34020_NORTH SHORE PARK_20030604

j�CAMA/ ❑ DREDGE & FILL
GENERAL PERMIT
Previous permit #
❑New ❑Modification 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 C 7 4 2 u co
�pp
0 Rules attached.
Applicant Name ky tt(,, /46 , I/w JtU• k t�c (/fvd- ) b tHJ Project Location: County /'c , 4ri
Address M - 8 ( P ',.I V , vE Street Address/ State Road/ Lot #(s)
City U- n F. State 14
Phone # ? ? 2 - j tl< Fax # (� )
Authorized Agent t // i /
❑ Cw
© EW i ] PTA
Affected
AEC(s}:
IDOEA
ElHHF ElIH
❑ PWs:
❑ FC:
ORW:
yes / no
PNA yes / no
Zip 2 3529
❑ ES ❑ PTS
❑ UBA ❑ N/A
Crit. Hab. yes / no
Subdivision
City / 6,h, FFpc.L. zip ? .S/
Phone # ( ) ff River Basin
Adj. Wtr. Body FL;iV r !+ U t1 [1 (nat; /man /unkn)
Closest Maj. Wtr. Body 6JorV E ./cur j
Type of Project/ Activity
(Scale: Ah-A.)E )
Pier (dock) length
Platform(s)
—
} —
—...—
—_
.ram_
-_
_—
_.
i—
�.._._
j
Finger pier(s)
F.J,A
Groin length
number
I
�
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
i
Basin, channel
Ld
i
cubic yards
Y
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing►r
jz�,
Other
A
-^
i
u 4
114111.
Shoreline Length
SAV: not sure yes no
Sandbags: not sure yes 119
—
—
Moratorium: n/a yes
Photos: yes�o
Waiver Attached: yes �ia
r7
A building permit may be required by:
tt
/' 41o,t �c 1�U f l
❑ See note on back regarding River Basin rules.
Notes/ Special Conditions
W t.+ -6 k r CIO, w 4� .
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0 NC -,kilt to,
TIP at,
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Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit
0ir-C-o0
Application Fee(s) Check #
Permit Officer's Signature
4 c3
Issuing Date
Expiration Date
Agto"fie tgvtL
5s�glV
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, certifythatthis 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
Mailing Address:
1638 Mail Service Center
Raleigh, NC 27699-1638
Location:
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293 / 1-888-4RCOAST
Fax: [phone]
Elizabeth City District
1367 U.S. 17 South
Elizabeth City, NC 27909
252-264-3901
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

ERIC B. ELLIS NCDL 65047
JASA M. ELLIS PH [phone]
205 NOTfINGHAM DR.
MOREHEAD CITY, NC 28557
2456
66-30/531
Date W133
Pay to 1 I
Order
.11
FIRST CITIZENS -
Trust 1' flank &Trust Company
1067,66
Iollars �,w•m��
First-Qnzons
IKJ'H—I-r j� Atlantw Boach. N.C. 28512
Foils #� Sgo 2 U M . Abg m k P �-�--�p-
1:0531003001:00131744878011' 02456
-"I�1.G—�-"—>z� GUAROIANW SAFETY BLUE ESBL
OdarNe Amemm�

Eric Ellis
DOCKS vSEAWALLS * BOAT LIFTS
CONSTRUCTION & REPAIRS
TELEPHONE: [phone]
205 Nottingham Lane Morehead City, NC 28557
L✓ I � /'� � GC O �
Capps Printing, Morehead City

/KIFvr ,✓ TorjcA.soA)
Blue =existing mobile home
Brown = existing pier
Green = yard
Red = Proposed boat lift
j
11XIE6"-f4
C

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/UNCOVERED BOAT LIFT)
-T-
I hereby certify 'that I own property adjacent to is
(Name of Property Owner)
property located at ��� /I��I .���rr
(Lot, Block, Road, etc.)
on � inT���'�+`�FiiC�
(Waterbody) , N.C.
(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. I understand that a pier/uncovered boat lift
must be set back a minimum distance of fifteen feet (15') from my area of riparian access unless
waived by me.
I do not wish to waive the setback requirement.
I do wish to waive that setback requirement.
V-------------------------------------------------------------------------------------------------------
------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
5 « 4 77A C0k4v110 G -- e-K u-18 t7 1
gnature
�►4 nit S � C� i4- (�('/C' � T�
Print or Type Name
_12-3 6 �—S'?dS
Telephone Number
Date: G, --Z,/ -43

It - c �5)</--/1a /i 1
Blue =existing mobile home
Brown = existing pier
Green = yard
Red = Proposed boat lift

A 11pr 30 03 12:15p p.1
q?H-2y-2UUS TUB. U8:: I An K5 SANK MA NU, l9MZ i4DUyl F. Ul
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERI UNCOVERED BOAT LIFT)
I hereby certify 'that I own property adjacent to 'eop- Ja��F,s
(Name of Property Ownear)
property located at _I"'_6-i I,-
(Lot, Block,, jRoa/d, etc.)
on Joau i' �ec n N�! in f��/,fw1 _I'c N.C.
(Waterbody) (Town and/or Couiaty)
He has described to me, as shown below, the development he is proposing at that
location, and, I have no objections to his proposal. I understand that a picr/uncovere:d boat lift
must be set back a minimum distance of fifteen feet (15') from my area of riparian access unless
waived by me.
I do not wish to waive tie setback requirement.
I do wish to waive that setback requirement.
------ ------------------------------------------
DESCR]FnON AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual privposing development)
5 d•E /� 7''%!� �� D2Aly/� O E><N /l3 l7 l
Signature
Print or Type Name
1'/�s-
Telephone Number
Date: 4Z

A
ADJACENT RIPARIAN PROPERTY OWNER STA
(FOR A PIER/UNCOVERED BOAT LM-)
I hereby certify 'that I own property adjacent to eow �a F1— is
(N e of P6perty Owner)
property located at
(Lot, Block, ,R�/oad, etc.)
on v d m�'� ':� , N. C.
aterbody) (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. I understand that a pier/uncovered boat lift
must be set back a minimum distance of fifteen feet (15') from my area of riparian access unless
waived by me.
I do not wish to waive the setback requirement.
/y I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
Signature
6Ar-y' i It"'14
Print or ype Name
'131 33 s6S"2
Telephone Number
Date: 6 �.Z f p?