41985_WORRELL, BARRY_20050718

- CAMA / '. i DREDGE & FILL
J"*
41
9185
GENERAL PERMIT
Previous
ermit #
�r
7—New -iModification ]Complete Reissue
❑Partial Reissue Date pre ious 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 j '... r %/ l
Project Location: County
Address. - i t > > j ! �t j,
Street Address/ State Road/ Lot #(s)
City �. r ..,,'. i State_ `,, ( ZIP
-`�%
Phone # ( ) ., " - �`/ , 6! Fax # ( )
Subdivision
Authorized Agent 3
City_ / ' "� 'C _ ZIP_
Affected ElCW L EW PTA El ES ❑ PTS
Phone # ( _) z River Basin
❑ OEA HHF ❑ IH ElUBA El N/A
AEC(s):
1 (,� J c
Adj. Wtr. Body .; � j - � �
nati /man,, /unkn
( )
ORW: yes / no PNA yes / no Crit. Hab.
Closest Maj. Wtr. Body _ :%` "6 �k d
yes / no
Type of Project/ Activity
(Scale: ) I
Pier (dock) length
Platform(s)_
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
j
cubic yards______
Boat ramp _
Boathouse/ Boatlift
Beach Bulldozing
Other _
Shoreline Length
$AM 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: _ 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
Application Fee(s) Check #
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:
] I. 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 252-264-390 1
Location: Fax: [phone]
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293 / 1-888-4RCOAST
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 (0/05/01

.I
0•
0�/24/2005 17:24 FAX [phone] VALUMAX MOTORS 2.02 .
ADJACENTRie
.(FOR A PIER/UNCOVERED BOAT IJI
I herebv c-'16EY that I own ro rt a
p pe y Adjacent to
nee or Pr�t3,�ner.
properry located at
(Lot, Block, Road,. etc.)
(Water -body) (To*n andlorl county)
He has described to me, as show:n below-, the developrpent he. is' propo:s at that
location, and, I have no o6jrians to his proposal. I understand hhat a.piet/untevered.bge.li�
trust be set back a minimum dista,nc:� of rir't&_a fe~t (IS') from myIarea of riparian acc�;'s tigr ess
waived by me.
� l I do not with, to wa.ive-the serback requirement.
j I 9 wish to waive that setback requirement.
.. '
DESCRCPIZON AND.IOR DRANVI iG OF PROPOSED' DEy E1L.OP?YjI—NT: y
(To bg Xed ire ay jT. vjdu V pn;Fosing dgrel��+ment)
•L 1' i 4� �-
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2!W:
Telephone NUrtlb r
` Date_
'4

r 05/24/2005 17:21 FAX [phone] VALUMAX MOTORS la01
orb wt 1,
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05-).,) D,35 -'iq`10

A.DJACENL 7 RIPARIAN PROPERTY OWNER STATEINIENT
I hereby certify that I own property adjacent to 134e-p\ [00}gL L s
(tiarne of Property Owner)
property located at 5 -x>R— ,
(Lot, Block, Road, etc.)
on M�tO M INM C— L , in PLMb6j4rI L T C� - I C41"'OF- 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 proposal.
DESCRIPTION AND/OR DRANVC�G OF PROPOSED DEVELOPMENT
(To be filled in by indt'vidual proposing dereloprnent)
_T> �� , / 0
------------------------ ___----
Signature
SC477 [ F�
Print or Type Nam-,
Teleohone Numbe,

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NOT VALID OVER $1,000.OQ
2, 63229129
ISSUING BRANCH
DATE Jill '- -' .,—f '
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PAY TO THE
ORDER OF DE�172-
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DRAWER: TRAVELERS EXPRESS COMPANY, INC.
BOX 9476, MINNEAPOLIS, MN 55480
"AWEE: FIRST INTERSTATE BAMqEL?r4
93-541/920
DOLLARS BY SIGNING YOU AGREE TO THE SERVICE CHARGE
v) . AND OTHERT RMS ON THE REVERSE SIDE.
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III C- a 2 29 1 291" 1:09 200 541 11:0 170 ? 104 5 109 2110
■ THIS DOCUMENT HAS AN ARTIFICIAL WATERMARK PRINTED ON THE BACK THE FRONT OF THE DOCUMENT HAS A MICRO -PRINT SIGNATURE LINE AND BORDER. ABSENCE OF THESE FEATURES WILL INDICATE A COPY.