33654_MINNIS, DON_20030311

11 LAMA / ❑ DREDGE & FILL
GENERAL PERMIT
❑New -Modification f-.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 ')y n P� r r, r r f
Address
City i,- r State---_-- ZIP —
Phone # ( ��) i�{�/ -J�� Fax #
Authorized Agent 'At. jjia
Affected CW 2 EW PTA E ES PTS
AEC(s): OEA ❑ HHF ; IH ❑ UBA _l N/A
❑ PWS: -1FC:
ORW: yes / no PNA yes / no Crit. Hab. yes / no
Previo s permit #
Date previous permit issued
attached.
Project Location: County r e r f r,,, l
Street Address/ State Road/ Lot #(s)
Subdivision
City- 9-!!r N� /.rL ZIP
Phone # ( ) _ River Basin
Adj. Wtr. Body M d, h ro g r 1* ra N,* r (nat /Chap' /unkn)
Closest Maj. Wtr. Body__ off Icv r-r i
Type of Project/ Activity I c c t i w erl re f
c. L. (Scale: i✓ ) ( �Jc
Pier (dock) length
Platforms)____
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards 1�LL
Boat ramp - - — I— -, -
i
I
Boathouse/ Boatlifttv Adx -
Beach Bulldozing
Other
Shoreline Length _ �S
-�
�
-ram
' , �
O
' g r �'
J +3
{i
SAV: not sure
yes
Sandbags: not sure
rr�
yes tl3p
r ,.i
1r�a r �,r l<r-
Moratorium: n/a
yes no
{
-
f
r
• - }�1 Lr
Photos:
yes no
j
!' i ! U_
AIL
Waiver Attached:
yes no
----
-
A building permit may be required by: A410r+r
5far L
C See note on back regarding River Basin rules.
Notes/ Special Conditions
Wf 6 1 ✓f 1 t. � ! t j
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Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit*
Application Fee(s) Check #
4J (ram
Permit Officer's Signature
Issuing Date Expiration Date
1 floa-- , tw"Ir/ 3(.3(`/ 11/5
Local Planning Jurisdiction 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 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 / 1-888-4RCOAST
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)
www.nccoastaimanagement.net
Revised 10/05/01

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• ••� �. -vrvc ranch yr INC IJUGUMENI CHANGES COLOR GRADUALLY AND EVENLY FROM DARK TO LIGHT WITH DARKER AREAS BOTH TOP AND BOTTOM
NOT VALID OVER $1,000.00 ISSUING BRANCH .61.6.9 2 0 5 3
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DATE :- :F; :I. i 93-541/920
PAY TO THE �+4 f
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ORDER OF _ :I.
BB&T
UFIAWFR. TRAVELERS EXPRESS COMPANY, INC.
PO BOX 9476. MINNEAPOLIS. MN 55480
DRAWEE. FIRST INTERSTATE BANK, HELENA. MT
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DOLLARS BY SIGNING YOU AGREE TO THE SERVICE CHARGE
��' V�/� AND OTHER TERMS ON THE REVERSE SIDE.
T� �URrHASE f-JAIfr r DRAWER
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CITY &STATE (?S9 +•••�
111616920S3ii, 1:0920054111:01?07104S1092111
THIS (XKU&IEN'F HAS AN AR'I-IFICIAL WATERMARK PRIN"FED ON THE BACK. THE; FRO %I (,I: "HIE DOCUMENT HAS A MICRO- RINT SIGNATURE LINE AND BORDER. ABSENCE OF nw-s . FEAIURES WILT. INDICATE A COPY. ■
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FACSIMILE TRANWITTAL
STN CUSHION COMPANY
3 INDUSTRIAL BLVD.
P.O. BOX 2510
THOMASVILLE, N.C- 27361
PHONE [phone]U
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