40306_PIGFORD, TURNER_20041026 (2)

-ZA,MA / DREDGE & FILL
GENERAL PERMIT
❑New El Modification [-]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 I SA NCAC
Previous permit #
Date previous permit issued
-.J Rules attached.
Applicant Name ' Project Location: County
14
f;
Address_ -�' ` ` Street Address/ State Road/ Lot #(s)
City
7j( T"1._
State ZIP '
Phone # ( )
Fax # (_) r
Subdivision
Authorized Agent
City ZIP
Affected - CW
C EW - PTA _ ES _ PTS
Phone # ( ) River Basin
AEC s : -OEA
-HHF IH UBA N/A
Ad'. Wtr. Body—,nat
man unkn
ORW: yes / no
PNA 0 / no Crit. Hab, yes / no
Closest Maj. Wtr. Body
I 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/.$oatlift
Beach Bulldozing
Other
Shoreline Length
r
SAV. not sure yes
no
Sandbags: not sure yes
no
Moratorium: n/a yes
no
Photos: yes
no
Waiver Attached: yes
no
A building permit may be required by: _
Notes/ Special Conditions
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Agent or Applicant` Printed Name
Signature Please read compliance statement on back of permit **
Application Fee(s) Check #
(Scale: )
jiffs '' do�
J'L
-5ee note on back regarding River Basin rules.
Permit Officer's Signature
Issuing Date Expiration Date
i jrIR
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:
J Tar - amlico River Basin Buffer Rules ] Other:
,�..-i- 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
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 Citv 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
15 I -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

TURNER C. PIGFORD
BEVERLY B. PIGFORD
NCDL 7749721 NCDL 7724074
2061 DOVE LANE PH 919-550-2493
CLAWON, NC 27520
Pay to the
Order of _
WACHOVIA
Wachovia Bank, N.A.
ACH R/TM:lFor-'�c��%
I:053000 2 191: 10 144 2637330611' 7054
7054
66-21/530
BRANCH 44734
Date
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ADJACENT RLPARLAN PROPERTY OWNER STATENLEl"i-f
(FOR A PIER/MOORING PILINGSIBOATLIFTIBOATHOCSE)
I hereby certify that I own property adjacent to :7�;rAer f, ti fy r d s
(Name of Property Omer)
property located at ko 21 �ivmr, rsn s Gre4 It ✓lam( .
(Lot. Block, Road, etc_)
on ejfti ti5 Cfee- /c ,in ftre t N.C.
(Waterbody) (Town and/or County)
He has described to me, as shown below, the deve?opme:,t he is proposi-V= a_ that location,
and, I have no objections to his proposal. I 'unde=.id. tha_ a pie;/mooring
pUk,,gs;boatlirt/boathouse must be set back a minimum distance of f i-Lee i f=, (i 5') from my arca
of ripa-ian access unless waived by me.
I do nnt wish to the setback requiremeIIt_
I sIn_ wish to waive t :at setback requirement.
DESCRIPTION AND/OR DRAWLNG OF PROPOSED DEVELOP`fEtiiT:
(To be filled fn by individual proposing development)
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -------- ------
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Siang ure
Print or Typz Name
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Te!ephone Numbe-

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ADJACENT REPARL-,N PROPERTY OWINER STATEMENT
(FOR A PIER/MOORING PILINGSIBOATLIFTIROATHOCSE)
I hereby certdfy that I own property adjacent to %UP/Je r- // 9 ��ei s
(Name of Property Omer)
prope,7 located at L o f 2 7 Gy n" ^',' /1S
(Lot. Block, Road, etc.)
on c�wirv� r'rt S ��-C e &< , in C a � •e I-e- f , N.C.
(Waterbody) (Town and/or County)
He has descroed to me, as s<<own below, the development he is propos:-= a_ G`at location,
and, I have no objections to his proposal. I unde:s=d tl'.a7 a pier,'moorna
pilings; aoadiftJboathouse must be se: back a minimum distance of riiZtn f�t: (i >) f,om my area
of ripalian access unless waived by me.
I dQ nnt wish to wa,,-e the setback requirement.
I �Lo wish to wa.i,ve t�.at setback requirement.
DESCRIPTION A.N-D/OR DRAWr G OF PROPOSED DEVELOP`fE`T:
(To be filled in by individual proposing development)
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Signature
Cyr V IL
P: int or Type Name
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Te?eonone Numbe:

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