37906D - Prevatte

317906
lICAMA/ 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 --7
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC / I/. 12 0 //
f� ('Rules attached.
Applicant Name 6 n o i re� lj'VA—rTC Project Location: County au vScc>/Gdt
Address 1p /
0Q l Ot 7/ Street Address/State Road/Lot#(s)
City So u 14 Po-r-r State ilC ZIP ?i�%%/ g 02 6t 1 Zgt-Z. ii-t. O
Phone#( II Z 30 2FZ#( ) Subdivision
Authorized Agent City 04k (SLR ZIP (O
Affected NA4W [4 LW 6A ElES ❑PTS Phone# ( ) River Basin
AEC(s): ❑OEA ❑HHF El IH ❑USA ❑N/A Adj.Wtr. Body (Vet- 4g0 an /unkn)
❑ PWS: ❑FC:
ORW: yes / ; PNA yes / no Crit. Flab. yes / no Closest Maj.Wtr. Body /W�
o
r Type of Project/Activity 'V Wi 0/ lX(ji #c/ c A-T rz/n �4"h 7 )( /4
gi� P'E2 pt€2
• (Scale: )
Pier(dock)length ,j$ X y
Platform(s) t 0 X (�D` ._ at z }� .- (JQ/�
Finger pier(s) r _ r ,._
Groin length
number L..v r
Bulkhead/Riprap length !$ �i>1
71
avg distance offshore i6
max distance offshore 0tc--� ! IBasin,channel __ G.,,,,,,r.1
cubic yards .5,/� 5r6l31
Boat ramp f Q4 _
Boathouse/Boatlift —
Beach Bulldozing t I \\4 '/ j
Other I OW .
- - j t i I
Shoreline Length 139' - _el.)
Euma
not sure yes n ;
DAB• lIo CPsri /� --4.16
yes yes n r_ p � ,
rt
Photos: Y no '- ' 1 -. /5 9
Waiver Attached: yes no ; I �./n� ,� -- 1
A building permit may be required by: (:) . /564/La /ivy ae" . I"!See note on back regarding River Basin rules.
i
Notes/Special Conditions / -e 1 QT �B e!_c4 //UM /5 Prt p� /44/
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TO /o¢3 d s /y 45-17 S,u s��/t-4-zP 4c sea, 74. /2a
P IL,), ,,ec,k ,
Agent or Applicant Printed Name Permit O�fffiice s Signa re
f
7 /5O 7 /5" - i
S' re �"�`Please read compliance statement on back of permit'"* Issuing D e ratio ate
/00 Z37/ 04� /561i 'OL/1c s4
Application Fee(s) Check# Local Planning Jurisdiction ver File Name

r
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 I)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(9 I 0-395-3900)for more information on how to comply with thesebuffer rules.
Division of Coastal Management Offices
Central Office Elizabeth City District Washington District
Mailing Address: 1367 U.S. 17 South 943 Washington Square Mall
1638 Mail Service Center Elizabeth City, NC 27909 Washington, NC 27889
Raleigh, NC 27699-1638 252-264-390I 252-946-648 I
Location: Fax: [phone] Fax: [phone]
Parker Lincoln Building (Serves:Camden,Chowan,Currituck, (Serves: Beaufort, Bertie, Hertford, Hyde,
Dare,Gates, Pasquotank and Perquimans Tyrrell and Washington Counties)
2728 Capital Blvd. Counties)
Raleigh, NC 27604
9I9 733 2293 / 1 888 4RCOAST Morehead City District Wilmington District
Fax: [phone] 15 I-B Hwy. 24 127 Cardinal Drive Ext.
Hestron Plaza II Wilmington, NC 28405-3845
Morehead City, NC 28557 910-395-3900
202-808-2808 Fax: [phone]
Fax: [phone] (Serves: Brunswick, New Hanover,
(Serves:Carteret,Craven,Onslow-above Onslow-below New River Inlet-and
New River Inlet-and Pamlico Counties) Pender Counties)
Revised 10/05/01
www.nccoastalmanagement.net

nrusiON OF en4.STAL MAN k ,MEN-
. ADdACE_11T RiPARiAN PRnPFRTY nVPi�tFR 'OTiFt(`ATiA *R* •� ���
Name Of Individual Applying For Permit cf o S C-d/, 8 V'tG ko
Address Of Property: T' O 2 U�,L:z,-4 fit)) #9,,
(Lot or Street#, Street or Road, City.&County)
I hereby certify that I own property adjacent to the above-referenced property. The individual
applying for this permit has described to the as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions, should be provided with this
letter.
I have no objections to this proposal.
If ynn have nhjertinnc to what is being prnpncerl, pleace write the nivicinn of Cnactal
f arrfinal Drive gTilmino�n» i�*nrrh ' 7�n�
�9f1f1 wrthm 1()ria4 of rnrr+,..► •e '1� nr tall 910�9� _
csf thtt txrntx+ Nn duct nnc�.c -nciden��the c�m�nc..., yrr,ten
if you have been notified by Certified Mail
WAIVER SRC'TIoN
I understand that a pier,dock,mooring pilings;breakwater, boat house, lift or sandbags 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.
0 I do not wish to waive the 15' setback requirement.
Signature Date AIM
Print Nam/v a7(y 7h y? NCDENRTelephone Number With Area Codle ereurnsper or
•
Emeinermocr Mep Hama.Reap Fs

DIVISION OF cn&S1'AL MAN&GEMENT
i'
ADJACENT RIP 4RIAN PROPERTY OVPNFR NO'iTFt(•AT1O1\LWA VER FORM
Name Of Individual Applying For Permit 'O S •/h u f-G N ,/a
Address Of Property: gQ 2 64 i /�4 e t) iOr,
O8-1( Z�SLgh � it/ e
• (Lot or Street At, Street or Road, City&County)
I hereby certify that I own property adjacent to the above-referenced property. The individual
applying for this permit has described tome as shown on the attached drawing the development
they 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 Coal
Management 177 North Cardinal Dore, Wilmina n_North C
19011 within 10 days of receipt of this notice_ No is_considered reli es or rail 41 a Lion
response the same as no objection
if von have been notified by Certified Mail
WAIVER SECTION
I understand flint a pier,dock, mooring pilings;breakwater,boat house, lift or sandbags 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.
1 ikutoi wish to waive the 15' setback requirement.
3 -VI -aLi
ATCIOYA
44Signature Date
eient K��us Di- i9M Wovics r
Print Name
_ qt0- 218 ^ Boll NCDENR
Telephone Number With Area Code
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