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dAMA / O DREDGE &;'FILL: ''z -NO. 61 143►
V. ENERALr'.PERIVIIT. . , � Previous,permit # .
ew ;❑Modificat'ion ❑Complete'Reissue ❑'Partial Reissue .; Date'previous.permit issued..
As authorised by the State of NortFi'Carolina Departmerit of Environment and Naturarces l Resou` f
and the Coastal Resources:Commission mian area of environmental concern pursuant to'F5A'NCAC : '
Applicant Name _ W Protect Location 'County
'!Address:44
Street Address/ Siiie
Road/. Lot #(s)
City State ZIP��d.
,.' Phone- ( ) '4 Fax # (__) 1,.. Subdivision
t.
Authorized Agent City ZIP
Affected ❑ CW,. �� A p Es. ❑ PTS Phone # (, ) ' River Basin
'❑ OEA ❑ HHF ".'n IH U UBA ❑ WA r ,, �'
AEC(s): Adj. Wtr. Body! # n��J:�t ��r at an, unkn
ORW: yesC"' . / PNA yes / Crit.Hab. yes / no Closest Maj. Wtr. Body
Type of Project/ Activity
Pier (dock) length
Platt
Fing
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Bulk
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Boat
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A building permit.may be required by: ". See note oq back regarding River Basin rules:
Notes/ Special Conditions ' t:l J "71 P , T , , i + ( 1 , C •" `Q 'l r i "! . ` t �
, .AJ i�\, E 1. + I•;:. f f'' r ?1, ' ' ! ;fit ', _. (,/i :t%�;/li �. 1� il.�r `i 1 ..Y
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} nt or - p icant Phifted N e1.
Permit Officer's Signature
-
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f•
. .tip. •� ,� F ;,.+.
-
jSig n,r C ** Please read compl`
ce statement on back of permit **
Issuing Date ,�
Expiration Date
C 4f
.
jAppli ation Fee(s) '
Check #
Local Planning Jurisdiction
Rover File Name
T�`5ar:
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:
❑ 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: 919-733-1495
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ 1-888ARCOAST
Fax: 252-247-3330
(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: 252-264-3723
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax: 252-948-0478
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-796-7215
Fax: 910-395-3964
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)
.,, MZZq.,
cunw' In your i:a 1tac ,da sheet.
Habitat Name
(�
I
iJ187UR i `(°E
Choose One
f't,i:'s..S�;. Fs, iy;=lil . SG. Ft.
(A.ppiiad rcr. (A,iricipated final
Disturbance total disturbance.
includes any Excludes any
anticipated restoration
restoration or and/or temp
temp impacts) impact amount)
TO, L Feet
(Applied for.
Disturbance
total includes
any anticipated
restoration or
temp irn acts
� FiigAL Faci
(Anticipa,ad fir al
disturbance.
Excludes any
restoration and/or
temp impact
amount
Dredge ❑ Fill ❑ Both ❑ Other
14L�
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 ❑ 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 ❑ Fill ❑ Both ❑ . Other ❑
i
252-302-2130:8 .. 9-033 RCOA3 n:71.AWAA
12 01:26p - _ PERRY'S CONSTRUCTION CORP 919 732 3420 p.1
_ • , ..,. NU. 514 P. 2
ADJACENT RIPARIAN FROkERTY OWNER STATEM NT.
(I'Of? A PMRIMOORING'111LINGSIBOAMI, TIBowY110USE,) '
I hereby ee.ctify that I owit pXoperly adjacent to _
of 4 (Nauue of Properiy Owner) °?
property located at e ✓x a
(Street Address, Lot, Block, Mond, otc.)
Oil , in /�'r�JGi'' �'-f , N.C.
(Waterbody) (Town and/or County)
I3e/she has described to me, as sI wa below, the development he/she'is proposing at tliat
location *and I have no objections to this proposal. 1 understand UML a pierlmoorirg
pilings/boatlj.ft/boathouse must beset back a minimum distance of fifteen feet (15') from1ny area. of .
riparian access unless waived by me. I have i6dicatvd my intentions by Initialing below:, • '1: r',
I do not agree to waive the 15' setback requirement.
I do agree to waive the 15' setback requirement.
4011 �)
.._---___..._-----------.---- --------- ----------------- ---------------- -------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVE, LOPMENT;
(To be}illed in by individual proposing development)
t�t8l ( ID, 0001 boo-- Ii4 d-rt,
1
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rint or Type Name
i
Telephone Number
Date;
JAN. 2.2013 3:44PM NO.550 P. 2
`; ' 7) 7 7 fc**�k,k,k,k�Iok,kleKcKoK*�K8c,1e PHONE NO. 99 Dec. 29 2012 01 f 15PM P01
:�. r4�
{ dc3sluV(xf1tAP11sRIAIOOIIING�fLINGSIIJ() TL1I?;1lrll�ll,j
1 hemby puffy thm I own proporly ecljamst.tp
�q Vamp of Fcoparty Owner) �+
r, • 0 � � •
;e propCu'ty looated at ' " ...�,.' ' �'
(Strout Addl-ass) Lut? Mod, Rood, etcD)
Oil
(VVat�s'botly) (Towlnd/or County)"
He/slip has demobbed to mo, ns shorn below, t17e 4yoiopmolit ho/8110Is proposing at tlltat ,
looattoil. 'and I h* ovo no objeoi ms to this In'opusal. I uucloretaricl 111111, a pla:hnooring
plunge''/boatljWboathouse must be set back a minimum dist'anco of ftftoon foot (151) from i17Y tt<'da of ,
xiparlan a;acess t.tnlus waived by me. I Jim hidiostod my itit-otWons•by lattlaling below: , ;
I jjj agt'ca to waive the W.Ratbuk requiremont, 1
I c,�Q agree to waive the 15" Botbacit requiroment.
' (Initlal�)
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P95MPTION ANDrt R DRAW&7T OF PR02osm-D1tiVit<Lf,1P11 m:
' (7b bar,llled Ere by hidivDi lwrt propodaff development)
50"r7.
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Print or Tnie Name
Teleph ma Number
' bate:._Az — a.
JAN. 2.2013 3:43PM
NO. 550 P. 1
M.�xWEc,L.
BUILDERS, INC.
GENERAL CONTRACTOR
COMMM?CJA' L & R4VID&VnAL
NC LICENSED AND INSURED
.940 COLLARD TOWN ROAp, GOc.DsaORa NC 27594
0MCE79196778.4406 r4X-919n77a4436
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MESSAGE: a► ! // ' S
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