Greene, Mark

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ERAL,PER"T rtmous permit
NewModifi6ii6h C6mp ete Reissue 10artia!ReIisUeQate previous Dermit.issued Y.
&a'uth6riz6d by - the 'State of Nbrt:K.Carolina; Department: of Ehvieonrnentand. Natural Resoui'6�"
s Commission in-an:a�*di 6f.en�ir*cinmental concern to I SA NCAC,
and the Coastal Resources
ou conc r pursuai6t
ram, ; ��.; . I , I � .1 , . . -, c e 2911bles A
FAOplicant Name .County
Troject Location !i I
�:.
Address,.Street Addriiss/,�State Road/..Lot,#(s)'
d 8A 7
CitY--2-�L-Je State ZIP �
7-
Phone # Su'bdiyisidn Fax #
Authorized Agent City ZIP.'
CW.
Affected w PtA PTS Phone'#,;( . River Basin 'ES El
El OEA EIHHF: EAH* El UBA 0 N/A Y If enat,lman unkn /
AEC(s): Adj. Wtr. Bod I /-;v K
El PWS: 0FC-
ORW: yes 8 PNA no Crit.Hab. yes /Cho Closest Maj. Wtr. Body
Ty0e of Project/ Activity
Pier (dock) length x (00
Pla,(ormff
Fing
Gro
Bulk
Basii
Mai
Bow
Beac
Othi
Sho
SAV:
Sand
Mo
Phot
Wait/
A.bu
(Scale:
-r pier(s)
-I length
number
jead/ Riprap length
avg distance offshore
max distance offshore
ME
channel
ENE
MENEM
91
NONE
A
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Ll
No
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ME
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Notes/�S.eci I Conditions
4
U
Agent or Appileafit PU
Perm0' Jficer'iSlinature
0
afi
nature plib�c
$ignat PJease reaj�� e statement on back of permit
Issuing Date
, .
Expiration Dhte
1Y
..... ...
Application Fee(s)
np�
Check#
Local PlanningJuriscliction:
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, 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 Headquarters
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 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)

I
CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONMAIVER FORM
Name of Property Owner.
Address of Property: D Y-,y
(Lot or Street #, Street or Road, City & County)
Applicant phone #: �� - �q DOW_ Mailing Address:
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to"me as shown on the attached drawing. the development
they ar proposing. A.descripiaon or=drawirto: with dimensions must" be "provided witis`lettgr,.
I have no objections to this proposal. I have objections to this proposal.
if you have objections to what is being proposed, you must notify the Division of Coastal Management
(DChp in writing within 10 days of receipt of this notice. Contact information for DCM offices Is
available at www.nccoastaimangementnet/contact dcm.htm or by calling 1-888-4RCOAST. No
response is considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, or lift must be set back a
minimum distance of 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 wish to waive the 16 setback requirement.
I do not wish to waive the 16 setback requirement.
(Property Owne=rmation)
Signature
G - y)---),=), <z Y, e-
Print or Type\ Name
M ' ing Address
City/State2ip
Telephone Number
?- 11 1-3
Date
JA.'4anMXTer
Information)
fur
m4riiy4
k
Print or Type Name
few
/ 7 A A'V-0h,
F-�
Mailing Address
64U4-+,IJC•
/
City/State/Zip
a5--.a- r-36-
Telephone Number
Date

otv e
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any
q

CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DMSION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOMFICATIONIWAIVER FORM
Name of Property Own
Address of Property.
(Lot or Smear #, Shvet or Road, City & County)
Applicant phone#: S f '34 1 Mailing A 0�->
C . MC 1 i _f .• . .. � .. •.0 • t _ ... Y' • .. ••• C
_�• • •I -ills 1 • c • • c: • • _ r • 1 m «ir.7. •1 - • 1 • c • a
Ill
_ _i •: •:• • .i a. ej;t)i aJ • _ �J.( [,� ,1Lt + ltti�si^.�•11_ �7. `.: +Jli!i--�? �il!i U F
ffyouhave ohWtbmfo*lWis ,yDun ii,inotFytheDbWmofCcastalAbangwmnt
aWAQ In *rXV wftin 10 days of receipt of this notice. Contact hrformafion far DCU offices !s
avaUable at wwwnerasts Lnet1contact dcmhbn or by calling 1-$884RCOAST. No
response Is_considered the saute as no oblecbon ff;6u )me been mxMd by CerbDed AAA.
WAIVER SECTION
I undue that a pier, dock, moorhg dings, breakwater, boathouse, or lift must be set back a
minimum distance of IS from my, area of riparian access unless waived by me. (if you wish to
waive the setback, you must inHJal the appropriate blank below.)
1 do wish to waive the 15' setback requirement
I do not wish to waive the 15 setback requirement
(Property nfo 'on)
Signature
� • YYI �I� icG- ��no„�
Pnnt or The Name
md!�TRIC"MQi
,33U�'-4 Y-)
Sato -'?y)- -:1
Telephone Number
g) I 1�
Date
( Properly i ormation)
.A
�gnafure
faint or Type Name
G /./,vo,u -po , . T 6Acl
M .. gAddress
City/State/rrp--7-r—
Telephone Number
06(3
Date

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1796
ELKIN CREEK MILL VINEYARD & WINERY INC
318 ELKIN CREEK MILL RD
ELKIN, NC 28621-8860
r7. 69-129-515 -
DATE
PAY
TO THE
ORDER OF i���\�1✓---
11 �- p
DOLLARS 8.�•a..
1V V[
Community Bank
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FOR
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