47405D - Quinn

CAMA / 12 DREDGE & FILL
GENERAL PERMIT Previous permit #
[]New ❑Modification El 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 7 �'t j �� `'
N Rules attached.
Applicant Name -1=, i. tv-,-
Address i� C)
1 A
Ci
V F- L- C
State K)
zip
Phone # O
Fax # ( )
Authorized Agent
'6
❑ CW
DEW
;KPTA ❑ ES
❑ PTS
Affected
AEC(s): ❑ OEA
❑ HHF
❑ IH ❑ UBA
❑ N/A
❑ PWS:
❑FC:
ORW: yes / no,'
PNA
yes /-M> Crit.
Hab. yes / no
IType of Project/ Activity
Pier (dock) length
Platform(s)
Finger pier(s) }
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin;;channel ic��
cubic yards
Boat ramp -
Boathouse/ Boatlift -
Beach Bulldozing
Other
Shoreline Length ' 5
SAM not sure yes no -
Sandbags: not sure yes rid—.
Moratorium: n/a yes (fi$
Photos: yes (Lw-
Waiver Attached: yes `t O5- r
A building permit may be required by:
Notes/ Special Conditions
T
Project Location: County I �P n� r
-
Street Address/ State Road/ Lot #(s)
City �,--3- 15c. zip
Phone # O River Basin L�A �-
Adj. Wtr. Bod(nat /ma-n n)
Closest Maj. Wtr. Body L i�-
(Scale: I i - -Z �:, )
'} • ❑ See note on back regarding River Basin rules.
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
Pg` mit Officer's Signature
1 LI c)
Issuing Date Expiration Date
Local Planninglurisdiction Rover File Name

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, certify that this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
Tar -Pamlico River Basin Buffer Rules �_ Other:
[JI 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
Central Office Elizabeth City District
Mailing Address: 1367 U.S. 17 South
1638 Mail Service Center Elizabeth City, NC 27909
Raleigh, NC 27699-1638 252-264-3901
Location: Fax: [phone]
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
Fax: [phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Morehead City District
400 Commerce Ave
Morehead City, NC 28557
202-808-2808/ 1-888-4RCOAST
Fax: [phone]
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico 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)
Revised 06/29/05

‘ ....2p1()Z(
CAMA/ , 'DREDGE & FILL
GENERAL PERMIT Previous permit#
iNew —Modification iComplete Reissue iiiPartial Reissue Date previous permit issued
x'ized by the State of North Carolina,Department of Environment and Natural Resources
Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC 7 1 . / 5'0 fl
J�Rules attached.
it Name Zhrs.. 0 LAr Project Location: County 1 e i�t
P. 0 • 13 0.A 3 3 U Street Address/State Road/Lot#(s)
E0ANSVLI-Lt State IJt ZIP Zg3919 92,LI G11, / Ay
v( ) Fax#( ) Subdivision
zed Agent 6'Av t G Alt D u€ A.._ City c PS at L_ ► eA e-N ZIP 7_81-'1 I
i ❑CWWTA ❑ES ❑PTS Phone#
( ) River BasinLgQ
❑OEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Bodyok'S Al L S '& (nat<
❑PWS: ❑FC:
` Closest Maj.Wtr. Body go Po KS C--H ate,_i
C_
yes / PNA yes sp Crit.Hab. yes / no
if Project/Activity in Ai.�,i c N r, 0 c_.- E e x C.A✓A--r 1, ►..)
(Scale: i l' :.
ck)length
n(s) I ' ' ` -` + —
Dier(s) I T
ongth i ---
ember i I
id/Riprap length
i j r _i t 1 - I I --
g distance offshore
ax distance offshore
1 I I
:hannel (2v SOX-9 5"a tJlw F1P.ixi dtpro, I
ibic yards i_..
use/Boatlift --~r--- -
Bulldozing I i — ? !
z� i
v1
/ 1
/,1 /� 12
ie Length 'j��J f 'not sure yes now, I I I
s: not sure yes 4 .
4
rium: n/a yes (� L f `, I- t
yes In , I
Attached: yes Or) I I , I I

-03-2007 09 :55 AM P. 01
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9111.ACENT 432A,' AN PROPERTY Q i QI.ITLC J1 • W•_V R F':r ti
lure of:ndisidaal Apply g For Permit: fi r 4r is'/J
.Acl Less ol'Proper;�y: 41111 C4 4 STliet
Lrn Or Street#, Street'or Rocr_`
(CID eld County)
•
1 .heccby certify ths: 1 ow property adj4cent to the above-refereve.:c roper!), The
for tn:s perr it ha described tc me as shown el tFe art;ched dra vin3 the.fe.
:re iroposin,t. A descr:p►.'.n or drawing, with dimensions, shoLid t+e.p ovided«itlt ::r.s I.7;e=.
• _I I have io cajections to this proposal. •
if yr.ou have objections o what s i'
1 is betst, proposed, please ,, rite ..ae Utti•utc'►r, of t_t.:1st.1.
V1:1 hagernent,- 12 i Cardi al Drive Extension, 1 i;rtingtoa, NC 28105 or call 91071'9/i-711!
w itisin 10 days of receipt •fthis notice. No response Is considered ch,e same as no otseciir„t
vent hove beet notified b Certified Mall. ; -
WAIN/T.R SECTION .
•
I erder9tand that a pitr, .ack;.tto•orin.gpilings,b-ekwater,boat house or boat lift rtast.be r:t
1)ck a minimum distance ►.f irfrom my area ottiparian access-uallIs whii•ed by inn.
ish ?c, % aice the setbac ,you must initial the eppropr:ate black b .
ish to waive the IS'setback requirement.
I o I wish to waive t'oe 1 'setback rc urernettt�
Nap" Date
•
l
Print Name •
—
• NCDENR
Tttephor:eNumber with ea Code

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: 9� - / T1 (9d/n/J
Address of Property: f vi G t.: /7UL
(Lot or Street #, Street or Road)
R e , `6 , . . gae,
(City nd County)
I hereby certify that I own property adjacent to the above-referenced property. The indiv
applying for this permit has described to me as shown on the attached drawing the developmen
are proposing. A description or drawing, with dimensions, should be provided with this len
I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Co
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-796-
within 10 days of receipt of this notice. No response is considered the same as no object
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock;:mooring pilings, breakwater, boat house or boat lift must I
bck a minimum distance of 15' from my area of riparian access - unless waived by me. (I
wish to waive the setback, you must initial the appropriate blank below.)
i I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
/ %A / .113/-v
L
Sian Nam Date
______,-41 A/ kn./7L6 /i) . - A'f 'rA
Print Name .
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