59786_DOCKSIDE YACHT CLUB_20120321

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❑CAMA / ❑ �y DREDGE & FILL sV,
�. 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
Applicant Name, i Project Location: County
Addressi, ; Street Address/ State Road/ Lot #(s)
City State ZIP
Phone # O _ Fax # (} Subdivision
Authorized Agent City ZIP
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Phone # O River Basin
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body (nat /man /unkn)
❑ PWS: ❑FC:
ORW: yes / no PNA yes / no Crit.Hab. yes / no Closest Maj. Wtr. Body
attached.
Type of Project/ Activity
(Scale:.
)
Pier (dock) length 1 j
Platf
orm(s)
n length
number
head/ Riprap length
channel
cubic yards
ramp
h Bulldozing
eline Length
not sure yes no
bags: not sure yes no
atorium: n/a yes no
os: yes no
i
r pier(s) _
- i I
avg distance offshore i
max distance offshore
t
house/ Boatlift
1 -
r
I
I I
t
I
I I
Agent or Applicant Printed Name
PermitOfficer's Signature
Signature ** Please read compliance statement on back of permit"
Application Fee(s)
Issuing Date
Check# LocatPtanningJurisdiction
Expiration Date
Rover File Name
Agent or Applicant Printed Name
PermitOfficer's Signature
Signature ** Please read compliance statement on back of permit"
Application Fee(s)
Issuing Date
Check# LocatPtanningJurisdiction
Expiration Date
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 ❑ 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 (910-796-7215) for more information on how to comply with these buffer rules.
Division of Coastal Management Offices
Raleigh Office
Mailing Address:
1638 Mail Service Center
Raleigh, NC 27699-1638
Location:
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
Fax: [phone]
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ 1-888-4RCOAST
Fax: [phone]
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico Counties)
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)
Revised 08/09/06

I
NCO
North C.atolima Department of Environment and Natural Resource.,-; �
Division of Coastal Management
F,9i411! i . E dsley, Ckmi or Charlo$ S..loner,,, Diretor 'AWharn G Rm.)r. sarfatary
Applicant Name
Je t O c64-b.
Madirrl; /Woress t_ a^ s4-
--goyt ked� OCI a.Ys51
1 cvrd y that X have authorized (agc•nt)6-—,&—,V,1' n�_-a to act 4►11 my
bi lla h" 1'm' the purpose of applying for tad obtaining :tll Permits ueces,;ary to
install or construct (activitA.) - -- �-- _ =t � hC.t O�AC• - ..
at (lor.ati(t:) tNit`'"__; tnJerz..-_G�LxK�-�c�r�ea
This vertif catiou is valid thru fcl:t(c)
RECEIVED
LIAR 19 2012
DCM-MHD CITY
400 (;ommeiGe Avowme, htorehu(Id (arty, North Gare_il►im 28,55;%
'hone; FAX �5� �4i 333� 1 lr�terlt?t: www.lto;+�as,t�lmaitar�«�nlr�nt.net
5.•Itnn Gmniny,a . �fl°� fIl^/�•n•t1�A1'lll�: f�,�,a,

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSIBOATLIFTIBOOACI� C/�b
( hereby certify that I own property adjacent to �D�1e(z y6m &✓ I -1.a s
(Name of Property Owner)
property located at
so - 3 r4
(Lot, Block, Road, etc.)
Oil � in r A _, �1.C.
U� Town and/or Coulity
(Waterbody) (
Applicant's phone #: Mailing Address:, n � �g GrK 33f-7 � O
IP"7L{
sue, J oWs -- \,OLk� 3 k cpa-
1Ic 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. (If you wish to waive the setback, you must initial the appropriate blank
below.)
I do not wish to waive
"-�I do wish to waive that setback requirement.
-------------------------------------------------------------------------------------------- -- -
--DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing developntenl)
I-tT C(k' r- � cef \cce-- 6&r- &- (-3 )
(Information for Property Owner Applying
for Permit)
�.rb- G-OX 331C
Mailing Address
City/sLai�iLip
Telc hone Number
S'larlaiure
mate
RECEIVED
MAR 19 201?_
DCtit-:LID CITY
(Riparian Property Owner Information)
_— annre
Prilit ut Tylk; i\auie;
Telephone Number
Date

03/19/2012 12:46 2527262267 TOWN OF MOREHEAD CTY PAGE 01/01
ADJACENT RIPARIAN PROPERTY OWNER STA TEMEN- <'
(FOR A P7F_R1111f00RxrVG Pfll'1dGSIBOATLIFT/B011 TfXUfiSF_)
11elelly col'tiry alat I mxn pr,opet-ty adjacent to
(Name of Property Owner)
property located at
(Lot, Block, Road, etc.) .
�VF'atert!ody) (To�1'n andlor Got>ttty')
Aticlxess: t'i a
ri,l�p[icant's phone tl: _ _.._ Irslailin g _
?ter 1f iS
No has described to 111c, as (9 ; Uc�ow, fl% deuc1opment he is proposing at that location, and, 1
have too objections to Dais propbsal..l understand that a pier/mooi-ing pilings / boatlif{ / boithouse:
must be set back a minimum distance of fifteen Feet (151) from my area of riparian access unless
waived by me. (If you Kish to waive the sethac[c, you must initiol the appropriate blank
below.)
I do not Wish to waive
J do wish to waive that Setback roquiremenlL
'PE,SCRIFFION AND/OR DRAWING OF PROPOSED fit: VFLOPMFN'!':
(To be filler! iir by indis4dual pr'oposhig rlenelopfiterd)
RECEIVED
MAR 19 2012
r '.D CITY
(Inform8tion for Property Owner Applying (Ripari;m J'ropert3l Owner Information)
for Permit)
Ma i I i n 9 A ddi'o-" it�Jl«ILI!'L
Ciiyi �L�eter�.ili ------ Piillt uJ iypr: iV'1;lJi
Tel
1phone � is
ll;lbu l-Elcpbonc Nunl!Scr
3'f91L-
,� F4,71�171-I c:•

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