34758_JACKSON, JEREMY_20030827

E-CAMA / 1 DREDGE & FILL
GENERAL PERMIT
_]New Modification _.Complete Reissue [-]Partial Reissue
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
Applicant Name_ w9 y �Q 1c.f c
Address f - c _ +9c r
City !. In rr j 6[ k StateZIP q 2.
Phone#Fax#( )
Authorized Agent n h i rl
Affected ❑ CW ❑ EW [�J•PTA ❑ ES ❑ PTS
AEC(s): ❑ OEA C HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS: ❑ FC:
ORW: yes / �i9 PNA yes / raid Crit. Hab. yes / no
Previous perr¢ilt #
Date previous permit issued
-770 '7O[,
attached.
Project Location: County i�, I(" �
Street Address/ State Road/ Lot #(s)_
Subdivision { �1G le, j!
City /"/'bL9 n ZIP ? �1- 7 c'
Phone # () River Basin
Adj. Wtr. Body r (// [ r F K c nat :/� man /unkn�
Closest Maj. Wtr. Body el
Type of Project/ Activity ec ; ai!! r/ 15- Alt f1n-, �•c . r1{i, rI I , 7yr v r • � i
i'f it.� a lrc�1 /t C� 3 yNPGI�lr ! d , (Scale: A%cN F )
Pier (dock) length r
Platforms) L i '." ; � ---- -- —' -- - -
1 T I
Finger pier(s) I i
�iacx k >
Groin length
I
number
Bulkhead/ Riprap length I _
avg distance offshore
max distance offshore
I I I i � I
Basin, channel
cubic yards
Boat ramp
Boathouse/ B'oslift
ly'ror
Beach Bulldozing
Other
Shoreline Length
7
•F L+-
SAM not sure yes
no
i
I
--
ii
Sandbags: not sure yes
Moratorium: n/a yes
no
no
Photos: yes
h o
1'
17
'AA
r—
_
t
` _
L t'
—L
I--
J Af
�
I y_0
—
-
Waiver Attached: yes
no
A building e rmit ma be required
P Y 9
f
b '� r
r
Y r
back regardingRiver B in rules.
❑ See note on bas
Notes/ Special Conditions
i r N t f'Y1 ► f �r
-ll
b v C - ' • r
L
' .41" "N, n C Nw ( t!
1'1• e •,N
I
�Z. 1 /li ^-If tjt
/
(!
`` t
,1� U f
z ixn li.r
6�.
Agent or Applicant Printed Name
Signature Please read compliance
esstatement on back of permit
CA M �'/,
Application Fee(s) fCheck #
-P,ld,/;-'t'
Permit Officer's Signature
73 f3
P1]. t
Issuing Date
Expiration Date
r /
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, 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 E, 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 / 1-888ARCOAST
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

'UNITEDST/JTES
posT�csERvicE® POSTAL 1VIONFI' ORDER;5_eoo
SERIAL NUMBER .. .. ....... ........ ..... .. 000
O ^ YEAR. MONTH. DAY POST OFFICE. U.S. DOLLARS AND CENTS
6 rJ 0 6 � 0 6 2003-08-27 ::285570
AMONNTONE HUNDRED DOLLARS &: D0t
PAY TO 1- y'�R+pp t�
ADDRESS-
17OT7� ��:'Lil�lLY ISi F .��', .s. t.`E: f�l�:?:i_-
5ev�
FROM A? - _���.� CI FRK
OR/'� � //�� r
USED FOR 1 1LJ� Z\J TT
�
�.000OOB00 2e: a:.....___,.
0 6 10 2 7 0 6 2 0 6 n■
0

j�TJtL /AU�G2 5 2003
_i

ADJACENT RIPARIAN PROPERTY OWNER -rA ; EI' UNT
(FOR A PIER,UNCOVERED DOATAL,I ) Ll 2003
t hereby certify that I owe property adjacent t+a �,___�__':
e,rtt of
party l?evrarr}
v_
property located at.
(Lot, ® Mick.- and, etc.)
on 0"?lUdLIM 1 NC
('Waterbody) r I (Town sad/or County)
He has described to me, as sbown below, the development he Is proposing at that location.
and I have no objectioas to his proposal. I understand that a piertuncover•ed boat lift must be }es
sack at a tra601sseatsn of fllnteen I33'y from trey arts or riparian access unless wahrd by me.
# Aligi with to waive the setback requirement.
_ 149 with to waive that setback requirement.
DESCRIPTION AND/Ott DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
°A
41
r.
' �egnatu,e
�clephone Number
Prom or Type Name t

ADJACENT RIPARIAN PROPERTY OWNER sTATEMF.NT
(FOR A PIER/UNCOVERED BOAT LIFT ), 2 5 2003
t hereby certify that I own property adjacent t4
(NanEpe�_
)�_,° s
rty Owner
property locatird at _rl�' _ -
(l.ac, Block, R d, eton
c. "
(Watsrbody) (Town and/or County)
He has described to me. as sbown below, the development he is proposing at that location,
and I have no objections to his proposal. I understand that a pierlvwcovered boat lift must be :get
back at a minimum of fifteen (15') from my area of riparian access unless waived by me.
I do so wish to waive the setback requirement.
I jig wish to waive that setback requirement,
DESCRIPTION AND/OR DRAWING OF PROPOSEDDEVELOPMENT:
(To be filled in by individual proposing development)
'�)0-0 Fv s .e d-
Print or Ty a Name
urnber