33188_HADDOCK, BETTY JEAN_20030727

CAMA / ❑ DREDGE & FILL B� ?
GENERAL PERMIT Previous permit #
EINew ❑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 15A NCAC
O Rules attached.
Applicant Name i e, ��y-11, �� ��i. ��c �! Project Location: County
Address
City I ` L N State "f� ZIP
Phone # Fax # O
Authorized Agent j VJ ,t �
Affected [ICW ElEW ❑ PTA El ES ❑ PTS
AEC(s): OEA ❑ HHF ❑ IH ElUBA El N/A
ElPWS: C FC:
ORW: yes / no PNA yes / no Crit. Hab. yes / no
• /l • Y
Street Address/ State Road/ Lot #(s)
t�.1�32
Subdivision r - `,4
City ZIP "<= riC
Phone # O / ' % ` C t River Basin
Adj. Wtr. Body f 3cw.r r (nat /man /unkn)
7
Closest Maj. Wtr. Body- -�"Jr v
Type of Project/ Activity
/
(Scale:
n%
)
Pier (dock) length
PlatformO
Finger pier(s)
Groin length
number
Bulkhead/ R ' p length : ' ,'
avg distance offshore_!_
max distance offshore S�
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
hj-_ G
a , l -;'T
�
-
I
�.yr
�-------
41
i
r
--r-
{
k
--
i
i
I
ILI
L
I
P
T
p
i
Shoreline Length I r
SAM notsure yes
Sandbags: not sure yes �o c t~'_ i i
Moratorium: n/a yes
Photos: yes} _ I
Waiver Attached: yesVoI ---
A building permit may be required by: II {{] See note on back regarding River Basin rules.
Notes/ Special Conditions ' Vu v 14 'jc k � 1-16 f e c 4 +�i f • !` / M t'r r ., % cl -. L1 4 f N o . /"
t I j �
r� t+x'rrIJ 61�,, i ;Lf lJ '!��'C i6f� -IC( {:/�. '.,ii.�tvf I(rdWR,,I c M4f, J liVr
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit
r
Application Fee(s) Check #
Permit Officer's Signature
Issuing Date Expiration Date
Local Planning Jurisdiction Rover File Name
� - _ i[ �1•� I61A .�.bay3- t i��'+'SLL! sV6::1�K:

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
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)
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

i
BETTY JEAN HADDOCK 1330
NCDL 1908048 PH. 252-749-1410
P.O. BOX 365
5821 E. LANG ST. Date,{ —
FOUNTAIN, NC 27829 66-19/530 NC
1109
Pay to the
Orderof
v �'i r� ��. V �i Dollars
Bankof America.
Bank of America Advantage-
ACH R/T 053000196
For
1:0 5 3000 19 D: 0001131L,1717111 -'13 30

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to 'Z' Is
(Name of operty Owner)
property located at ✓� ��' 3� �f -- /�v Y ,t Q., %� �-� .�,
(Lot, Block, Road, etc.)
on C'_d� , in , N.C.
(Waterbody) (Town and/or County)
� �4k-has described to me as shown below, the development? proposing at thatTocation,
and, I have no objections toffs proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development)
_,Q' 3o
hAl
_/
l �t ur c&'y /;it ,
7V7-i q/v
f16vs e Ne X7` Z D /9A/11P 7e eel"
i7a� 7
r,
Cr
Print or Type Name
9/�' S,' g --7-- -7- -Z---
Telephone Number
Date: /-- y

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to,4ob� !'� �.,�,i /,,/-6/4,4
(Name of Property Owner)
Property located at
(Lot, Block, Road, etc.)
on 4�1e�-7 a e4-6—,� , in �� -��� & - , N.C.
(Waterbody) (Town and/or County)
�y
�ndescribed to me as shown below, the development-t e`rs proposing at that location,
and, I have no objections to his proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development)
z �,�=�"� �a 7
Signature
Print or Type Name
-7 5- ga t- -
Telephone Number
Date:- - 0-3