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ENERAL PERMIT
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evious permit #
DNew '_1Modification 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
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ED Rules attached.
Applicant Name i3�7��iF �/
/
Project Location: County TE
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Address 6 /7G}L yS ___--
Street Address/ State Road/ Lot #(s)
City 7�,/tl ti'y/C f�fit.t� State ZIP
Phone # (-'�'�)�y ;/" ��1,,7, Fax # (_ )
Subdivision
Authorized Agent
City ' f�,u 5 ZIP
-1CW ❑ EW q PTA ES I PTS
Phone # (Z`) -) 7' :� z/ ry River Basin 4L
Affected
OEA El HHF El IH UBA N/A
❑ AECs:
Adj. Wtr. Body � (nat lman lunkn )
C. PWS: I I FC:
Closest Maj. Wtr. Body
ORW: yes / no PNA yes / no Crit. Hab.
yes / no
i
Type of Project/ Activity -
Ll
Pier (dock) length
Platforms)_____
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore_
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
(Scale:
1 J�}flGv'
Shoreline Length ( f
SAM not sure yes no
Sandbags: not sure yes no
Moratorium: n/a yes bo
Photos: yes tlo'
WaiverAttached: yes ;no' - -- ------
A building permit may be required by: ��/Z�%� 7 (/;,o • See note on back regarding River Basin rules.
Notes/ Special Conditions O "G ' C L 6/ t ✓/ : j i
I fir:
J f ' •Y _ / � t � �7
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Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit
Permit Officer's Signature
7 _...
Issuing Date
Expiration Date
L070-7i!D /1�
Rover File Name
Application Fee(s)
Check# Local Planning Jurisdiction

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 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: Fax: [phone]
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293 / 1-888ARCOAST
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

ADJACENT RIPARIAN PROPERTY OWNER STIt NT
(FOR A PIERAVOORING PILINGSIBOATLIFTIBOATHOI ) G.
I hereby certify that I own property adjacent to
/ (Name of Propertv Owne
property located at YZ' C) ( )
(Lot, Block, Road, etc.)
on�,�1.1 Y , in C't O�Y�JZ. 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. I understand that a pier/mooring
pilings/boatlift/boathouse 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 d4 wish to waive that setback requirement.
DESCRIPTION AND/OR DRANVPNG OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
AA
y},Vrv'r�
JUL 0 5 2005
Morehead City DCM
S f�nat
A'Aeo"'
M-2J16(--JS-
Print or Type Name
Telephone Number
Date: if

To
CBRTIFIED MAILTM RECEIPT
(Domeffic Mail Only; No Insurance Coverage Provided)
7
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Postage
$ /'�
-
M
p Certified Fee
$2.30
06.89
ED Return Reciept Fee
(Endorsement Required)
116 Postmark
Here
$1.?5
C73 Restricted Delivery Fee
-0 (Endorsement Required) $f1,11Q
ri
Total Postage & Fees $ $¢, ¢i 06110/2005
O Sent To R ' OF —I O�
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17, SYreet, Apt. No.; ---------- ---� � -��� ----
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or PO Box No. 7(�(j A /c L %¢1 v lv
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PS
3800, June 2002

Morehead City OCIV,

[�Secueify e 7 Ced d <t f See Gack: — delaifs. []
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FIKE-RAMSEY ENTERPRISES, INC.
PH(252)247-2455
P.O.. BOX 895 ss-3o/53 t
ATLANTIC BEACH, NC 28512 DATEl 133
PAY 1
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FYRST CITIZENS M
'�,�^7u Fti-tiitiz . Ba N.C.&Trust Company
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Atlant c Boach .28512
www.firstcitizens.com
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