32891_HOWARD, ROY_20021021

t -'CAMA / DREDGE & FILL v493289f-
GENERAL PERMIT Previous permit#
'New ]Modification (_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 15A NCAC '- ! 17 _.
F-, Rules attached.
Applicant Name c,f rlct..x «' (Jarl, f)rr
Address j3 4 3C S
City —C)Ork _ State ZIP
Phone # (? i )yUU F - ? Fax # ( )
Authorized Agent
Affected ❑ CW [IiW EM-fA ❑ ES ❑ PTS
AEC(s): ElOEA ElHHF ❑ IH ❑ UBA ❑ N/A
❑ PWS: ❑ FC:
VR11. yes / [lu rl\F1 yes / Ilu trill. flay. y0.
'7l
Project Location: County _
Street Address/ State Road/ Lot #(s)
Subdivision
City -- - ZIP- --- -
Phone # ( ) River Basin
Adj. Wtr. Body i C c,v , l_ (nat /man /unkn)
Closest Mai. Wtr. Body�"�
Type of Project/ Activity Ci
(Scale:
Pier (dock) length
Platform(s) _
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore_
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach ,drozing 41I /
Other C c I c: Ja.
Shoreline Length l tsi7
SAV: not sure yes
Sandbags: not sure yes
Moratorium: n/a yes
Photos: yes
Waiver Attached: yes
A building permit may be required by:
Notes/ Special Conditions l 4 1r-k.i
i Nis = r i ,c , ',,
_ !a t ,-
Agent or Applicant Prinked Name
Signature Please read compliances tement on back of permit"
Application Fee(s) Check #
See note on back regarding River Basin rules.
Permit Officer's Signature
1, 1.
Issuing Date Expiration Date
yr,
Local Planning Jurisdiction 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, 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 I_ 1 Other:
� euse 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: Fax: [phone]
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293 / 1-888ARCOAST
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

ROY J. HOWARD 32�4z7/
PH. (252)444s1n
303 FARINA DR.
HAVELOCK, NC 28532
Pay to the
Orrler of -------_ �
USAA FEDERAL SAVINGS BARK," y �C
Nu
10750 MCDERMOTT FWy
SAN ANTONIO. TEXAS 782884)544
us /`(210)456-80001-800-8323724
For_40C
31407426Lit: II-ISOmL
TRANSIT Rni)TINf. NNMRFR 0 1111 3 II
—Ml INT NU A f-R
1189
Dote QA-/b-Z1 30-7426/3140
Dollarsm
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9

ADJACENT RIPARL-.N PROPERTY OWNER STATE-NtENT
(FOR A PIER/MOORING PILINGSIBOATLIFTIBOATNOC
I hereby certify that I own property adjacent to
(Nam of Property Owner)
propery located at 30.S O f . cat
kLot, Block, Road, etc_) on u.—CKer C—re-e—% , in /4aye— 1Gck , N.C.
(Waterbody) (Town and/or County)
He has described to me, as shown below, the developmen: he is propos -_ a- that location,
and, I have no objections to his proposal. I undersmnd that a pier/moor-Ina
pEinas,•boatdfrfboathouse must be se: back a minimum distance of EI'Leen fee: (;') from my area
of roa-ian access unless waived by me.
I do not wish to wane the setback requireme^t.
I do wish to waive t� at setback recuirelne::t.
DESCRIPTION AN-D/OR DRAWr G OF PROPOSED DEVELOP`tE\_T:
(To be filled in by individual proposing development)
7i r- --30�r .
NEAR°IJ own rz-b
SiEiqatuN`--
Print or T� � Name
Telenhone \umnz-

ADJACENT REPARLkN PROPERTY OWINTR STATENIEN T
(FOR A PIER/MOORING PILINGS/BOATLIFTIBOATHOC'SF)
I hereby certify that I own property adjacent to !fie T A; , r 's
(Nam of Property Owner}
prope.-y located at �� i n� Q z of e r (,rR,- k ,
(Lot, Block, Road, etc.)
on 7"acrKer Lre�,—K , in Pave- kc- , N.C.
(Waterbody) (Town and/or County)
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 unders=—d that a pier; mooring
piii„gs;boadift/boathouse must be se: back a minimum distance of Fl�een fee: (f) from my area
of riparian access unless waived by me.
I do not wish to wa%-e the setback requirement.
I J- wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWLNG OF PROPOSED DEyELOPNIE.NI':
(To be filled in by individual proposing development)
5'
aa�r
I
Signature
Print or Type Name
Telephone Number
Date: /6 O� r C'Z