Robertson, Charlie

-4A DREDGE & FIILCI'
O. 61174
GENERAL PERMIT I
Previous permit #
8N OComplete Reissue OPartial Reis sue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources J.
and the Coastal Resources Commission in an area of environmental concern, pursuant to 15A NCAC
Applicant Name k", N
E5 Rules attache&.
Project Location: County
'Address V
Street Address/ State Road/ Lot #(s)
City, LI TO State X,_..ZIP 7, -
y57 Phone,# Fax #
� 7- r
- 7;
f
Subdivision -
Authori ze v v
City.
'ZIP
❑ CW �,EW PTA El ES El PTS
T i,
Phone # River Basing t'.,
Affected
El OEA [I HHF EI IH El UIBA El N/A
AEC(s
Adj. Wtr. Body nat rma )/unkn)
El PWS: El FQ
/*
'n 'no
I
Closest Maj. Wtr. Body lt
ORW: yes //no PNA/ yes,/ no Crit.Hab. yes
ti
Type of Project/ Activity I n
I
(Scale:
Pier (dock) length_
Finger pier(s)_
Groin length _
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards_
Boat ramp 5—,
Boathouse/ Boatlift
Beach B�llrzlpg
Other
Length-
'Shoreline
SAV: not sure yes
Sandbags: not sure yes no
Moratorium:: n/a yes no
yes,j n -Photos: 01
Waiver Attached: yes no
V
-A building permit maybe required by:
i
El See note on back regarding River Basin rules
Notes/ Spe ial Conditions
L I
c
7
Z
�gent or Applicant Printed Name
)A
Permit Officers Signature
S1 ture, Pleas ad compliance statementon backof Permit **
PI CoMplian
- I lssuinkDai�
—J
Expi�ation!Date,
P.
'4�1 cation Fee(S)
Check#
Local Planning Jurisdiction
Rover File Name

4b
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 I) 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, certifythatthis project is consistentwith the North CarolinaCoastal Management Program.
River Basin Rules Applicable To Your Project:
Tar- Pamlico River Basin Buffer Rules ❑ Other:
0 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 (252-946-648 [)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 Washington District
Mailing Address: 400 Commerce Ave 943 Washington Square Mall
1638 Mail Service Center Morehead City, NC 28557 Washington, NC 27889
Raleigh, NC 27699-1638 252-808-2808/ 1-888ARCOAST 252-946-6481
Location: Fax: [phone] Fax: [phone]
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
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)
(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)

Y AL A
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue, Governor James H. Gregson, Director Dee Freeman, Secretary
Date 31—
Applicant Name ���✓�0 —
Mailing Address / , Uf .
I certify that I have authorized (agent) to act on my
behalf, for the purpose of applying for and obta - ing all CAMA Permits necessary to
install or construct (activity) T 4f !,444 01~
at (location) -I/ Oc. ! B q 4—a—*M 1`

r JACE�. r mp, uti' Pgoi3t
-
hereby certi that:I OWn property adjacent to
• (�,'ttme of PrcpertY - Owner)
Property located :at :�-rrr�:
- - izQc; Block,=RQ�ed; etc.3: • - , . .. ... - _ . .. •
(SVnterbody)
CFc.. aaiUor-Couoty2
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"I hav�nq ob,�echo to hispioposI IundecstI6d--that apierltu�on piit oatiiRbcacho10
use
in
be si bacl:.a mi' 'i' ucri discan �' ce of fi-iteeai feet3')'from my area of riparian access unless
waived by me:
I sgot ish to n give iha•setback �egt�ittieitt: :
I �+' • to iilive'tha;setback rrquii+tien
711
DESC P'I7Q AllD/fit I) Ati 'ii�G -Olr PAOPOSEi�<DEi'EI.OP IEi�'?•':
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o be f11lerl iii L��iiuff 111ira1 propos•�'rrgrterPlopiitri;j
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