41373_THOMPSON, GAY_20050511

PAR'
,
r ' CAMA / ❑ DREDGE & FILL
GENERAL PERMIT
/Previous permit —
❑New ❑Modification ❑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 15A NCAC
/ rr❑ Rules attached.
Applicant Name �r /� r^�°l ° ` Project Location: County
Address +! 1 -j 4-7)'' e L Street Address/ State Road/ Lot #(s)
City_ v State/VC ZIP -`'
-7 J- ! I
Phone # ( I.) Fax # O Subdivision
Authorized Agents l , C City �JI `�'� ' r 1 �a! ! '� ZIP
❑ CW E�'tW C9-0TA ❑ ES ❑ PTS Phone # O River Basin
Affected F-, OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A ,.�
AEC(s): Adj. Wtr. Body �S `"`Jz ! (nat man /unkn)
❑ PWS: ❑FC: - ti i
ORW: yes / no PNA yes / tno� Crit. Hab. yes / no Closest Maj. Wtr. Body
Type of Project/ Activity
-
(Scale:,
Pier (dock) length
Platform(s)
Finger pier(s)_
Groin length
number
Bulkhead/ Riprap length—^�
avg distance offshore
3 u
)
max distance offshore
Basin, channel
cubic yards
pt v r �— _' a�a
, r �l •' ,
Boat ramp
Boathouse/ Boatlift�
-
Beach Bulldozing
Other
Shoreline Length �✓
<r '/" '
SAV: not sure yes no
0
Sandbags: not sure yes no
i
Moratorium: n/a yes no
Photos: yes no
I t
•
Waiver Attached: yes no
--
.. ;� . •. > >� � ,fib-
A building permit may be required by: ell �
r-c.:,r � See note on back regarding River Basin rules.
Notes/ Special Conditions
' ° K�"o ' J
,: 7� /0 EI!f-5
AgenApplicant Printed Name
j f
Sign Please read compliance statement on back of permit **
Application Fee(s) Check #
Permit Office 's Sig -nature
Issuing Date Expiration Date
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
landowners).
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 i_ 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

�'a dAA�el' Pr
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1��'�it✓�
,r
a Complete Items 1.2, and 3. Also trorrrplete
item 4 N Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the madpkmo
or on the front if space pemft.
1. Article Addressed to:
RuTH E. AAI-Me-@
Ad'
r� T
D- Is delivery address dMlereM from Am 17 -0 Ye;
if YK enter dekvwy address below. O No
Z 3. Service Type - -
%�.4r� q 3111- ❑ Carmed and Cl Espraee Mag
❑ Registered ❑ Return Receipt for Merotnndlse
❑ iriarLued Mau 0 C.O.D.
4. RestrxW Mhwy? (Extra Fees) ❑ yes
11 7004 0750 0000 5085 6704
PS Form 3811,_Februe►y 2oo4 Donvesoc Retvn Remo t er tsao
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44
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MARCH 16, 2005
MEMO TO: RUTH E. PALMER
FROM: GAY THOMPSON
MY PROPERTY ADJOINS YOURS IN PINE KNOLL SHORES, NC. I WOULD
LIKE TO ADD A BOAT LIFT TO MY EXISTING DOCK. THE SET BACK
DISTANCE EXCEEDS THE MINIMUM REQUIREMENT OF 15. THE
PROPOSED LIFT IS OUTLINED IN PURPLE ON THE ENCLOSED. THE
TOWN REQUIRES THAT PROPERTY OWNERS BE ADVISED OF ANY
CHANGES TO ADJOINING PROPERTY. I WOULD APPRECIATE YOUR
SIGNING THE FORM AND RETURNING TO ME AT YOUR EARLIEST
CONVENIENCE.
THANK YOU.
GAY THOMPSON
104 LOCHSTONE LANE
CARY, NC 27511
919-854-2490 HOME
919-677-6111 WORK

ADJACENT RU'.ARL4N PROPERTY OWNER STATEMENT
("FOR A PIMUNCOVERED BOAT L n)
I hereby certify 'that I own property adsa=t to
ogre of Prate..,
Ixrty Owner)
Property located at
(Lot, Block,
etc.)
on _ bp_G (J - ie. � . in �p,t�5 N.C.
(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 ptopow. I unders=d that A pierlw=vtred boat Iih
must be set back a minimum distance of fiftoen feet (15,) from my area of riparian access unless
waived by me.
I sio not wish to waive the wback requirement.
I Aa wish to v--4vt that setback requiit t.
D'FSCR1rMN AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be jlled in by individual proposing deveiopmew)
E x ► 5 -rin+ 6
f13
pk,gPe,ery TO !3
LIFT'
? oPc3ec
r
VO U'K PRO Pe a)-yl,
000-k 51x 300'
Pe- Qry L»/C- Ta
fc 4t o'
Signature
Prin r or Type Name
Talcphone Number
Date:

r
ADJACENT RWARMN PXOPZKTY OWNER STATFII�N'I`
I her**y cerdty vw I own propcM admit to - 0AU &. ' AO `s
ame at Property OVW)
prop" located ai .2- G.'l 0,4K L 941o!
mr
etc.)
an 804 v C env Nai r a U fio,�„e s . N.C.
(Vl�ater6odY1
('Taw>a aad/or C US")
He iva docfibcd to me, as shown >babw► d*- davraia oerrc be ic pmpocftbat am
oa
kgMf , and, I have no objections to Ins proposal. I n�'cMod Ober a
piniowwwo mast be sct back a nnaimum &IS21we of filleea fact CIS') (Mm my am ofdpariaa ask=
waived by me.
I do na wisb to waive the a WMA Vic.
wish to wsive drat adback ngnirexrieat.
DESCRtPITON AAMWOR DMd Hr24& OF PROPC"D DEVF,LpPhBiN'r:
(To be friW in % bowdod p da"�O j
fX 15 INx 30o
j L
'
13
I3'
�r?O�FatTjIL/NC 1� E--- Ji ?kpPL-oTY LING TO
t_1r
Si,�autte
Print or Tree Name
J. _ 7 - e* 1& 3
Tdgftee Number
DoIc
->3- a

ERIC B. ELLIS
JASA M. ELLIS PH [phone]
205 NOTTINGHAM DR 2967
MOREHEAD CrTy, NC 28"557
Pay 14) tjj(� Date I
or 'ro
Pay
Ot-d(�'r
—�
F)R'S-r CITIZENS,,, Dollars
BANK Allanbc
Bank & Trust ���coV.ny P4
*1-1, N C 20512
irsqtt.
For
: 0 S 3 100 30oi-00 13 1
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