41710_VICK, JOHN & DEBBIE_20050517

!-JCAMA DREDGE &FILL 41,710C�
G_ ENERAL PERMIT
Previous permit #
'New ❑Modification C!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
❑ Rules attached.
ApplicantName
U, �� Project Location: County_ -
Address_ Street Address/ State Road/ Lot #(s)
City State ZIP % i i- i ;^ c c
Phone # (-)
Authorized Agent
i CW
Affected
AEC(s):
Ci OEA
I : PWS:
ORW:
yes / no
Fax # ()
�jEW ❑PTA
1-1 HHF C IH
❑ FC:
PNA yes / no
ES _ PTS
_i UBA C N/A
Crit. Hab. yes / no
Subdivision
1 7 1 .,
City -
Phone # { -_ ) ! ' River Basin
Adj. Wtr. Body- Anat1man _/unkn)
Closest Maj. Wtr. Body
Type of Project/ Activity
(Scale: )
Pier (dock) length
Platforms)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length_ —
avg distance offshore —_
max distance offshore
Basin, channel
cubic yards __
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
Ali, -
Shoreline Length
SAV: not sure yes no-
1
Sandbags: not sure yes no
Moratorium: n/a yes no 1
Photos: yes no
Waiver Attached: yes no
A building permit may be required by: _ See note on back regarding River Basin rules.
Notes/ Special Conditions
Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit
Permit Officer's Signature
Issuing Date
Date
Application Fee(s) Check # 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:
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 / 1-888-4RCOAST
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

05/15/2005 09:44 919-571-948e
J MICHAEL RAY
PAGE 01
FFZ. hN : W I V'K ; . NE -SON FRX NO. ' 252-354-7380 Md 15 2005 07 : 02PM P 1
AWACENTWP" PROPERTY U NAl 1:4V t:r i
(FOR A FlfR/MOORING PILINGS150ATLIFT'IBOAMOUSE)
I hereby certify that I own property adjacent it �'O�G i,C` `-'s
/ n (Name of Property Owner)
property loc abed at .�C D 7,� �J�� i� �u — f4 Y Jdp:�e & G lr I
(Lot, Block, rR-�oad, etc.) �%
on
(Waterbody) (Town and/or County)
He has described to me, as shown below, the deveiopment he is proposing at that location,
ard, I have no objections to his proposal. I understand that a pier/mooring
pilurgs/boathft/boathouse must 5c set back a minimum distance of fifteen felt (IS') from my area
of riparian access unless waived by me.
I do no wish to waive the setback requirerncnt.
I d2 wuh to waive that setback requirement.
DESCRIPTION AND/OR DRAWDriG OF PROPOSED DEVELOPMENT:
(To 6ri1led in by individual praposfnb developmsnr)
,oy'0's60f'Y -
Telephone Number
Date: _„ �—

To Whom It May Concern:
dam applying for a CAMA General Permit to place
sandbags as a temporary erosion control structure in front of my property located
r—
at 1©'?�.30cc,c' G� ; in the town of e'-- eW,5V'D 5k
I have read the specific conditions in 15A NCAC 7H.1700 and understand that by
receiving such a permit, I will be responsible for the removal of remnants of all or
portions of any damaged sandbags, and that the sandbags may remain in place for
up to two / five years after the date of permit approval. Once the temporary erosion
control structure (sandbags) is determined to be unnecessary due to the relocation or
removal of the house, the bags must be removed within 30 days.
I also understand that the removal of the sandbags shall not be required if they are
covered by dunes with vegetation sufficient to be considered stable and natural two
years from permit approval date.
Authorized Signature Date

ADJACENT RIPARIAN PROPERTY OWNER STATEINIENT
(FOR A PIER/MOORING PILINGS/BOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to Zro-�/) x oeiiz'r- //, C 's
�1
.46 7- (Name of Property Owner)
property located at 4 6- §3 &Fe G 6 u r J`— 04 q )
/ (Lot, Block, Road, etc.)
on &qZl e -� 4 le7L , in L4cl �ye t L o s��'rcrlQ�7--
,
(Waterbodv) (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/boadift/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 dQ wish to waive that setback requirement.
DESCRIPTION A.ND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
�QyS a , �' 9`'Qj4crlt
dale 20 eYaS�4�
------------------------------- -------------------
Signature
Ir-
Print or Type Name
45-�I 35y- 731976
Telephone Number
Date: :�- �l% - G5'!�—

JOHN U VICK 2089
NCDL 2714410 PH 919-676-6555
1705 LOOKOUT POINT CT 66-763/531 CC
RALEIGH, NC 27612
Date
Pay W)The
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Order Of / %
wV l�(J/\ UOZZQYS � o°.un. o.
e.<v.
TACHOVu
Wachovia Bank. N.A.
Raleigh, NC 27609-5757
Memo I N D C 1 Zx
l:053 L076331: 6 268 3703 11' 2089
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