32078_MIDSOUTH GOLD LLC_20030214

'CAMA / DREDGE & FILL (� �207
GENERAL PERMIT Previous per #
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
Rules attached.
Applicant Name
Address
City ----
Phone # (_ )_
Authorized Agent
Affected ❑ CW
AEC(s): ❑ OEA
❑ PWS:
ORW: yes / no
i [ fC
State ZIP
Fax # (`)
D-EW O PTA
❑ HHF ❑ IH
❑ FC:
PNA yes / no
Type of Project/ Activity
Pier (dock) length
Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing_
Other
Shoreline Length
SAM not sure yes
no
Sandbags: not sure yes
no
Moratorium: n/a yes
no
Photos: yes
no 1
Waiver Attached: yes
no 1
A building permit may be required by:
Notes/ Special Conditions
❑ ES ❑ PTS
❑ UBA ' " N/A
Crit. Hab. yes / no
Agent or Applicant Printed Name
i Signature ** Please,read compliance statement on back of permit"
Application Fee(s) Check #
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision
City - - ZIP_
Phone # ( ) _ River Basin
Adi. Wtr. Body_ -
Closest Mal. Wtr. Body- _
(Scale:
(nat /man /unkn�
See note on back regarding River Basin rules.
Permit Officer's Signature
Issuing Date
Local Planning Jurisdiction
Expiration Date
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, certifythat 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 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 / 1-888ARCOAST
Fax: [phone]
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)
Revised 10/05/01

2173
FOLEY & FOLEY CONTRACTORS, INC.
MATERIAL ACCOUNT
1810 OLD AIRPORT RD. PH. 252-636-2515
P.O. BOX 3482 �// 66-85/531
NEW BERN, NC 28564 DATE C/
TAY
O THEVDU U U
ORDER OF _ 1—� O- -- —- — --
DOLLARS U =a�
RBC
Cntura
RBC Centura Bank
• New Bern, N 28560 NP
FOR
1110000 2 L 7 31" i:0 5 3 L008 50i:0 3900 L 6 3 E 51"

C
02/03/03 16:12 FAX
Z01
T0: Tracey Wheeler (Canna)
Fax#: [phone]
Date: February 3, 2003
Page#: 3
From: Foley & Foley (Sandy)
Phone#: [phone]
Customer Work Sheet
1D a,, c� : P0,3 Sac s,
Customer Name: Mid South Golf Lie. Date: February 3, 2003
Mailing Address: 555 Board Creek Rd. New -Bern. -NC 28560
Job Address: Fairfield Barbour Phone: [phone]
Adjacent Property Owners
Left Side: Price Right Side: Weeks
Bulkhead Repair & Replace
Dock/Walkway
Platform end of dock
Boathouse
Boatlift/jet ski
Piling
Ramp/Jetty.
Dredge_
Rip Rap

02/03/03 16:12 FAX
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Py
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(Bulkhead/rip rap)
I hereby certify that I own property adjacent to a Sou7A r-v Fy E , _,s
(Name of Property Owner)
property located
(Lot, Block, Road, etc.)
on SPO,N 6 gazi in N � ,c? .a C°�oa� , N. C_
(Wa�body) (Town and/or County)
He has described to me as shown below, the development he is proposing at the
location, and, I have no objections to his proposal_
4;:�_
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(to beflUed in by indhftal proposing developmnt)
CItA c I-.
)` lo"0
f-
Foley & Foley Contractors, Inc. atu
Phone#:[phone]
Fax# [phone]
Print or Type Name
Telephone Number
Date
M
0

02/03/03 16:12 FAX
Z02
I
ADJAuENT RIPARIAN PROPERTV OWNER STATEN11ENT
(Bulkhead/rip rap)
1 hcrehy cc i ll (y lhnl I mvi► pfopcl ly adjacent lu /n ; J Sou th za
(Name of Property ( )wnei )
pic,rt) treated nl S1- 'o ik( r : IC l
illock. Roved. etc.)
Oil S rP
4 - C wrlr. in A) Svc? N c
(Water bod.l') ('Town and/or County) —�
I
f
Ile has described to me as Shown below, the development he is proposing al Illy
location, and, l hnvc no ohjcclinna to his prolwsnl.
DESC'RIP1116N AND/OR DRAWING* OF PROPOSED DEVELOPMENT
(to befilled In by individual proposl►IM developmenr)
C7
h�-w 10%
Foley & Foley Contractors, Inc,
Phonelt: [phone]
Fax# [phone]
?
c, Mi- I
-/.
1 t ` I� l�r, •I
... X
Signature
F
Print or Type Narm-
`SZ �e 30 _4& 22,
Telephone Numhe►
Date