47426D - Riveli

❑CAMA / ❑ DREDGE & FILL
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
Applicant Name
Address
City
State ZIP
Phone # ( )
Fax # ( )
Authorized Agent
❑ CW
❑ EW ❑ PTA ❑ ES ❑ PTS
Affected
AEC(s): ❑ OEA
❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
❑FC:
ORW: yes / no PNA yes / no Crit. Hab. yes / no
❑ Rules attached.
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision
City ZIP
Phone # ( ) River Basin
Adj. Wtr. Body (nat /man /unkn)
Closest Maj. Wtr. Body
Type of Project/ Activity
(Scale:
)
Pier (dock) length
Platform(s)
Basin
Boat
Boat
SAV:
Sand
Mo
Waiver Attached. yes no
A building permit may be required by:
Notes/ Special Conditions
❑ See note
on back regarding
River Basin
rules.
I
i
Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit **
Application Fee(s) Check #
Permit Officer's Signature l�
Issuing Date Expiration Date
Local Planning Jurisdiction 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:
❑❑ 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
Mailing Address:
1638 Mail Service Center
Raleigh, NC 27699-1638
Location:
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
Fax:[phone]
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)
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

LAMA/ ❑DREDGE & FILL t
iEN ERAL PERMIT Previous permit#
dew ❑Modification ❑Complete Reissue 11Partial Reissue Date previous permit issued
,Eed by the State of North Carolina,Department of Environment and Natural Resources -7 �\
iastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC �. I rl • ` Z`T
Ilf Rules attached.
Name t,.5 i a L�t- 1 Y d LL Project Location: County Oti t,.p L.,....1
P ?X G9 L') Street Address/State Road/Lot#(s)
L iNt>S C'-4 R-1 State N(- ZIP '- L,o 2- VHe:..t t._t.(-- 6-4 f r x C1---\
lb )) 3 Z`l' OLIcIl Fax#( ) Subdivision rr
d Agent City`D iv t=1-1' S re-i2iL:-1 ZIP Z z-1C;
❑CW tEW ) TA ❑ES ❑PTS Phone# ( ) River BasinWN1-1 .
❑OEA ❑HHF ❑IH ❑UBA ElN/A Adj.Wtr. Body V\/�?i-e4-t r2 Z.--121 ? -.— na Ii
❑ PWS: ❑FC: 'V vV ^l .l�
es ;/,no\ PNA yec , no Crit.Hab. yes / no Closest Maj.Wtr. Body
Project/Activity -r JS'r P) L k J r r t A- 1-N N>> I, X 7 ;� 'i- \A L W 1
�1 (Scale: )1,
t)length Co X 1(� fi iNr'
S) 1 x 2 _ - — -
:r(s) -
; I j , � I
fiber / 4 I
f _._ - - i-
fi Riprap length — 1, T
distance offshore ,
distance offshore . ;... I _ .
finnel :* f
I
c yards j i► }-
i i
e/Boatlift
— --�
j
Ildozing
I
. t.. _
y: f
Length 1 �jC1 4 IiI
-
not sure yes no - 4 4- .• i 1
not sure yes ::
im: n/a yes I W 6;.,Lt,it 4_Q e_L _ ... ..-R ;__,—_ _ +
yeS iiii: 7 ;..__ 1 !.. 1
1-
ttached: yes o

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THIS NOTE IS LEGAL TENDER BA 29070527 A
FOR ALL DEBTS PUBLIC AND FRI \,:.it it i
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..-- THIS NOTE IS LEGAL TENDER
.-- FOR ALL DEBTS.PUBLIC AND PRIVATE l , t /4.
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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: /.304if /.7g / p.Q JP II
Address of Property: ,3d G)k/Qf S cfeei 1bL D
(Lot or Street#, Street or Road)
ice ,� 7 72 cj ,Afe-A13 [D/2/51�
(City and County)
I hereby certify that I own property adjacent to the above-referenced property. The indivic
applying for this permit has described to me as shown on the attached drawing the development t
are proposing. A description or drawing, with dimensions, should be provided with this letter
✓ I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coa!
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-796-7:
within 10 days of receipt of this notice. No response is considered the same as no objectio
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must be
bck a minimum distance of 15' from my area of riparian access - unless waived by me. (If3
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.q ement.
ei A. VAlits P` E •
Sign Name Date
O -_--

ARD OF COMMISSIONERS
ma Collins
zirman
rtin Aragona,Jr.
a-Chairman
it Buchanan ONSLOW COUNTY Midgett
eph McLaughlin
NORTH CAROLINA
www.co.onslow.nc.us
LOCAL CAMA PERMITTING OFFICER
604 COLLEGE STREET
JACKSONVILLE, NC. 28540
PHONE: [phone]
FAX: [phone]
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
'PLICANT NAME: �S�-QI (R._ . 1?- 12.�
)DRESS OF PROPERTY:. .Q'c S Chiadti. lam_
'PLICANT'S PHONE: 3a [ .' 3,I t \ 33) z34v -oquiet
[EREBY CERTIFY THAT I OWN WATERFRONT PROPERTY ADJACENT TO THE ABOVE
1~.ERENCED PROPERTY. THE APPLICANT HAS PROVIDED ME A DRAWING OF THE
.OPOSED DEVELOPMENT.
EASE INITIAL THE STATEMENT BELOW IF YOU HAVE NO OBJECTIONS TO THE
'PLICANT'S PROPOSAL.
I HAVE NO OBJECTIONS TO THIS PROPOSAL
J NATURE'OF RIPARIAN.....?--- ol.. .,
INT NAME OF RIPARIAN ,P e
)DRESS OF RIPARIAN %Lk t0 ` '
L>
)MPLETE PHONE NUMBER " � � -
SEE ATTACHED PLOT PLAN

3oMAPS - Onslow County NC Public Access Page 1 of 1
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—. T ax Record NC PIN Number r) inert,i Zoom In Buffer Reports View PRC Find Ajoiners Ta•• Parc.ei ID
Number
Zoom In Buffer Report VI e:w PRO Find rIjoiner .:•i. 772-84 22299 428906496839 RE VELL E5-
7oom in Buffer Report View PRO Find Ajoiner s 772-84,1 63248 428906496892 RE JELL PHI
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