Staley, Charles

^ ;KCAMA f'❑ DREDGE & FILL N? 62103 G
GENERAL PERMIT Previous permit#
❑New ❑Modification El Complete Reissue El Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Res
sour
the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC9,1200
❑ Rules attached.
Project Location: County_-�
Street Address/ State Road/ Lot #(s)
Subdivision
city rr s zip ►�Z�
Affected ❑CW TKEW .PTA rXES ❑PTS Phone # ('�°— ) L 4-71 Rive Basin yv t'f"Q
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ USA ❑ N/A Adj. Wtr. Body �Gti a man unkn
❑ PWS: ❑ FC:
Closest Maj. Wtr. Body I
ORW: / no PNA yes / no Crit.Hab. yes / no ye
Type of Project/ Activity
Pier (dock) length Q',,x(
'X A Platform(s) 20,
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards_
Boat ramp
Boathouse/ Boatlift
Beach
Other
Shoreline Length r
SAV: not'sure- ®e no
Sandbags: not sure yes
'Moratorium: n/ayes
Photos: yes
Waiver Attached: yes L...
. i '. -r• e. 1
--7' 1.
r` d
(Scale: I a- U )
cation Fee(s)
tatement on b(k
ermit Isi
u�nrgJurisdictibn x-( . A

•
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, certifythatthis project is consistentwith the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
Tar- Pamlico River Basin Buffer Rules ❑ Other:
E 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)

f4c-
14i,
20-13;
• Sender: Please print your name, address, and ZIP+4 in this box •
Cl c i'e S j�-al I
3117 iN fl

■ Complete items 1, 2, and 3. Also complete
iterfl,4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
Cu a kDv-'
AIL
A. Signature
Agent
El Addressee
B. cQivudhby" rin/d� C. ata 117
D. Is delivery address ri ferent from Item 1?1 ❑ Yes
If YES, enter delivery address below: No
3. Servi Type
rtrfied Mail ❑ Express Mail
Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
`3 11 14. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number
(Transfer from service label)
PS Form 3811, February 2004
7012 1010 0002 8059 3290
Domestic Return Receipt 102595.02-M-1540

UNITED STATES POSTAL SERVICE
First -Class Mail
Poslag .&Fees Paid
USPS
Permit No. G-10
• Sender: Please print your name, address, and ZIP+4 in this box •
3117 14;c-.,K y
V
-,-733 0 D/

■ Complete items 1, 2, and 3. Also complete A.
item 4 if Restricted Delivery is desired.
e Print your name and address on the reverse
so that we can return the card to you. ,: `
■ Attach this card to the back of the mailpiece,
or on the front if space permits. 4. ^
1. Article Addressed to: 4
ra
Ll
N-
(,L ❑ Agent
E Addressee
by (Printed Name) 10. Date of Delivery
Ny address different from item 12 ❑ Yes
enter delivery address below: ❑ No
3.FC
ce Type
ertifled Mall ❑ Express Mail
egistered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (EXtra.Fee) ❑ yes
2. Article Number 7 012 1010 0002 8059 3283
(Transfer from service label,
PS Form 3811, February 2004 Domestic Return Receipt I102595-02-M-1540

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
lame of Property Owner: X-a A e- 5;
O I1 f t
Adress of Property: 1 �1 �� he r i- y U t,' c A3 Hk Y-'k-e c�5
(Lot or Street #, Street or ad, City & County)�� )
C« r#a ref Cc, to � .� �C.
applicant phone #: 1 — %j Mailing Address: , 1 � t e-r �-
hereby certify that 1 own property adjacent to the above referenced property. The individual
pplying for this permit has described to me as shown on the attached drawing_the development
iey are proposing. A daagdptlon or dramna, with diMenglIns. must be proviftIbis test
I have no objections to this proposal. I have objections to this proposal.
`you have objections to what is being proposed, you must notify the Division of Coastal Management
DCM) in writing within 14 days of receipt of this notice. Contact information for DCM offices is
vailable at www.nccoastalmangementnet/contact dcm.htm or by calling 1-888-4RCOAST. No
esponse is considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
understand that a pier, dock, mooring pilings, breakwater, boathouse, or lift must be set back a
linimum distance of 15' from my area of riparian access unless waived by me. (If you wish to
taive the setback, you must initial the appropriate blank below.)
1 do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
Property Owner Information)
'ignature
Tint or Type Name
4ailing Address I
;G fire, cc�,'� 2i3 3G�
:ity/Sta e/Zip
elephone Number
r L413
)aid I
(Riparian Property Owner Information)
Signature
1 a 61h E v^
Print or T pe Name
Mailing Address A11
City/State2ip
Telephone Number
Date
!- t_B 0 (i 101

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner:
e'
Address of Property: 1: 0 1 lie �llf' Y r5 -r:5
(Lot or Street #, Street or Rbad, City & County)
ff `
Applicant phone #: l q— C1 99— 7� 71 Mailing Address: 10 '7 14,c Ly (- ,1 �r _
,So P1 -(�rFA I , A/ C . a. � --3 -'�- e)
1 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 are proposing. A description or drawijng, 38dLh dimensionsmust be provided with .
I have no objections to this proposal. 1 have objections to this proposal.
If you have objections to what is being proposed, you must notify the Division of Coastal Management
(DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is
available at www.nccoastalmangement.neticontact dcm.htm or by calling 1-888-4RCOAST. No
response is considered the same as no objection if you have been notified by Certirted 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 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
Signature !
rl6r e—s a
Print
/r or
TypeN/'am/eo V^-
r44
Mailing Address
,)<q n -Cb (A, JVC --2) ? G
CitylStatelZip
q l Q-1/67 9 - 1-171S
Telephone Number
.Date
(Riparian Property Owner Information)
Signature
Print or Type Name -
Mailing Address y
CitylState/Zip
Telephone Number
Date

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