33132_MALINOWSKI, CHARTER_20030113

C'CAMA/ El DREDGE & FILL � o c 1 + —c
GENERAL PERMIT Previous permit #
❑New ❑Modification ❑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 r "7' 1. d `1 G0
Rules attached.
Applicant Name I'a (A 1- nt W
Address
City '' n Vi'I tt k State h), ZIP �." c
Phone # (.."'SZ) IN11 13r,`M Fax # (i)
Authorized Agent c; e, N r ra i k' ki
Affected ❑ CW ❑ EW ❑ PTA El ES ❑ PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ USA ❑ N/A
❑ PWS: ❑ FC:
ORW: yes / no PNA yes /.no Crit. Hab. yes / no
Project Location: County (.eA vat',
Street Address/ State Road/ Lot #(s)
l r i $ '/
Subdivision `)A Trp k-A 1/ r 1 fif-C
City 14,.ti cfte ZIP
Phone # ( ) River Basin
Adj. Wtr. Body A oAAA / ?,, fir F !c at t/man /unkn)
Closest Maj. Wtr. Body A�"Vz 660,
Type of Project/ Activity o fdr - 0 MF L, Ttfe f l i G ?
(Scale: NC wE )
Pier (dock) length
Platform(s) --�—� — ------�,_.._ —
I i i
Finger piers)
Groin length '
I
number I -
Bulkhead/ Riprap length + 1
avg distance offshore a .--- e-o�—
max distance offshore J—.L. _. __
Basin, channel
cubic yards j
Boat ramp
t6 k
i I I 4 1 i
Boathouse/ Boatlift
Beach Bulldozing N Fpt r— w
-- — - -
Other , iJ
I -
Shoreline Length ' !=
SAV: not sure yes no
Sandbags: not sure yes no Ei
Moratorium: n/a yes qo
Photos: yes
Waiver Attached: yes Fle
A building permit may be required by: (,tA, rYft f0. L El See note on back regarding River Basin rules.
Notes/ Special Conditions ) Qtc + �}�tr . I ►1� c�n at nn l aft+^ 6 j aG 1LV I'i �k+ A -I -wt Jub r410 ill. Pcr It
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tie tfort is
7
Agent or Applicant Printed Name Permit Officer's Signature
i as
3
Signature Please read compliance statement on back of permit Issuing Date Expiration Date
(rap,F� 4, Ji,1f0/7$
ApplicationFee(s) Check# Local PlanningJurisdiction Rover File Name
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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:
J 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 / 1-888-41RCOAST
Fax: [phone]
Fax: [phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Morehead City District
151-13 Hwy. 24
Hestron Plaza 11
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

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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIUNCO
VEREi3 BOAT IdFD
I hereby certify, that I o property vsm P adjacent toIS
/ate✓. ,, '/JA /f
property lO
ocateUI at "� e
(Name of propY wner)
(Lot,, Block, Road, etro)
on
t'�'4'a�dy) �'"� ��
N.C.
(Town ands,UF a,a�►j
He h>� d�k�� to me, as shown below,
location; and, -I. have no objections ' the dvvelog�a ,,,, he is proposing at that
)edistan to his proposal. I understa � t a P1ex./uncover boat Iift
must beset back a z�nimum distance of fifteen feet (15') from ��y Of'riparian waived by me. Pariah access unless
I 4 t wish to waive the setback require,ne L
I J99 wish to waive that setback requiremera,
i--ts-
DE.SC JON &PIWOR DRAWING OF PROPQy;� I)L,"V
(To be filled in by ind Mu& pro
Fosassg d'a e�,,��P�T .
Si5 h�uv-�
Signature
Print or tn►pe Name
Telephone Number
Data: /G' — / . �