33920_MULLINS, SAMUEL & LAURIA_20030403

•� CAMA / - DREDGE & FILL
GENERAL PERMIT Previous permit #
I -_New -Modification-iComplete 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 , rrli,, L c,< ire / I
Address
City rx )nd c) P State fJC_ ZIP . i �T/o
Phone # (' ') ', t i_ Fax # ( )
Authorized Agent
Affected CW DEW PTA ❑ ES ❑ PTS
AEC(s): OEA ❑ HHF D IH ❑ Ill ❑ N/A
❑ PWS: ❑FC:
ORW: yes / no '' PNA yes / no Crit. Hab. yes / no
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision
City __ ZIP
Phone # (�) - River Basin
Adi. Wtr. Body ! )' _t_� ,>..-. !!, % <" gnat- man /unkn)
Closest Mal. Wtr. Body N��,c �; : t. .
Type of Project/ Activity
IJ irt)L- (Scale: 9J )
Pier (dock) length
Platf
Fing
Groin
Bulk
Basir
Boat
Boat
Bea(
Otht
Shor
SAV:
Sanc
Mor.
Phoi
Wah
er
rm(s)—
pier(s)
length
I
I
,
number
lead/ Riprap length
avg distance offshore
max distance offshore_
i
CF-77
T
1
'
1
(
_
S
f
j
I
,channel
j
�-
I
cubic yards
ramp
louse/ Boatlift
x
i Bulldozing
r— —
-
dine Length not sure yes no
nags: not sure yes no
torium: n/a yes no
�s: yes no
er Attached: ves no
I
-
—�;
-
. _
-
_
I
A building permit may be required by:
Notes/ Special Conditions '-V
Agent or Applicant Print Name
Sign re'� Please read cofnpliance statement on back of permit*
Application Fee(s) Check #
ff See note on back regarding
yRiver Basin rules.
1 �
i
-Permit Officer's Sigil
Issuing Date n f i Expiration Date
Local Planning jurisdiction Rover File Name
L

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:
[vj'�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:
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
151-13 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.nccoastalmanagement.net
Revised 10/05/01

SaNuel y ,mullifts 66-30/531 1795
,Caura Y MulliHs 471
327 901411d 1d 252 ;249-0702
Arapahoe, r1VG'28510 DATE _ -
PAYTOTHE
ORDER OF
�•SG'lLC'lJ-- - -./C�-C�_—_ — - _ DOLLARS
Look for: Micro Print signature line, gray type and linework, First Citizens Bank logo on back. if not present, do not cash.
FIRST CITIZENS 477 C]?j°PSG
BANKFirst -Citizens Bank & Trust Company
Bayboro, N.C. 28515 �
FOR
1:0531003001:004717St. M65i1' O17 5

ADJACENT RIPARIAN PROPERTY OWNTR /STATEMENT
I hereby certify that I own property adjacent to ^o-l�ii�/ 's
(,N'ame of Property Owner)
property located at 4a S vZ 7 D led
r ,
r (Lot, Block, Road, etc.)
on �VAgvsoti �/�—i.� 1( , in &iLc_ a , N.C.
(Waterbody) (Town and/or County)
He has described to me as shown below, the development he is proposing at that location,
and, I have no objections to his proposal.
Rlf P U,,Jeg Poch -j- /,.57' aw. foc,4 Spock
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development)
�t ,moo
( -
v bc.w...
�< L'C7(
Print r Type Name
3 7-
7) 2--
Telephone NUM er
Date:D4—
-29-

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
T
I hereby certify that I own property adjacent to M e lle-�-r 's
(Name of Property Owner)
property located at/-d
3 a7 gdlrid R. A"�
(Lot, Block, Road, etc
k%. Il/4-- '-�--�'Tx,
on 30� ` iQ�-TIC , in PfIr1 I ��GO N.C.
(Waterbody) t T own and/or County)
He has described to me as shown below, the development he is proposing at that location,
and, I have no objections to his proposal.
DESCRIPTION ANTD/OR DRA` VING- OF PROPOSED DEVELOPi1IENT
(To be filled in by individual proposing deti,elopment)
d
a
rn
Signature V
Print or Type Name
Telephone Number
Date: - — a 9 ®� —
—29—