41166_SHELOR, ALAN_20050405

IG�
LCAMA/ _1 DREDGE&FILL
GENERAL PERMIT '
rP evious permit
�ONew L.Modification ❑Complete Reissue E lPartial 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 15A NCAC "
❑ Rules attached.
Applicant Name �114k; 1f'r ��%;� Project Location: County
Address
City t i t-'.� c:< <,� State l r ZIP
Phone # ( ) Fax # ( )
Authorized Agent
Affected _i CW R EW ®'PTA ❑ ES ❑ PTS
AEC(s): i I OEA ❑ HHF ❑ IH ElUBA El N/A
El PWS: ❑ FC:
ORW: yes nod PNA yes / no Crit. Hab. yes / no
Type of Project/ Activity
Pier (dock) length
Platforms)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
Street Address/ State Road/ Lot #(s)
Subdivision
City ZIP
Phone # ( ) River Basin
Adj. Wtr. Body (nat-/man Junkn)
Closest Maj. Wtr. Body
cubic yards
Boat ramp
Boathouse/ Boatlift
f
Beach Bulldozing
Other
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
Agent or Applicant Prir)*dNaName
Signature Please read compliance statement on back of permit"
Application Fee(s) Check #
(Scale: )
;1. ',
1
See note on back regarding River Basin rules.
Permit Officer's Signature
Issuing Date 1 tiorrBate�
Local Planning Jurisdiction me

v
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 [)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:
❑ 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:
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
151-13 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

i. UL
ADJACENT RIPARIAN PROPE, RTX OWNER STA'i'RMFNT
(POR A PIER/MODRING PILINGS/BOATLIF!'/13pATIlOUSF_
I hereby certify that I own Property adjacent to 5hG—�
(Nan►e of Property Owner) ,s
Property locaiM at ' (` �;'�l , �:� - ??I ,
(I-ot, Block, Road,
on _�� , ins
(iV:ifcrhody) (Town and/or ounty) , N.C.
IIe 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
pilings/boatlift/boathouse; must beset back a minimum distance of fifteen feet (l5-) ron�/my
of riparian access unless waive(, by mc.area
1Jo.,110t wish to waive Elie setback requirement.
I dQ wish to waive that setback requirement.
D1-.SCItiP 10N` AND/OR DRAWING OF PROPOSED DEVF,i.OPMFNT;
(7`o be�lleJ in by individual proposing development)
Signature
A., Ate, f 4 UA '�
Pant or Type Name
C c
Tcl Pho c Number
Date; .(, 6S�

" : t I Ivn vu I L4 ns ► "U u 1 V Vr UUIIZ I HL I7tri M I rf g tIU. 4 P. u2
AD .TACF,NT RIpARIAN r` opERTy ()WNER STAB.' NT
(FOR A PIkRIMOORING PIUNCSl6OATLjFr/ SgATIIDI VX)
I hcruby certify that I ounr property adjacent tQ A1a4 SAtG y/ 'S
Nance of Prouty Gwocr)
Projzrty locatod at
(Lot, Block, Road, etc,)
in
(Waterbody) (Town andlor County) }
Ile has described to me, as down below, the development he is proposing at that locaEicna,
and, I have no objections to his proposal. I understand that a piprlmooring
pslin8xlb0aIUfVb0ltth4xIS0 mu-0 be set back a minlinum distance of Fifteen feet (t�') from lzty area
Of xilrarian access unitss waived by stye.
._ I IioatQt wtS11 to'vaive the setback rcquircmem
I & wish to waive chat Setback requirement_
�.�_�..r _.—_,---- -------------,�—
DESCRIPTION AND/OR n'bRhrNG OF PROPOSED ]( EVELOPMEN-r, -- --
(To be filled in by Indll v!du41 prgp0$i g development)
PA t or Typc Same
Tc1cPhone Numbcr

OUTER BANKS MARINE CONSTRUCTION, INC
1501 FIRST AVE
MOREHEAD CITY, NC 28557
[phone]
PAY TO THE
ORDER OF
FIRST CITIZENS BANK
MOREHEAD CITY, N.C. 28557 1462
3/16/2005
* * 100.00
66-30/531
137
One Hundred and DOLLARS
D.E.N.R.
MEMO N466 LE-f Qy 6,09 f l M.-
DOIill L46 20 1:0 5 3 100 3001:00 13 12 L8 2