42445_SEABORN, DIANE_20050818

L CAMA / }DREDGE & FILL
GENERAL PERMIT Previ us permit`
ONew L 'Modification 'Complete Reissue C]Partial Reissue Dat 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 F `' Project Location: County
Address i ` , / f
City JIr5J State ZIP'I'����
0.
Phone # (` -�) Fax # ( )
Authorized Agent L� �
Affected ElCW AN N.PTA N S ❑ PTS
AEC(s): ❑ OEA a HHF ❑ IH ] UBA ❑ N/A
i! PWS: ❑FC:
ORW: yes / no PNA yes / no Crit. Hab. yes l no
Type of Project/ Activity
Pier (dock) length -
Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore 1
Basin, channel �—
Street Address/ State Road/ Lot #(s)
r
Subdivision 2-1 �� 7c '� •�
i
City �'- ZIP
Phone # (,) River Basin t'✓l i ^ `J` y-
rs -`'�tTf ri{✓ )'
Adj. Wtr. Body f'] (nat(/`lma� nkn)
Closest Mal. Wtr. Body
(Scale: )
cubic yards
Boat ramp
Boathouse/ Boatlift
> _ U 4e
Beach Bulldozing
Other
Shoreline Length ' `t
SAM not sure yes ! no
Sandbags: not sure yes no
Moratorium: n/a yes r no
Photos: yes no,
Waiver Attached: yes fi y y�6 i
A building permit may be required by: See note on back regarding River Basin rules.
Notes/ Special Conditions y
A- 1. Part et'
Agent or Applicant Printed Name
Permit Offik6r's Signature
Signatur�j� , Please read compliance statement on back of permit
Application Fee(s) Check #
Issuing Date Expiration Date
(i
j 3 A
Local Planning}urisdiction 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 consistentwith the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
Tar - Pamlico River Basin Buffer Rules 1 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
Mailing Address:
1638 Mail Service Center
Raleigh, NC 27699-1638
Location:
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293 / 1-888ARCOAST
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
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

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Adjacent Riparian Property Owner Statement
(FOR A PIER/MOORING PILINGS/BOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to L*+4Co is
Name of Property Owner
property located at �� 3C eRIocic A ,
Lot, block, road, etc.
on -J lCw , in Cox krc,.' NC
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 do_ not wish to waive the setback requirement.
I do wish to waive the setback requirement.
Description and/or Drawing of Proposed Development
(To be filled in by the individual proposing development)
&,—Ir%d 1.; u
Print & typename
Telephone number
Date
�cc ,IVw�
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Adjacent Riparian Property Owner Statement
(FOR A PIERIMOORING PILINGSBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to 1-4 �CO
Name of Property Owner
property located at SeoL aa0*- Z V ock A ,
Lot, block, road, etc.
on TC IA.,� , in Qo rk.a- , NC
Waterbody Town and/or county
I
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 do_ not wish to waive the setback requirement.
IzI do wish to waive the setback requirement.
Description and/or Drawing of Proposed Development
(To be filled in by the individual proposing development)
566
Signature
i1rlS AICA /P y 5 /7 S?
Print or type name /i%rel�egd C� . '-V ('
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7L,f- o LCv
Telephone number
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ARTIS BRYANT HARDEE II "r' 2280
104 South 19th Street
Morehead City, NC 28557 66-21/530
BRANCH 77615
Date
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WACHOVIA
Wachovia Bank, N.A.
p�wa/chovia.comA
For
I:0530002L91:L05462LL630C3Wo 2280