Parker IV, Linwood

P-/
'_:1 LAMA / " ! DREDGE & FILL A B C D
GENERAL PERMIT Previous permit #
-!New Modification Complete Reissue 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 in an area of environmental concern pursuant to 15A NCAC
Rules attached.
Applicant Name Project Location: County
Address Street Address/ State Road/ Lot #(s)
City _ - State_— ZIP
Phone # ( ) E-Mail Subdivision - -
Authorized Agent ' .1 I , I __ City_— —_-_ ZIP_ _
Affected CW EW PTA El ES ❑ PTS Phone # O _ ___- River Basin
-
❑ OEA HHF IH ❑ USA ❑ N/A
AEC(s): Adj. Wtr. Body _ _ (nat-/man /unkn)
❑ PWS: ---
ORW: yes / no PNA yes / no Closest Maj. Wtr. Body-_-_---- —__--
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Agent or Applicant Printed Name
Signature "Please read compliance statement on back of permit**
Application Fee(s) Check #
Permit Officer's Printed Name
Signature
Issuing Date Expiration Date

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 L_ 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 how to comply with these buffer rules.
Division of Coastal Management Offices
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ 1-888ARCOAST
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.nccoastalmanagement.net/
Revised 08/27/ 14

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to L-4n V400 H 1' G,/ V-./ s
(Name of Property Owner)
property located at
on
(Waterbody)
Address, Lot, Block, Road, etc.)
in N e,4pia /-y N C _e* , N . C.
(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 DEVELUPMtN i
(Individual proposing development must fill in description below or attach a site drawing)
t�✓e •�.r�m' A+\-o e�I ed
WAIVER SECTION
I 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 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.
on)
Print or Type Name
111 ---I -ne-1
Mailing Address
f�l Dy,�A QS1 o
City/Sta e2ip W OtN
5 a • C64(O . (O (0-5�0 QC . yr If -. C�'lr�n
Telephone Number/email address
10-71.1-1
Date
"Valid for one calendar year after signature*
(Adjacent Propry Owner Information)
bS\-�
Si nature*
� e. �-C,
1�
Print or Type Name
Mailing Address
N 9-, r��} r-3 C �'?�S'1 L
City/State2ip
Telephone Number/email address
Date I-t7l "� �EIVE
(Revised 4#A.R2216) 2018
DCM- MHD CITY

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to L %*n%t-i0INc4 Inc✓ ,s
(Name of Property Owner)
property located at � �� }-iw�l 01�
(Address, Lot, Block, Road, etc.)
on &Qa )P Sc1MICi �i� vJ —,in N e.�pp./j, t1C (O e,/ py N.C.
—�3 (Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
x 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)
WAIVER SECTION
I 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 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.
n)
Print or Type Name
—11 k H w.q 04
Mailing Address
�I a ier n.�iA r4 C Q25:3
City/State ip
005a • t_o,-t In • (n (. -so
Telephone Number/email address
%a_-,.1-,
ro=$ 4
*Valid for one calendar year after signature"
(Adja nt ro ty formation)
SS,'gnature *
K c./ R ro,-A,n
Print or Type Name
'm -10-1 H.,►..a0-44
Mailing Address
City/Stat6/Zip
Telephone Number/email address
Date
(Revised AU A(x)2018
DCM- MHD CITY

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