36660_KOEZOT, RYAN_20031208

::1CAMA / Ll DREDGE & FILL
GENERAL PERMIT
-New II]Modification L '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 I SA NC/
,1
Previous permit #
Date previous permit issued
�9N.1�o0
/ n W Rules attached.
Applicant Name (gold V,, 7 iYl . (01 rL tl Project Location: County "i r 4t, e 4
Address ! I I C 1.� �u r+�� fs<vr /� t r� i �c y Street Address/ State Road/ Lot #(s)
City %�i�an J r Tva{� State Nr ZIP 2'2QZ- 0d,a(40-
Phone # Fax # ( ) Subdivision /I, 1r,
Authorized Agent City I filar ?�� L rJar( ZIP t /L
C CW [I EW P7 PTA ❑ ES ❑ PTS Phone # ( ) River Basin t^/lrt i � `a i(
Affected f J OEA ❑ HHF [IIH ❑ UBA ❑ N/A
AEC(s): Adj. Wtr. Body Ma rr ! lr r i (nat Can /unknn
❑ PWS: ❑FC:
ORW: yes / no PNA yes / no Crit. Hab. yes / no
Closest Maj. Wtr. Body_ ,''v F LIC'V c
Type of Project/ Activity
(Scale:
Pier (dock) length
Platforms)
Finger pier(s)
Groin length
number
Bulkhead/ Nprap length_
avg distance offshore
max distance offshore
Basin, channel
Itr�rrvFi, l,wu_ f,
c�
cubic yards
Boat ramp r : � e . L L. j _ (..
Boathouse/B'oatlift 41-_--_---
�� iyt j t
I`
--- is d1 �• t^
Beach Bulldozing
Other �i�i u ` (��ti'�{/ C-A►vt sf lrfj, rF(I l� �2i ic•
Shoreline Length %',
SAM not sure yes Rio
Sandbags: not sure yes no
Moratorium: n/a yes no
Photos: yes �J
Waiver Attached: yes nog
A building permit may be required by: -ei rL
Notes/ Special Conditions fit b r! . t �•
(j
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
_- See note on back regarding River Basin rules.
r
Permit Officer's Signature
Issuing Date 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, 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 / 1-888ARCOAST
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
151-13 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.nccoastaimanagement.net
Revised 10/05/01

YMUD BUCKET DREDGING, INC-
ATLANTIC BEACH CALIS 6 2 91NCDL 8039839
po BOX 3355 PH(252)
ATLANTIC BEACH, NC 211512
Pay to the
(lrr1t'.1- of_
(�1R5T CI
Ti7,CNS 133
�n1„ FIrst GnizonsR NC820512 ompany
Ir/1 Allanbc©oath.
www.firstci izens.com
o-T 6?C26OU 3734
(v�o
3 66-30/S31
Date 133
Fore
L00 300i:00 13 L 2 1606 7 3i1
PYmrxr /Imemun
$ x"_.
_Dollars 8 °rt
1 ryp
0373►+ - -_
@:
GUARDIAMJ SAFETY BLUE WDBL

0
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own propert`.y adjacent to
` !' A%_/ 1<�c!,>C'Z-O F 222- 21?7-IA -s property
located at Ilf (-7 14TLAI,�TtC 496 (CAV5640AGj' on
(Lot, Block, Road, etc.)
AeC��s '�� biGt �L- i n A-rL 4,4 iiC 646�kie¢ ( N . C _
(Water Body) (Town ar d/or County) CSC 2__
He has described to me as indicate(. below the development
he is proposing at that location and i have no objections
to his proposal. I understand that a pier, pilings and
dredging must be set back a minumum aistance of fifteen feet
(1S') from my area of riparian access unless waived by me.
101
Date
I do not wish to waive that setback requirement_
I do wish to waive that setback requirement_
Description and/or drawing of proposed development:
(To be filled in by individual proposing development20
c
�-
ExNSTiNj Ir-,ARlA14 A9)C<AC),CY
w
ca
0
N 60 '3oA l
r N s T,A I-L A'r o N
--,gc-::,
300
O L? O 17 Q Q
oCk--L
Signature
Print Name
Phone Number
d
a
0
0
a

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
0
I hereby certify that I own property adjacent to
c
KC A,,./ k 222- �QZ(a s property
located at A-rLAgTIC 'SCA'M on
(Lot, Block, Road, etc_)
1*ex�
A0,e6�_5' �.�F' 1MIA in ATL4a %ic 6,cAc f N.0
(Water Body) (Town ar d/or County) Z-Ssl
He has described to me as indicate(. below the development
he is proposing at that location and 1 have no objections
to his proposal. I understand that apier, pilings and
dredging must be set back a minumum aI�stance of fifteen feet
(15') from my area of riparian access unless waived by me.
I do not wish to waive that setback requirement.
I do wish to waive that setback requirement.
Description and/or drawing of proposed development:
(To be filled in by individual proposing development
0
N
W --ZA L-t- Ar tar! OF t467W 90A i la F 1" &Yf ri 1 t/ CK)
Exq!;T1141 mARIAIA .T.<.n9,6_, v
w
0
N E'c) uoA i
lusT,au-aToN
0
&U I F it "ir
0
o 0 o L0 4 Q o
- T3c:,>A -,�:>oer-L
C•i
0
Soo"
a_
^ T
Signature _--{
Print Name
\ i Z::? • c'�3 - \Z
Date Phone Number

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
0
I hereby certify that I own propert'"y adjacent to
s property
located at �! AVAgTIC '864'Cti (0409C&A�l , on
(Lot, Block, Road, etc.)
'YVqUEi '5;aUA117
AeeE�� �'tgA�- in t�TLAa�T1rC ��%eff N.C_
(Water Body) (Town ar d/or County) ,VSC
He has described to me as indicatec. below the development
he is proposing at that location and I have no objections
to his proposal. I understand that a.pier, pilings and
dredging must be set back a minumum aistance of fifteen feet
(15') from my area of riparian access unless waived by me.
x
I do not wish to waive that setback requirement.
L� I do wish to waive that setback requirement.
Description and/or drawing of proposed development:
(To be filled in by individual proposing development.)
I&Sf A-rioa of ��+� 90A i L r - &Ytr jo l o
1 w
C-Ag5T-1NJ MA- RJ vA �a9 Y do
0
U
W
M
N �iJ 6flA i
rN ST,q u-aTr oN
o I� I1 1 1 7 O O R 7
e1
D
eG
z
Signature
Prir:t Name
/Z- 3 _ ds Z�t ;)--//i
Date Phoi,e Number