Gerhart, David

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9"%AMA / ❑ DREDGE & FILL 62174 �
GENERAL PERM1 Previous permit#
EMew ❑Modification ❑Complete Reiss Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources —7/l
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC /"/ r�
-0 Rules attached.
Applicant Name V) �` � Project Location: County (fow- r/,
Address (,.� �'�'Y v/iq c% Street Address/ State Road/ Lot #t(s)
City } r^ j r' a, Stated ZIP / �! ✓! t i �, h
Fax # (_) j Subdivision
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Authorized Agent City .14 % �''`� ZIP :1 S 77
Affected ❑ CW 2EW ill ❑ ES ❑ PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ USA ❑ N/A
❑ PWS: ❑FC:
ORW: yes /ono) PNA (yesy no Crit.Hab. yes / no
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•
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 [)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, certifythat 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 Headauarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ 1-888ARCOAST
Fax: [phone]
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico Counties)
Elizabeth Citv 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

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to batllW % - L41-4 � Pr%tares 's
(Name of Property Owner)
property located at
(Address, Lot, Block, Road, etc.)
on �I [�i� _!1 C�e�/c in 4 Q , N.C.
(Waterbody) ( ty/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
Y I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION ANDIOR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must rill in description below or attach a site drawing)
�tcaax�i�a
£lOZ I ddV
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set
back a minimum distance of 15' f ea of riparian access unless waived by me. (If you
wish to waive the setback, your6ust initial t e appropriate blank below.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Informatio )
Si nature
d►Jt'�( 1q.0
av`�
Print or Type llyyame
Mailing Address
M % rg . _A/
- 128S?`� -
Ciby/S te/Zip
9 -
Telephone Number
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Date
( ent Prope wne Information)
ignature — - -ed 914e—P
Print or Type Name
Mring Address
m q r /1 a, .tlC 7-eS-7�
City/ te/Zip
Telepho e N tuber
Date
(Revised 611812012)

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to b fvid d-h. m 6 e t- a,--f- is
(Name of Property Owner)
property located at / 9� 6r//ii�ehurs� 1�aard
(Address, Lot, Block, Road, etc.)
on �A l �� ��� !'e�� in
, N.C. r
(Waterbody) JCitylTown and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set
back a minimum distance of 1 ea of riparian access unless waived by me. (If you
wish to waive the setback, yo must initial t appropriate blank below.)
140V,� I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
Sr nature
LL Ul � 6 QV rf
Print or Ti�Name
19 S� GU%t�hurz� ,P�.
Mailing Address
Ale
Cit / ate&ip
;7o- r4'v - W!9S
Telephone Number
O c/- o�f— eZo/3
Date
(Adjacent Property Owner Information)
,-"I At 1, A I
'ODU
Siture
gn
S /!
Awe
Print or Type Name
Mailing Address
d" 4 rR -q-,
Cite/ ate/Zip
rt52. - %a',=4/2I0�
Telephone,Number
Ddte,
(Revised 61182012)

bl(l4 194 Whitehurst Rd Smyma NC 28579