60160_CULBRETH, DOUGH_20120507

❑CAMA / r] DREDGE & FILL r" — hIO. 60160
GENERAL PERMIT Previous permit#
`_-]New ❑Modification _!Complete Reissue JPartial 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 Project Location: County
f
Address Street Address/ State Road/ Lot #(s)
City } State ZIP
Phone # (_) `' ,Fax # () _ Subdivision
Authorized Agent City ZIP
Affected CW Lj EW ❑ PTA ❑ ES ❑ PTS Phone # (_ _ _ _ River Basin
AEC(s): OEA ❑ HHF L IH ❑ UBA [IN/A Adj. Wtr. Body (nat /man /unkn)
PWS: ❑ FC:
ORW: yes / no PNA yes / no Crit.Hab. yes / no Closest Maj. Wtr. Body
Type of Project/ Activity
Pier (dock) length
Platform(s)
Finger pier(s)_
Groin length
number
Bulkhead/ Riprap length
avg distance offshc
max distance offsh
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing_
Other --
Shoreline Length
SAV: not sure
Sandbags: not sure
Moratorium: n/a
Photos:
Waiver Attached:
A building permit may be required by:
Notes/ Special Conditions
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit
(Scale: i .. )
See note on back regarding River Basin rules.
Permit Officer's Signature..,
Issuing Date
Expiration Date
Application Fee(s)
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:
[J 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 (910-796-7215) for more information on how to comply with these buffer rules.
Division of Coastal Management Offices
Raleigh Office
Morehead City Headquarters
Mailing Address:
400 Commerce Ave
1638 Mail Service Center
Morehead City, NC 28557
Raleigh, NC 27699-1638
252-808-2808/ 1-888ARCOAST
Location:
Fax: [phone]
2728 Capital Blvd.
(Serves: Carteret, Craven, Onslow -above
Raleigh, NC 27604
New River Inlet- and Pamlico Counties)
919-733-2293
Fax:[phone]
Elizabeth City District
1367 U.S. 17 South
Elizabeth City, NC 27909
252-264-3901
Fax:[phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
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
910-796-7215
Fax:[phone]
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)

ERIC a SwS
JA" M. BAJS
206 NOTnNGHAM LN. 262-72"776
MOREHEAD WV1 NC 28667
4574
66-30/ 13
33
Date
w Pay to the
Order of OC IV ?e vim, o
—Dollars
First Citizens
Bank
For _
�:053 L00300�:00 L3 L7448780�i` 04574

Eric Ellis
Marine Construction
DOCKS • SEAWALLS •BOAT LIFTS
DECKS & REPAIRS
Phone & Fax: [phone]
Cell: 252.342.6775
205 Nottingham Lane Morehead City, NC 28557
'-r

V
;,oplicart: '� J�� CC-k
Date:
J^
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
found in your Habitat code sheet.
Habitat Flame
DISTURB TYPE
Choose One
TOTAL Sq. Ft.
(Applied for.
Disturbance total
includes any
anticipated
restoration or
temp impacts)
FINAL Sq. Ft.
(Anticipated final
disturbance.
Excludes any
restoration
and/or temp
impact amount)
TOTAL Feet
(Applied for.
Disturbance
total includes
any anticipated
restoration or
temp impacts)
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount
Dredge ElFill
Dredge ❑
tbD
ElBoth
Fill❑
❑
Both ElOtherredge
Other
❑
Fill ❑
Both ❑
Other ❑
Dredge ❑
Fill ❑
Both ❑
Other ❑
Dredge ❑
Fill ❑
Both ❑
Other ❑
Dredge ❑
Fill ❑
Both ❑
Other ❑
Dredge ❑
Fill ❑
Both ❑
Other ❑
Dredge ❑
Fill ❑
Both ❑
Other ❑
Dredge ❑
Fill ❑
Both ❑
Other ❑
Dredge ❑
FiIf ❑
Both ❑
Other ❑
Dredge ❑
Fill ❑
Both ❑
Other ❑
Dredge ❑
Fill ❑
Both ❑
Other ❑
Dredge ❑
Fill ❑
Both ❑
Other ❑
Dredge ❑
Fill ❑
Both ❑
Other ❑
Dredge ❑
Fill ❑
Both ❑
Other ❑
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■ Complete :terns 1, 2, and 3. Also complete
item 4 if 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 mailpiece,
` or on the front if space permits.
Article Addressed to:
'4-o4lj-�L
G C"- ,
36,33I
A.
X
B. Received by (Printed Name)
❑ Agent
❑ Addressee
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
3. Service Type
❑ Certified Mail ❑ Express Mail
0 Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number
(Transfer from service label) 7 011 3500 0002 3325 0648
i
PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540 ,

UNITED STATES POSTAL SERVICE
First -Class Mail
Postage & Fees Paid
USPS
Permit No. G-10
• Sender: Please print your name, address, and ZIP+4 in this box •
is t�tf!]ilttl JJlt��t:IttSlt'tJtt�(it: �tt �f li �tff(il t:l:

ADJACENT RIPARIANi U 2' i i STATE 3 '� T
I hereby Certify that! own property adjacent to dP, "3
('dame of Property Owner)
property located at
(Lot, Block, Road, etc.)
on c f �<-Soy rc1c� , in ��"' f,'c � ��c.� , N.C.
(Waterbody) (Town and/or County)
Applicant's phone #: C,ry �� en�s7Mailing Address: G �% F�eW,�/
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 DRAWING OF PROPOSED DEVELOPMENT:
(To befilled in by property owner proposing development)
(Information for Property Owner Applying
for Permit)
Mailing Address
City/State/Zip
Telephone Number
Signature Date
(Riparian Property Owner Information)
Signature
Print or Type Name
Telephone Number
Date

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