42764_PETERS, ROMAINE_20050831

❑ C.AMA / ❑ DREDGE & FILL1� GD�P�P�z'z+--
GENERAL PERMIT viouspermit #
❑New ❑Modification '-]Complete Reissue ❑Partial Reissue ate 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 %1GL f ? I .1� i; C Project Location: County
Address ) y 1706 u)ej,4 k3&4�, J /)+ , Street Address/ State Road/ Lot #(s)
City State_ ZIP ;- 7g q
Phone # J'7`,) Fax # ( ) Subdivision
Authorized Agent k:.DIP1-1i'P j,y� � b City / l %�+j ll ; �� ctL. ZIP
Affected ElCw ❑EW .PTA El ES ElPTS Phone i, } ,�L> �'/ >� River Basin
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A Adj. od man kn
❑ PWS: ❑FC: q
ORW: yes / no PNA yes / no; Crit. Hab. yes / no Closest Maj. Wtr. Body
Type of Project/ Activity
Pier (dock) length 1, �- r
Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/'Boattl'A 12 ,X /
Beach Bulldozing
Other
Shoreline Length 7
SAM not sure
yes
dn$
Sandbags: not sure
yes
Co'
Moratorium: n/a
yes
6.
Photos:
yes
C9
Waiver Attached:
yes
Co
A building permit may be required by:
Notes/ Special Conditions
, I \
(-. J:�*
Agent or A`Ol5licark Pry ted ame
Signature P ase reagYompliance statement on back of permit"
Application Fee(s) Check #
(Scale: /k, j )
❑ See note on back regarding River Basin rules.
i
Permit Officer's Signature
�l I/.3D-o.5
Issuing Date Expiration Date
l'7EalTIGe�
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 I J Other:
L] Neuse River Basin Buffer Rules
If indicated on front of permit, your project is subject to the Environmenzal 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 (910-796-7215) for more information on how to comply with these buffer 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
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
400 Commerce Ave
Morehead City, NC 28557
202-808-2808/ 1-888-4RCOAST
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
910-796-7215
Fax: [phone]
(Serves: Brunswick, New Hanover,
Orslow -below New River Inlet- and
Pender Counties)
Revised 06/29/05

/��.'��•`� k�l_t'f�1 �'� �t fir. �1 I Y
. rFOR A PIERIUNCOVERED BOAT I}t,r:
I hereby cetLify that I own properry adjacent to
�j �/ {tiJ�n..ae;of );'ro�ierty O«nci-)
proPe1 LY located at I i.jf'1(� ._.tG' ZLI—AV95
(Lat, Bfxk, Road, etc.
on 0.1nadj , in I G
(Town aadiorlCro atyl
He has desc ibed to me, as shown below, thevr
de-
.�,oS�rfient he� is pr,o.posTn ac �[-:at
1oG3tion, and, r have no objections to Isis proposa_[. I undetsrwd rh.ar. a pier/uncovered boat Lift
trust be set4back a minimum distance ai rxft n feet (I5') tTom MY Sar a --of NpAriaxl acce: s ut i ss
waived by me. --
I d-Q oot wish to waive ,the sciback requireme;Tt,
I do wish to waive that 5etback requirement.
DES CR-7710N ,&N-DIOR DRA WT,, G OF ,PRO POS EXY DEV ELOPXI 'vT
('To be JtUerl in by irzdivuiu<zl �r�Cstng ciaGE'l +pmenr)
, I
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -----_ +----___--..._
Sigriarure
Print or Tye-, N,,,rne
Telephone NUTTT[ jr
Date:
Fax from 08/08/05 11:98 Pg: 1

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0�l�r�_.
(FOR A P1,6RILWCOVERED 80AT IJIT
k-; •�i(:y � I hereby cer r r awn property .y j t oPUP-
prn-perty Iti'y chat1 �%' O.� [��4aii t,�,locatedat___ __1-1 / i T
r > (Lot, Blor-k, Road, etc.)
on AJA
y) l j� (Tawm andioriCoumt•y) n
He has desc-ibcd to me, as shown below, ttte devaloprricnt he i., p.ro,posulg_ at tf , t
location, arrd, I have no obj(�Ccions to his proaosa.l I untie t� d it
9v95
_rs n l.at 3 p: (PI /lanCove MC bclat llrt
must be set,back a minjmum distant- yr title° t fit (IS') ri-Om MY
urea ar` fiFatian ace^ss Stnl��s
j .vaived by me.
110 trot wish to waive.the setback rejuircment.
_ I do wish to waive that setback requitement.
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Print or Typ� Nlivilo
T�icphotle
Datc:
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