41191_REYNOLDS, SALLY_20050405

I_-1CAMA / ' DREDGE & FILL
GENERAL. PERMIT
Previous permit #
LiNew I 'Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued_
As authorized by the Stateof 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 ) I 'j j Project Location: County
Address �'" Street Address/ State Road/ Lot #(s)
City
Phone # ( )
Authorized Agent
Affected C, Cw
AEC(s): ❑ OEA
❑ PWS:
ORW: yes / no
State ZIP
Fax # ( )
n EW n PTA C ES 1 PTS
II HHF D IH F I UBA -I N/A
FC:
PNA yes / no Crit. Hab. yes / no
Type of Project/ Activity
Pier (dock) length
Platform(s) C
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 i
Shoreline Length
SAM 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
IN
.1 a; �" f\ t )r
ent or Applicant Printed Name
Signature Please read compliance statement on back of permit
Subdivision
4,1-9ic
City _ ZIP
Phone # O _ River Basin
Adj. Wtr. Body--- (nat /man /unkn)
Closest Maj. Wtr. Body
(Scale: )
l
1! * -1.
t
See note on back regarding River Basin rules.
Permit Officer's Signature
Issuing Date Expiration Date
ApplicationFee(s) Check# Local Plan ningJurisdiction
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 klasin Rules Applicable To Your Project:
�l Tar -Pamlico River Basin Buffer Rules Other:
F I 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

EMNT
ADJACENT RIpAMAN PROPERTY � OWNER � OUS
(FOR A PJFI�/1►fOOJt JNC
I hereby certify that t own property adjacent tn( artae of Pr ptNy oer)
property located at J (Uot, Block, Road, etc.)
_, in
on - _ (T�nzndlor Coonty) 1° :
( aterbody) s �
$in at that loaau
He has described to nx, as shown below, the development he is propo $ ''.
have no ob ections to his proposal. € understand that a piertmoori
and, i
6
1 ptltngs/boatl iflJboathouye must be set back a minimum distance of fitt�n %t (IS') from my
of riparian access ume.nless waived by ;
I anpL wish to waive the wback requ;TCment.
�t, re wrelnent
" �1 I dQ wish to waive that st,. � ck R
N---------...-.- --- - - ... - P�Upos>~o nEvEIdopl�zEwT_` ...__
DESCRIPTION ANDlOR DRANVING OF t me»r) ++
j--Marl in by individual roposint dei,vtop
I
�1!
PM
5;gnature �
prim Ot Type
Na�nt �
Te epho t Number
Date:-------

ADJACENT RIPARIAN PROPERTY OWNER STATE. VMNT
(FOR A PIER/MOORING PILINGS/BOATLIFT/ROA. THOU
L)'-
I hereby certify that E own property adjacent to
(Name of Pr perry ner)
property located at 3
Block, Road, .etc.)
on _, in Al see, _ — -- N . ,
:Idxdmp( aterbody) (To4in and/or County)
lie has described to r►)e, as shown below, the development he is proposing at that locatic
and, 1 have no objections to his proposal I understand that a piertmoori
pilings/boadift/boathouse must be set back a minimum dissance of fifteen feet {IS') from my aJ
of riparian access unless waived by rye.
I spot wish to waive the Wback requirement.
Y� I du wish to waive that sethack requirement
---------- ------------------------------------------.----.-.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT -
(To be Jddltd in by individual proposing dfl,'910mtnt.)
� ��,4 �es
---------- T
fti
Ott
Print or Type Name
9 (t
Telephone NuMt)er

6000
PH. 252-393-8555
SALLY C. REYNOLDS 66-112/531
319 PEARSON CIRCLE 3710 I
yT NEwPORT, NC 28570
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