33993_HARRIS, TIL_20030610

❑CAMA / ❑ DREDGE & FILL
GENERAL PERMIT Previous permit #
❑New ❑Modification El Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources -7 / _
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC + f l i��r �(f
_ , # ERules attached.
Applicant Name
Address
City State ZIP
Phone # ( ' ) Fax # ( )
Authorized Agent
❑ Cw
❑ EW ❑ PTA
Affected
❑ OEA
❑ HHF ❑ IH
AEC(s):
❑ PWS:
❑FC:
ORW:
yes / no
PNA yes / no
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision
City ZIP
❑ ES ❑ PTS Phone # ( ) River Basin J(((
❑ UBA ❑ N/A
Adj. Wtr. Body , ,at, /man /unkn)
Crit. Hab. yes / no Closest Maj. Wtr. Body
Type of Project/ Activity
(Scale:
Pier (dock)
Platform(s)i_._...--
Finger pier(s)-
Groin length
number
Bulkhead/ Nprap length
avg distance offshore r ,
max distance offshore
Basin, channel
cubic yards
Boat ramp Boathouse/ Boatlift
Beach Bulldozing
Others rt-e i i,r,rS
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Shoreline Length J t�'
4
SAV: not sure yes (no"� �� !
Sandbags: not sure yes no
Moratorium: n/a yes no
Photos: yes no -
Waiver Attached: yes no
A building permit may be required by:
Notes/ Special Conditions
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-
❑ See note on back regarding River Basin rules.
-F
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit
Application Fee(s)
Check #
Permit Officer's Signature I'
Issuing Date Expiration Date
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 consistentwith the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
n 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 / I-888-4RCOAST
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

TILGHMAN M HARRIS
427 SILVER ACRES DR
MERRITT, NC 28556
J'I. 1'7' ICI
327
�Q 3 66-30 472
�)n1r
J $ 200 to a
(f FYRST CITIZENS 972 ,
r INKFirst -Citizens Bank & Trust Company
Oriental. N.C. 28571
�www.firstcitizens.com
(' „67am#33943
t:0 5 • 3L00300t.0047L75455BO1i 00327
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ADJACE`tT RIPARLA.N PROPERTY OtiVi�ER STATEMENT
(FOR A PIER/MOORING PILINGSIBOATZ.IFTIBOATHOUSE")
I hereby ce:-dfy that I own property adiacent to'� z
(Name of Property Owner)
rorz. located at ���
r . -y
(Lot; Block, Road, etc.)
on Cfz--I?b , in "�, CDr/ `� , N. C.
(Waterbody) (Town and/or Countv
He has descroE-,i to me, as shown below, the developm--n: he is propos;-_ a: that location,
and, I have no objections to his propo� I. I une=d C:a_ a pie.,'moorin�
pI:iis:s, Goaiiftuboathous:, mils: be se_ beck a mil nirnum distance of f1 ttt i fe:: From my art.?
of riDa-ian access unless waived by me.
I dn nnt wish to wa v-- the setback requiramien:.
I do wis7 to w21v- t ..ar s-tbacl- rzcuiremen:.
DESCRIPTION AN-D/OR DRAVVD G OF PROPOSED DEVELOP%I—E.\T:
(To be filled ir. by individual proposir.; d-yelopmerzr)
OLI,IG.s 0A1 c-;r,�4 I t-C .
Signature
Print or Type N me
Te?eonone Nu b,27
Date: 5— 9 —03

ADJACENTI' RIPARL�'v PROPERTY OWW-ER STATE'�fEI•T
(FOR A PIER/MOORING PILINGSIBOATUMBOATHOUSF)
I hereby certify that I own property adjacent to r// �_ AlAe'e /'5 is
(Name of Property Owner)
property located at �0/ #20�
(Lot. Block, Road, etc.)
oni�G'AD C�� F/� , in ��L/ ��3�/� r , N.C.
(Waterbodv) (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 understand that a pier/mooring
piiir,gsiboadifr/boathouse must be se: back a minimum distance of fifteen fee: (I5') from my area -
of riparian access unless waived by me. --
I do not wish to ware the setback requirement.
I J wish to waive r`at setback requirement.
DESCRIPTION AN-D/OR DRAWLtiG OF PROPOSED DEVELOP`tE\-I:
(To be fzlled ir: by individualproposing development)
Signature
A"I" 11L
Print or Type Name
_ 6 S �/2 c/,)�>y
Telephone Numbe-
Date: 5 - l6 —O

ADJACDr,r MAPJAN PROPERTY OWNER STATEIINZ'
(FOR A PNERIMOORING PILINGS180A7L1MBOATNOC M
[ hereby ccrdfy thu i own property ad =nt to %1i�
(NAM of property Owner)
pmpc:ty I= at l_p�'''`Q,to_ SAear ,
(Lot, Blocky R02dy UQ
in N C.
(WaWbadr) (Town an&ar Coca r)
He has da=:WW to me, as town below, the deem—= to is propO ri ar dtu location,
and, r have no objectims to his pmpoW. V Uu&- ^.d ft. I oe;lt 6i aia
pi'ilr, 'hold /bvadWdse must be w luck tt minimum ifir toe of fiix, t fee: (0) ham my am
of rpaisa access unless waived by me.
I tla.= wish to wIN't d2a whack rquiromeat.
I da wish to waive ties setback Mquimmeng.
AESCItI'I?1'fOti ANDIOR DR.AWL1G OF PROPOSED DEVELOP M T..
M befilled it 6;I EltlifM�tti7�p�petug dt�/dopnt4nr}
Aura s ev t N .4.�%awdL �f��rr dN �xcro✓
4 d O a r/@IPAf
Prins or Tvpd Nark
159&- 91+ - IT bP
Te!cphone Numbe-