41198_SMITH, DOUG_20050412

CAMA / I DREDGE & FILL��
GENERAL PERMIT
Previous per
2New—]Modification CComplete Reissue LPartial Reissue Date prev? 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 /A 0o
;� ❑ ules attached.
Applicant Name !J;)�-' - "A,1 Project Location: County
Address Street Address/ State Road/ Lot #(s)
City . i �' irn'( State " t: zipLkV n r
Phone # Fax # ( ) Subdivision
Authorized Agent F' ` ' ! -1' City zip
CW ElEW C}�TA El ES ElPTS Phone # ( ) l / c ` River Basin
Affected ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
AEC(s): 'J PWS: ❑ FC: Adj. Wtr. Body >1R ''t" (nat /man /unkn)
ORW: yes / no PNA yes / no Crit. Hab. yes / no
Closest Maj. Wtr. Body `f " '
Type of Project/ Activity
Pier (dock) length
Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp
(ABoathouse/ Boat ft)
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 Printed Name
Signature "Please read compliance statement on back of permit"
Application Fee(s) Check #
4
(Scale: u' "r :5
E See note on back regarding River Basin rules.
Permit Officer's Signature
Issuing Date Expiration Date
Local Planning Jurisdiction
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 Basin Rules Applicable To Your Project:
f Tar- Pamlico River Basin Buffer Rules Other:
FI 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-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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T hereby coot:" That T oti4n properry adiac.cnit to 'bltsuG
CN:111,11C of Iry I W! I
p. roper—,, located ac
(Lot, Blo�-.k, Road, ctc..}
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(WaLerbodv) arl )I)rjcOullty)
He has dcsc-:ibed to me, as sfl(.,-,vn be'ow, the devc1or,)OPellt 11C is PrOP)-i-tl." It rl:,
location, and, I have , no objections to his proposal I undersuand dial a picr/uncovercd iJtl if 11
r-nusL be se, back a mlirilrnum distance of fil-Lcz-n fc-�r ("15') fifam naviarca oi,-- (jpa.n Lri ac u (i
by me.
waivzcz t�he sctack c.,
I do riot wish to FIR,
1 do v,ish to waive, U-,ac setback requiLF-cinent. RL
APR 0 5 2005
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DES( R'j g�I I ;:) N, A-N-D / 0 R D R- lk -W EN (--- 0 F P R 0 T' Lmmob — "I -
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(To be fL-Ued in bly itufiv)dual Proposii7g diaveL;)pMent
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('F-01--,'A ,BOAT 1,1171)
I hereby certify that r ov, n
adJac..-nir. to �ur-
CN4"unc of Prop-i t.v Owzwr
1ccaced at
cp
On %�w4 D
(Waterbudy)
(TOWTI and/arlCounty)
He ha-s desc.1bed to ane, as bcVv, the c!c-,,F'!L'pFncrI[ lie .IS PF0iX).5UI'j atL�
lc,cauon, and, T hav,, no objecEons Co his Pf'OV-0sal. I understand iihat a picr/uncover---t , bc)at I
MUSt be set back a Minimum, distanceOr ru"Letn fe:cr (15') from, my 0i - nparian ac*:-,,,,,,* ij
waived by me.
-ck. re -
I do at wish to �Valvc Me sc�ba
I -do iIkAsh to ',voive that setback -cx5,jLF-rr,e,-j(.
APR 0 !z '52005
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THIS MULTI -TONE AREA OF THE DOCUMENT CHANGES COLOR GRADUALLY AND EVENLY FROM DARK TO LIUM I WI I rl u-m-
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NOT VALID OVER $1,000.
ISSUING BRANCH
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DATE
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