40768_SMITH, T.J._20050113

!_-1CAMA /'I DREDGE & FILLi✓
GENERAL PERMIT /'�
Previous permit #
❑New C 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 I SA NCAC
} ( ❑Rules attached.
Applicant Name 1 J t r ` Project Location: County__
Address J'
City r �.�, I ey State ;E ZIP
Phone # () ` `i ��6 Fax # ()
Authorized Agent i)(`"•/ `'' /
Affected CW ❑fW LTPTA El ES ❑PTS
AEC(s): 0 OEA ❑ HHF ❑ IH ❑ URA ❑ N/A
❑ PWS: ❑FC:
ORW: yes / no PNA yes / no;' Crit. Hab. yes / no
Type of Project/ Activity
Pier (dock) length
Platform(s)_ 7
Finger pier(s)
Street Address/ State Road/ Lot #(s)
f'
Subdivision �� h
City_ % 1 Al ZIP _
Phone # ( ) River Basin -
Adj. Wtr. Body_ —r'' r % � (nat /man unkn
Closest Maj. Wtr. BodyC"'
Groin length
number - -- - - - -- —
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
Shoreline Length 1
SAV: not sure yes (�io
Sandbags: not sure yes no
Moratorium: n/a yes no:
Photos: yes no
Waiver Attached: yes C)
A building permit may be required by:
Notes/ Special Conditions
P ;
i
Agent or rkpplicari Printed' Name
t
I\_ %.i i
Signature Please reads omplianc,
Application Fee(s)
(Scale:
__,.See note on back regarding River Basin rules.
Permit Officer's Signature
on Mack of permit Issuing Date Expiration Date
Check# Local Planningjurisdiction 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:
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 / I-888-4RCOAST
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

FOLEY & FOLEY CONTRACTORS, INC. 1115 -1
MATERIAL ACCOUNT
[phone]
1810 OLD AIRPORT RD.
66-112/531
NEW BERN, NC 28562 DATE �'__ �-� s' 01901 ;
PAY
TO THE Al s Qb
ORDER OF_�_ FAO
Fg g - 9-3t-de %J -D61 O-YfDOLLARS B �
BIM it
BRANCH BANKING AND TRUST COMPANY "
NEW BERN, NORTH CAROLINA L��)1.�
FOR J-✓mot S'n / y /Il Ltl J--.--���7�
II'00 LLSu'I/I:053101L211:5290052159i1'

To: Stephen Lane (Cama)
Fax#: [phone]
Date: January 5, 2005
Page#: 3
From: Foley & Foley (Sandy)
Phone#: [phone]
Customer Work Sheet
Customer Name: TJ Smith Date: January 5, 2005
Mailing Address: 8809 Birch Ln. Shawnee Mission, KS 66207
Job Address: 1102 Kea Ct. (Fairfield Harbour) Phone: [phone]
Adiacent Property Owners
Left Side: Bull Right Side: Tridico
Job Type Description
Bulkhead Repair Tie Back Rods
Dock/Walkway 6'ft wide 32'ft long
Platform end of dock
Boathouse
Boatlift/jet ski
Piling (6) Tie Piling
Ramp/Jetty
Dredge Yes 161ft wide 50'ft long
Rip Rap

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PIL17VGSIBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent t 's
(Name of property owner)
property located at % % 6 -2A , `-
(Lot, block, road, etc.)
on S Y"�2• t , ce rit le , in New Bern/ Craven , N.C.
(Water body) - (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 understand that a pier/mooring
pilings/boatlift/boathouse must be set back a minimum distance of fifteen feet (15') from
my area of riparian access unless waived by me.
I do not wish to waive the setback requirement.
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(to be filled in by individual proposing development) IPAP 3 l
i,
cP2rrr,l�
IG
I
Foley & Foley Contractors, Inc.
Phone#: [phone]
Fax#: [phone]
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Print or Type Name
_A-G33-raa?I
Telephone Number and Date
M

Jan-04-05 17:01 RALPH TRIDICO 252 638 8288 P.01
AMAC MT AWASUM TRUMMY OVVNER S &TEN MNT
(FOJI A P waoAlwousip
I ?+er by certil'q t I atva prop y js r 'g
(Nate of property owner)
pmptsty ivc at
(Lot, block, road, etc.)
ap s��3_ �2-1— _ _ r Bern) Cromm N.C.
(WiL a y) (Tows nad/or ownty)
He bas described to me, w shown below, the d"*h3paat be is pwposiztg st that
location, and,, I have no objvctinna to b62 poMVMl i mood ttwt a piarlmvartug
must be set but a =uM= Of �t 05') from
my eroa of riper umms vX&m w^aivadbj mc.
I do not wish do vuaive the metbwk tcquiremeut.
I do wish to waive *" sotbm A moitmtreat
DESCRn'i't'ON ApmMR D►RAWDiG OF FR OPOSED DEVEL DT%MNT:
(90 be jiW lxby bWb" t ps i[ Aev+dop 0
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Foley d= Foley Cam, Tzc
pboae#• [phone] Si
Fix#- [phone] -'
Pnm or Typo Name
telephooc Numbcr wd Bate