47588D - Willetts

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CAMA / ❑ DREDGE & FILL
GENERAL PERMIT Previous permit#
❑New ❑Modification ElComplete Reissue El 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 ! AJ.' State::A,,'�. ZIP
Phone # 2 65 Fax # ( ) Subdivision
Authorized Agent City el ZIP
Affected CW ❑ EW 0 PTA ❑ ES ❑ PTS
AEC(s): El OEA ❑ HHF ❑ iH ❑ USA ❑ N/A
❑ PWS: ❑FC:
ORW: yes / no PNA yes / no Crit.Hab. yes / no
Type of Project/ Activity
Pier (dock) length _
Platform(s) i
Finger pier(s)
Groin length { —
number L
Bulkhead/ Riprap length
avg distance offshore _
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse(Boatlift
Beach Bulldozing
Other
Shoreline Length `ram
SAV: not sure yes no -.—--
Sandbags: not sure yes rno yr
Moratorium: n/a yes
---
i
Photos: yes �o
Phone # River Basin e,-
Adj. Wtr. Body ��"�"-(nat Crriah /unkn)
r
Closest Maj. Wtr. Body
Waiver Attached: yes no
A building permit may be required by: A/// C_ h
Notes/ Special Conditions / -7f fT ileoleG
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
(Scale:
❑ See note on back regarding River Basin rules.
VermitUtticer's Ji nature
Issuing Date
Expiration Date
IyHo
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
Raleigh Office
Mailing Address:
1638 Mail Service Center
Raleigh, NC 27699-1638
Location:
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
Fax:[phone]
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ 1-888-4RCOAST
Fax: [phone]
(Serves: Carteret, Craven, Onslow -above
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 -below New River Inlet- and
Pender Counties)
Revised 08/09/06

/ • _ .
]LAMA/ ❑DREDGE & FILL 4
3ENERAL PERMIT Previous permit#
]New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
ized by the State of North Carolina,Department of Environment and Natural Resources
:oastal Resources Commission in an area of environmental concern pursuant to ISA NCAC f r - 24D0
/ � �� //�
❑Rules attached.
t Name &iv 144�k 7 1 715 Project Location: County ,JGt-y vrp/�r i'
f 5 C-e4/ TS Street Address/State Road/Lot#(s)
)i hi;hf h StateM ZIP zi/Or 54 1,
(9/O) c2o. 2105 Fax#( ) Subdivision
ed Agent City / ZIP ,5e1417
❑CW I } PTA ❑ES ❑PTS Phone# ( ) s' Rivt�r Basin 6..lL
❑OEA ❑HHF ❑IH ❑UBA ❑N/A L c e04',f$. c-A+ nC /t
Adj.Wtr. ody ®/�' nat �F
❑PWS: ❑FC: Closest Maj.Wtr. Body ?O /�,�
yes' / no PNA ye / no Cntt..Hab. yes / no
� " '14r 4/
Project,/Activity yrt 544/�i%! O/1' 7 I (2) �7,/4s Gy/ 7e,A;
.</4//;is5 S/001. (Scale: Il�/I
:k)length
i
,gam '_M} - 7``� 1- - �- / n�r
i 1
I/Riprap length j I 1
distance offshore
x distance offshore t I ,
I
C ,
I
iic yards At _40 L j ..,:s j 1 • /
I ip - • --- ?/7-*(//%,
oatli I I _._�
dldozing rti DSt , I t 1-.
b q�f 11�'Tf 1-*i#4 I i I 1
r
Length �./� 4 ‘I J, 4
not sure yes no �' W
yes /tif+r/ f 1
not sure n !Z,f %r�
urn: n/a yes 6 Ifile
_ cC Le -f1 �- / /es _f/ �,ttached: s no I I t 1 ' /�-4
ig permit may be required by: /4/, ���J. . ❑See note on back regarding River Basin IT/ //rf . I ,. - - - •

Jimmy North - CMC FAX NO. : 9102566357 Apr. 05 2007 10: 13AM P
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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
me of Individual Applying For Permit: C.( 71 >
Address of Property: #S— —
(Lot or Street#, Street or Road)
�✓it—b101/6 fd rJ Art 4 l NE-4/��,q—�rry
(City and County)
I hereby certify that I own property adjacent to the above-referenced property. The individi
applying for this permit has described to me as shown on the attached drawing the development tl-
are proposing. A description or drawing, with dimensions, should be provided with this letter.
I have no objections to this proposal. h O01-
If you have objections to what is being proposed, please write the Division of Coas
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 objectioi
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. (If
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.
APR 0 9 ?on-)
(1/(e 1/4,(c
Sign Name a. Date
A ((
4Print Name
��
(1 . „ - A. _ .

COMPLETE THIS SECTION COMPLETE. THIS SECTION ON DELIVERY
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