Thompson, Jane

A ?J
©.LAMADREDGE & FILL PVT N04
66418 4�(
4 ENERAL PERMIT Previous permit # A B C D
'N ,e w ElModification El Complete Reissue 0 Partial Reissue Date previous; permit issued,
As authorized by the State of North Carolina, Department of Environment and Natural Resources
and the Coastal Resources Commission inran area of environmental concern pursuant to 15A NCAC
Rules ;itt4ched.
Applicant Name N Project Location: County
Address Street Address/ State Road/ Lot #(s)
Cl State
City f�-L ZIP
Phone# Subdivision
ail
Authorized Agent City ZIP
El Cw El EW El PTA S El PTS Phone# River Basin
Affected
El N/A OEA El HHF El IH El UBA 0 t
AEC(s): Adj. Wtr. Body11 k­ UtdCt /man /unkn
OIRW: yes /�n6 ) PNA yes/ ;ono
Type of Project/ Activity
Pier (dock) length_
Fixed Platform(s) —
Floating Platform(s)
Finger pier(s)­
Groin length
Bulkhead/
ayg distance offshore (11
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boad
Bead
Othe
Closest Maj. Wtr. Body
Shoreline Length
SAM not sure yes ono
I J I .. ... .... . ...... . . ..
n/a yes T 1-1
Moratorium: no'
......... ........ . .. ........ ...... .. . ....... ...... .... ... . ....
Photos: yes tnp�
7-
.0
Waiver Attached: yes no
A building permit may be required by:
Note Local Planning Jurisdiction)-,
Notes/ Special Conditions
�,7
A/ I
(Scale:
El See note on back regarding River Basin rules.
/-\ I / .1 /.
D-7
a�te,

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:
0 Tar- Pamlico River Basin Buffer Rules 0 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 Resources. Contact the Division of Water Resources at the Washington Regional Office (252-946-6481) or the
Wilmington Regional Office (910-796-7215) for more information on howto complywith these buffer rules.
Division of Coastal Management Offices
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ 1-888-4RCOAST
Fax: [phone]
(Serves: Carteret, Craven, Onslow -
North of 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 - South of New River Inlet -
and Pender Counties)
http://www.nccoastaimanagement.net/
Revised 08/27/ 14

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that i awn property adjacent to _.0(1 _. =s
property located atLLJ
(Name of Propbrty Owner)
(Address, t, Block, Road, etc.
an --y r r in Q `- N.C.
(Wmay) (CptyITown and/or County)
The applicant has described to me, as shown below, the development proposed at the above
locations,
I have no objection to this proposal.
.. _ I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
Oniftidua/ proposing development must fill In description below or attach a site drawing)
yt
U �C Vim- C.V V , ( Lk,.'— st t
-s-�
fl C
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set
back a minimum distance of 15' from my area of riparian access unless waived bXJU&1(f
wish• to waive the setback, you must initial the appropriate blank below.) (; E
I do wish to waive the 15' setback requirement. DEC 0 8 2015
I do not wish to waive the 15' setback requirement.
(Property Owner Information) (Ad ...._.,., ®C 11f1- M I -I ® CITY
(Adjacent Property Owner Information)
i�obPul W SgFR►1 166
I3
Signature Signature h , W oil
&,%� lhz so oj�j
P9n!nt or Type Name Print or Type Name�� rl�vt�
Alailing Address - ng
N o Bo X_�g
a�arlr a -
citylsra .�
Qfy&aWZip C icl i q -1 K- o a a `9
Telephone Number Totanhnn. Al.. k -- - Sat 3 f oZ S

Page 1 of j
Subj: T. Thompson document
Date: 11/25/2015 2:32:44 P.M. Eastern Standard Time
From: davidw priceO-bellsouth.net
To: robertsafritaaol.com
Wednesday, November 25, 2015 AOL: Robertsafrit

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to s
(Nanis dt PropertyOwner)
property located at
v (Address, t, Block, Road, etc.
on _ E o r S L , in o _.n1 • �-ca �- , N.C.
(Waterbody) (City/Town 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)
r-
L U r'
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin 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. RECEIVED
1 do not wish to waive the 15' setback requirement. DEC O 8 2015
(Property Owner Information) cenx Property Own
/'J--lC r-7 ' �` er i�
I -I D CITY
Signature
Print or Type Name
Mailing Address
City/State0p
Telephone Number
Date
Print or Type Na e
Mailin Address S� P-AiiT6rrt NC
CitylState2ip 7a $ `7 o q �.
Telephone Number
-- - 1 I - a4- -1 S
Date
�'JIQ�P�Pd' /l��lC—DUB(Reldse°&1&2°„)
�a a-iS

DEC 0 8 2015
®CM- MH® CITY