39736D - Robinson

0 CAMA / DREDGE & FILL
/
GENERAL PERMIT Previous permit #
Y� X.New Modification ritomplete 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 hi/`"' /' •i i u
Rules attached.
Applicant Name ba.4I-e( 40,be ii sen Project Location: County 8 t,i-7 S k l C ram.
Address -7'71 e a 55
/I Creek IZor_. ci Street Address/State Road/Lot#(s) a')5
City %r'..- 7aC/r? State A/C ZIP i` Ci le.r 1 ,1YCe1
Phone # ( ) - Fax# ( ) Subdivision
Authorized Agent Grey / - City 15Di/Via- ZIP"?7��!1
Affected ❑CW W✓ 4,'TA S E PTS Phone # ( ) _ River Basin (,(.(1u / 'I-'
AEC(s): E. ❑HHF n IH ❑UBA ill WA Adj. Wtr. Body 't)C+ -1-4)°1/�(U '--"L`� (na /man /unkn)
PW5: FC: ZeiC We'VdoC( ,ei1`C/L-.
ORW: yes / no PNA yes / no` Grit.Hab.' yes / no Closest Maj.Wtr. Body
Type of Project/Activity I-6 '' .4 • ..'C-f pie/'1 ;6'oci-t u,;_- - , 8ttlti,c ucL
(Scale: r . 1-..20' )
Pier(dock)length (0C)
I - i I S I I I
Platform(s) I I X l ——
Finger pier(s) I 2-X I I Cd> i. • 1 • jj (I
—+- I� - •i. �1 f e(
Groin length -I I )
number i I 112.1 • ` " --""--"7"••-`
Bulkhead/Riprap length � , , j . , _ _ _ - f t Y -/ Y__ } ✓—• -I y ..... _.. .l L r ._ r -f"`l-- ..... _ _ I- ... __4-__..
`-avg distance offshore _-I ',
max distance offshore I Y --_ __.__ ..__ 1 ,_+-..-..- r _I �
Basin,channel ' `+ � �1
.4,_ k.,._.,_., , , , . , -._ :
cubic yards } 1 I la? 0, . 4 ' f '
Boat ramp ---r— j . 1 , t}fir - ! ' 1 i -- _-.
Boathouse/Boatlift I 4 I f
Beach Bulldozing — _ 1 10 6l i
Other I .�I i i- - -
-1 f
�Shoreline Length_ � i - ' _. U' , r
SAV: not sure yes na i • ( '
Sandbags: not sure yes (no I eh*- I
Moratorium: n/a yes _ i _� _{ �
Photos: yes no �� 1 ' Ive i le �,
Waiver Attached: yes no I I i - I 1 __--__-- z 1
_
A building permit may be required by: 8✓1 v 5(4JI C k C0' . I I See note on back regarding River Basin rules.
Notes/Special Conditions - C-G1^61 t 'i-t( :i , 4- ')f-I /Ito 9- 7/ /Z.CZ) 'aj`-'/ ,4 -
►jo r v !,,,,A NI VS"' be- kt lu.>-td PI a,J-i d c c5-r,,0,c ,_t
Agent r;::apnt Printed Name Permit Officer's Signature
rw
Signature "°`Please r d compli ce statement on back of permit" Issuing Date Expiration Date
f3rz,rtSu��C,�C�l,,z-z`Y No/7/e n ah,pi
Application Fee(s) Check# 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 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(910-395-3900)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
I638 Mail Service Center Elizabeth City, NC 27909 Washington, NC 27889
Raleigh, NC 27699-1638 252-264-3901 252-946-6481
Location: Fax: [phone] Fax: [phone]
(Serves:Camden,Chowan,Currituck, (Serves: Beaufort, Bertie, Hertford, Hyde,
Parker Lincoln Building
Dare,Gates, Pasquotank and Perquimans Tyrrell and Washington Counties)
2728 Capital Blvd. Counties)
Raleigh, NC 27604
9I 9 733 2293 / 1 888 4RCOAST Morehead City District Wilmington District
Fax: [phone] I5 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)
www.nccoastalmanagement.net Revised 10/05/01

GENERAL PERMIT COMPUTER FORM
APPLICANT NAME: i)C' Lt c e (
ADDITIONAL NAMES:
AEC DESIG: FL.) E 5 PT DEVELOP AREA:__.c r PROJ DESC: P - /t
(Will only take 6) (Will only take I)
WORK: (,c) TE ,a l4
(Will only take 4)
L !1, / , 61,
MAINT:
(Will only take 4)
(will only take 6)
ACTION EXPIRATION
DREDGE&FILL REQUIRED: i//i 7/oV „,f/7/4''5
CAMA MAJOR DEVEL REQUIRED: ii�i 7/04f ..z//7/(,)

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• ' • DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONRVAIVER FORM
Name of Individual Applying For Permit: A.n )f/ Rak.(1.5.0q .
Address of Property: Z 7 S & s -e e
(Lot or Street##, Street or Road)
go y,k 04.C.
(City and County)
6/)•nv15 w,2 )(- Cv .
I hereby certify that I own property adjacent to the above-referenced property. The
individual
applying for this permit has described to me 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 Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910 39-3900
within 10 days of receipt of this notice. No response is considered the same as3900
you have been notified by Certified Mail. no objection if
•
WAIVER SECTION
I understand that a pier,dock, mooring pilings, breakwater, boat house or boat
be
set bck a minimum distance of 15'from my area of riparian access-unless waived by met I
"
you wish to waive the setback,you must initial the appropriate blank below.) 5
I do wish to waive the 15'setback requirement.
I do not wish to waive the 15 setback requirement.
Sign Name • Date
a.. il A/ (0 ait li , .
• Print Name - ,J
AtiliCIA-
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AnimmEnuft
(>� i' 571 t� ��eS na �q �� NCDENR
<r.e. w.- t d.,v�. .� c o,)„ woarn CAROUNA Dmianeser of
Telephone Number with Area Code (U/
S:lcama\shellslriparianproperty.frm . .

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DIVISION OP COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: ) ki017(150\ps,
Address of Property: Z7 &*
(Lot or Street#, Street or Road)
); /, �. , , Zg Z'v
(City and County)' 0,1 v,•/)..s cdC__ y0 .
I hereby certify that I own property adjacent to the above-referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development they
--are proposing. A description or drawing, ,Tith. dimensions, should-be provided with this letter.
a,,e.d I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coastal
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-3900
within 10 days of receipt of this notice. No response is considered the same as no objection if
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 set •
bck 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.
•
Sign Name Dated
ri__
Print Name NCDENR
NORM!CARouN&DEnurr}fzNr OF
ENVIRONMENT AND N.QuR*L RESOURCES
70 / ?IT — aer/3
Telephone Number with Area Code S:\cama\shells\riparianproperty.frm

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SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
• Complete items 1,2,and 3.Also complete I A. Received by(Please Print Clearly) B. Delivery
item 4 if Restricted Delivery is desired.
• Print your name and address on the.reverse C. Signature
so that we can return the card to you. ./� CI Agent
-
■ Attach this card to the back of the mailpiece, X�! dillis. 0 Addressee)
or on the front if space permits.
D. Is delivery address different from item 1? ■ Yes
1. Article Addressed to: If YES,enter delivery address below: 0 No
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3. Service Type
0 Certified Mail 0 Express Mail
Q J a 0,,) /V• L 0 Registered 0 Return Receipt for Merchandise'
1 i Si Q7 ElInsured Mail CIC.O.D.
0 4. Restricted Delivery?(Extra Fee) 0 Yes
2. Article Number(Copy from service label) -. - - -
7001 0360 0002 9100 6399
'S Form 3811,July 1999 Domestic Return Receipt 102595-00-M-0952
U S Postal Service , . , t.'U.S. Postat•Service ,
CERTIFIED IVIAIL,RE IPT' ` • , ' CERTIFIED MAIL RECEIPT
„:,(Domestic.Mail Only No7hsurance Coverage Provided) (Domestic Mail Only;No Insurance Coverage Provided)
+9 , �vL '•'ice ›1_
O Postage $ ,3 / i `:'`. —"""` -. -'--N O Postage $ f3� `�_,: ."Ir, ^.
r9 Er Certified Fee Z-3C/A\ / -''�4'\
0- Certified Fee 2.36 f p^ /
Postmark,, Postmark
r1J Required)Retum Receipt Fee 1 Here_ rU Return Receipt Fee
(Endorsement (Endorsement Required) Here
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\: p Restricted Delivery Fee r
o Restricted nt Delivery Fee p (Endorsement Required) f
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Total Postage&Fees . Total Postage&Fees
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d or PO Box No. P . „ ,o Z� O l L ,// / ,Ctg `1(.I'( hQ h�
p 9 0 City,State,ZIP+4
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iPyS�Form,3800 JanuaryS100,�! ?. S'ee Reverse for#Ins ructionsf=,g P5"Form'3,10,Janua`ry 2001.r,;; /. kSee;Reve�seifor liistti,p ons t"t'

ainsanuaamor '111MMINE9.11.1.1111 UMMIMMIIIMI=IMIMMIIM .
.,,.
,DANIEL Y ROBINSON D.V.M. 3458
PH.336-325-2400 .- . ,
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, •: 574 GRASSY CREEK ROAD i * 0„., //)///6t 66-112/531
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PINNACLE,NC 27043 f.,
71801
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