed to me, as s<<own below, the development he is proposi__ a_ teat location,
and, I have no objections to his proposal. I unders:and tr�a: a pier,`moor-iinQ
pin Es; aoadiftlboathouse must be set back a minimum distance of Eirtetn feet (15') from my area
of r,*Da ,'an access unless waived by me.
I do nnt wish to wai,.-e the setback requirement.
i✓ I dn. wish to waive that setback requirement.
DESCRIPTION A.+-D/OR DRAWL�+v OF ?ROPOSED DEtiELOPNIEtiT:
(To be filled in by individual proposing development)
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