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0 ►."4 CAMA / ❑DREDGE & F LL 35161D
NERAL PERMIT Previous permit#
yam. ew . ,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 I SA NCAC 4/-4 /ZOU .
ules attached.
Applican�Na e jecj 1 v.L) /��__ /� Project Location: County p&upcei
Addrd'ss_ �/YJ IMQ7&r1 r1 a(PS • /7d Street Address/State Road/Lot#(s)
City /Jg-w►,05r d State NO ZIP Zi9V u)451-1/NU` 't (-1Cite6L JZ D
Phone # ( 'O) .7()—6 39 Fax# ( ) Subdivision L 41 /pp/AJ T
Authorized Agent )'4 k CLF;�?o/%5 City CI1n/jS CI. ZIP Zg YV 3
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Affected .'ETA ,ES 'PTS Phone # ( ) " ' River Basin C2- r
AEC(s): OEA ❑HHF IH UBA N/A � w (it/Adj.Wtr. Body ! CO/man /unkn)
ElPWS: FC:
ORW: yes / no PNA yes / no Grit. Hab. yes / no Closest Maj.Wtr. Body / -_-.7-46,114.1
./
Type of Project/Activity 70 is t;td pg,ofi le ,)/E12- To 4-to e��S Gel l/.v79 T
(Scale: /v►s )
Pier(dock)length x 44.10 1 _ :2—f, /, ,.) ---/`->
Platform(s) (v (�/
Finger pier(s)
i a"OS el) ,
Groin length IS "—' X
20 number �U FLOA
Bulkhead/Riprap length
avg distance offshore
max distance offshore II
Basin,channel
i . 4 ..I- S 4 1 0 b
cubic yards I d 4 y S
Boat ramp f S o -. 4
Cl Z
Boathouse/Boatlift j y d ` . . ._.
Beach Bulldozing I 1 4 1 I /Z d
d r
Other FFlom. O x ZO 11 k a .1 14 _ y
ki
a u v Abe V
Shoreline Length 7091
pa ' ' `S �� Z
SAV: not sure yes no 1 " r� -kl --
Sandbags: not sure yes no I 7H,
Moratorium: n/a yes no 1 7- ii......."*--,,,gei 06?E 70 /SL/?ND
Photos: yes no l Ai/ ? O X 6 1 x 70 I
Waiver Attached: yes no 91_ /
A building permit may be required
by: {/open.' ---bU N _ . See note on back regarding River Basin rules.
Notes/Special Conditions QUAY NO7 F.kCE� d 1 J/D271 OF 44/97512&,7Y / Oe. E7O jogs T
' u3/-0 6 SE76N-dK arz. A-( 1) / �h.l-/we- WNI0ft60 /S i0
fe ST�li�T/L) N Q1, cStill d FOR. 7W0 sLl
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Agent or Appli t Printed e icer's Signature
t9!I / �,/--0- 6 y 6 y-, 0- G7�/
Signature '"Please read compliance statement on back of permit" Issuing Date Expiration Date
MO. oo �.,v v z- Gou N (31230/I/4
Application Check L 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(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 252-264-390 I 252-946-6481
Location: Fax: 252-264-3723 Fax: 252-948-0478
(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 / I-888-4RCOAST Morehead City District Wilmington District
Fax: 9 19 733 1495 151-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: 9 I 0-350-2004
Fax: 252-247-3330 (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 I0/05/01
GENERAL PERMIT COMPUTER FORM
APPLICANT NAME: Seri-y v f
ADDITIONAL NAMES: ✓ C 1 e'-v --(-7
AEC DESIG: C W fit"-, Pt S DEVELOP AREA: U O L PROD DESC:
(will only take 6) ✓ - �-
(Will only take 1)
WORK: �� co (0 3 D
(Will only take 4) 1 3 U •
S K, a1)
MAINT:
(Will only take 4) _
IMP: 6W i (e o
(will only take 6)
ACTION EXPIRATION
DREDGE&FILL REQUIRED:
v (/DO
C AMA MAJOR DEVEL REQUIRED: u (-( - c1 ,p 11
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of individual applying for permit: y QiQi
Address of property: Lic
ill+ r z�5zy
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 Coastal
Management, 127 Cardinal Drive Extension, Wilmington, North Carolina, 28405 or call (910)
395-3900 within 10 days of receipt of this notice.' Vo response is considered the same as no
objection if you have been notified by Certified Mail.
z
WAIVER SECTION •
(Does not apply to bulkheads or rip rap). -.
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
I do not wish to waive the 15' setback requirement.
/2-----/1- •
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Signature llate
Print Name
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Telephone number with area code .
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SENDER: COMPLETE THIS SECTION' COMPLETE THIS SECTION ON DELIVERY
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NI Complete items 1 2 and 3:Also complete A SI ur; r
item 4 if Restricted Delivery is desired. - ❑-Again
IIPrint your name andraddress on the reverse - -p Addressee. to =
so,that.we,can return the card to you.` B. ecei y('Printed Name) G.=Date of Delive
■ Attach this card to-the back of the or mailpiece,- / %¢ `4;
on the front d sp_ace permits D. )- 7 "
1 Article Addressed to -• :Is delidery�aaress different from item 1? = Yes 1"'
If YES,enter delivery address below. 0 No
571 -• i4k/ Jez.-r.
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iL9J2 i - 75105. 3. Service Typeef,
❑Certified Mail- .0 Express Mail /
• ❑Registered 0 Return Receipt for Merchandise '
- El Insured Mail ' ❑C.O.D. 19`
4: Restricted Delivery?(Extra Fee) ❑Yes
2. Article Number - - -. --- _ ___. -_,ts
(Transfer from service laheq 7003 0500 0003 6470 6 519
PS Form 3811,August 2001 a k
Domestic Return Receipt 102595-02 M 1540y; '•
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