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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
❑ Neuse River Basin Buffer Rules
❑ Other:
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 Washington District
400 Commerce Ave 943 Washington Square Mall
Morehead City, NC 28557 Washington, NC 27889
252-808-2808/ I-888-4RCOAST 252-946-6481
Fax: 252-247-3330 Fax: 252-948-0478
(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: 252-264-3723
(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: 910-395-3964
(Serves: Brunswick, New Hanover,
Onslow - South of New River Inlet -
and Pender Counties)
http://www.nccoastaimanagement.net/
nccoastaimanagement.net/
Revised 08/27/ 14
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Harber Contracting Inc
252-3429987
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_ADJACENT RIPARIAN PROPERTY OWNER STATEMENT .,
l hereby certify that i own property adjacent to itY
{Naar of Property Owner)
property iodated at '�
(Address, Lot, Block, Rozid, etc,)
aterbody) {Cit ifown andlor County)
The applicant has described to see, as shown below, the development proposed at the above
location. �,I 1f
l have no objection to this proposal, 05, �
l have objections to this proposal,
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must fill n'descrlptl below rir attach a site drawing)
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'ti} iNAIVERSECTIONwrt
l understand that a pier,. dock, mooring pilings, boat ramp, 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 roust initial the appropriate blank below.) RECEIVED
1— _ _
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l do not wish to waive the 15' setback requireme
,RITA STAR BANNS
'VawUbXdd ttar year a ter signature"
REG, 7at
MY:,', :AMISSION iwXPORES NOV, 30,2020
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FEB 2 0 2017