34515_LIVINGSTON, JAY_20030630

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QCAIVIA / 11 DREDGE & FILL
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GENERAL PERMIT Previous permit #
ZINew ElModification 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
[71 Rules attached.
Applicant Name -J ci-/-1V,,,)a
Address—i
City 1 1 1"ej C State ZIP 1
Phone # Fax #
Authorized Agent �-J rhilk., S
-(, r�a e
Affected El CW i�EW ffrPTA D ES El PTS
AEC(s): El OEA El HHF El IH Ll USA L1 N/A
D PWS: OFC:
ORW: yes / no; PNA yes / no Crit. Hab. yes no
Project Location: County ( , - ( \,r! �
Street Address/ State Road/ Lot #(s)
Subdivision
72 ZIP
City
Phone# River Basin �Jeu S "I
Adj. Wtr. Body N 1,/c 6�a /man Junkn)
Closest Maj. Wtr. Body
Type of Project/ Activity 4-c- i e-- ! 1 /7
C (Scale:
Pier (dock) length
Platform(s)_
Finger pier(s)_
Groin length
number
Bulkhead/ Rip
avg dista
max dirt
Basin, channel
cubic ya
Boat ramp _
Gentheuse/ B4
10"
Beach Bulldog
Other
Shoreline Len
SAM n(
Sandbags: n(
Moratorium:
Photos:
Waiver Atta&
A building permit may be required by: I CkJC0 60
Notes/ Special Conditions CI-( 1- Cie-4 Cfrlvcn rL) -14)sa. f-r-
Agent or icant Printed Name
Signature ** Plea,94 read compliance statement on back of permit
/M ni I�L- I ) 3L
Application Fee(s) f Check#
2 See note on back regarding River Basin rules.
Re6nit Officer's Signatu&
? r Z, ( 1"I& jL, 'S 2 p 2c rg,
Issuing Date- Expirati6n Date
r, TaJ en On frq ?n /-Y/-)
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, certifythatthis project is consistentwith the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
❑ Tar- Pamlico River Basin Buffer Rules ❑ 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

1136
PARTNERSNC. PH. 252-637-0381 / _i�__ o
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NEW BERN, NC 28564 3141
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I hereby certify that I own property adjacent to cJ-ir\
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(lot, block, road, etc.)
on T✓�C�� / r �._ in h/� i fries & L' N.C.
(water body) (town and/or county)
He has described to me as shown below the development he is
proposing at that location and I ha-ve no objections to l:is
proposal. I understand that this pier, bulkhead,) aroin structure
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mast be set back a minimum distaar-e of 15 feet from my area of
riparian access unless waived by me. I do,
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Description and/or drawing clf proposed development: (to be
filled in by individual proposing development)
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