40949_RICHARDSON, KEISTER & PAULA_20050228

]CAMA / C' DREDGE & FILL
GENERAL PERMIT Previous permit#
CINew ]Modificationr (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 I SA NCAC
❑ Rules attached.
Applicant Name C. t �t r �'' i!`' Project Location: County_ r-
Address ( r.� 1f L' `' Street Address/ State Road/ Lot #(s) i' 1
City ^l'^ ,L' u , ,i �� State ZIP ? N
Phone # 7 r0 Fax # ( ) Subdivision 1� t ' F s' e.
Authorized Agent 4)'4 '.5,4 r` City —. y cs_ ZIP
Affected ❑ CW ❑ EW Ll PTA ❑ES ElPTS Phone # ( ) River Basin
❑ OEA � HHF C IH ❑ UBA El N/A i
AEC(s): _ Adj. Wtr. Body 1' �{ r (nat /man /unkn)
i 1 PWS: F-1 FC:
ORW: yes / no PNA yes / no Crit. Hab. yes / no Closest Maj. Wtr. Body —
Type of Project/ Activity
Pier (dock) length--
Platform(s) �' 'L'• } a
Finger pier(s)
Groin length
number
— --- —;--
Bulkhead/ Riprap length ,r J
avg distance offshore
max distance offshore s �"
Basin, channel -- "
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other % -,y y
-
sT ✓
Shoreline Length
SAM not sure yes
no I
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
(' rkr-7 i //r) _ f ?
Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit
(Scale: )
J
z
--- See note on back regarding River Basin rules.
Permit Officer's Signature
-.—r-��
Issuing Date Expiration Date
Application Fee(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, certifythat this 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 howto complywith 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:
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293 / 1-888ARCOAST
Fax: [phone]
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

KEISTER L, RICHARDSON, ill 237-27-13344-81
PAULA F. RICHARDSON 223-13-6712 9168
P O BOX 7001
DANVILLE, VA �4541
68-404/514
31y to the Tate
Ofldelc od 1 7cz, ' yr _* ua,l l"Vuru.d
® ToRats
Peoples National Ban Jfl�ill ))j1�C
- DANVILLE, VA 24541 � 1
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02/pi/2005
Est. C
14:38 919-Vl-1271 JW PI-UTD LABS PAGE 02
Av,JACW. r RII'AIuAN pRor. jc'TY owN]C,R s ATUMWV
(FUR A 1111IM190RING ,PILIIYGS/IiOATLII'T/BOAHIOUSE)
I hereby certify that I own property adjacent to Nler V A)uki, c17arW Vl�'s
(Name of Property Uwuelr)
prvperiy located at a 4`rv7S 6-ee k- µev
))-� �/ (Lot, Block, Road,, etc.)
l'7
7n r7t7�n/t 'X /' P , 1J1 C�/2J �
(Waterbody) Yiif� , r �� rG. l 0 N.C.
(Town andlor unty)
He has described to mc, as strown betow, the development he is proposing at that
ovation, and, I have no objections to his proposal, I understand that a pier/mooring
iilalgslboatIift/boathouse must be set back a minimum distance of fifteen ,Feet (IS) front my area
if riparian access urdeas waived by me.
i do unt wish to waive the setback requirement.
I d¢ wish to waive'that setback requirement.
DMCRWrION AND/OR DRAWING OF PROPOSED DEVELOPMLNI': ------
(To be filled fit by indivirl(allrrnposing developrrlenl)
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Print or Type Name
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Te.lephone Number
Date: 4Z z(jp�
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411
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r >�d fil;L+ 1V 1 lt1-t'Al�1�IV 1'Itoi' � rrx o �vNLIt s•rA•IT�t�,
' (FOR A PIERIA100RING PILINGS/IIOATLIFT/IIOATIIOUSE
I hereby certify that I own property adjacent to Jj C/s`r v 'I /014X19 71` 1i?rA�
(Na-use or Property Owner)
Property located at L07� <���t,,,- ) ,
(Lot, Block, Road, etc.) '
on f / �
�t�� C�C�'�S /(t^L ,ill / I
Materbody) ��l c:_� N.C.
(To vn and/or County)
He has described to me, as shown below, the development lie is proposing at plat
location, aad, I have no objections to his proposal.
pilings/boatlift/boatliouse must be set back a Minimum distance of fifteen feet (15, pier/mooring from
area
a
of riparian access unless waived by ine. ) n1Y ��
I do not wish to waive We setback requirement.
I do wish to waive tliat setback requirement.
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ------------------------------------------
D ±SCRII-'I'ION AND/OR DRAWING OF PROPOSED DEVELOPNIENI':
(To be filled in by individual prwposing development)
CC
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Print or Type Name
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61
Telephone Number
Date: 0'�- / 0 - 0 S

02/ 1/2005 14:38 919-831-1271
JW PHOTO LABS
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