36811D - Skipper

0 CAMA / DREDGE & FILL .. ` 3 8a
GENERAL PERMIT ,� 11
�� New Modification Complete Reissue Partial Reissue Previous permit #
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 I5A NCAC 7�, /Z
E Rules attached.
Applicant Name �A0-'5 Y._G/$4 �si Project Location: County ,
` ��y-
�/uh Sr.�iClC l~a.
Address ,42 a 7Aidil fria/t Street Address/State Road/Lot#(s)
City 9ph J55/ 'V? State/UG ZIP 2-15 54Au
Phone# (q(0) Z 7-S"/Pi Fax# ( ) Subdivision
Authorized Agent Orriasr' City ZIP
Affected CW 'KEW g PTA ,ES PTS Phone # ( ) River Basin
AEC(s): ]OEA HHF IH • UBA N/A
Adj. Wtr. Body t,e/ nat)man /unkn)
PWS: FC: I
ORW: yes / no PNA V' no Crit. Hab. yes / no Closest Maj.Wtr. Body �!11)11)
Type of Project/Activity ibUl�lt:e %ii /i P.' v- /i,": x' ,yam' ,1 '», ,"
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Pier(dock)length ru Y '/� .`I
(Scale: 3Q )
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Platform(s) /0/X$i V fY N� CY
Finger pier(s)
Groin length ,r
number i
'9
Bulkhead/Riprap length
avg distance offshore
max distance offshore �[g/ t
Basin,channel - - - s!
cubic yards - 1
Boat ramp •
✓\\ \i
Boathouse/Boatlift r V
{( ;
r
Beach Bulldozing
Other
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2C/
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Shoreline Length c6
SAV: not sure yes j 6��G_
Sandbags: not sure yes �" 4��
Moratorium: n/a yes
Photos: yes
Waiver Attached: yes i 1
A building permit may be required by: a/1 /5 44 . See note on back regarding River Basin rules.
Notes/Special Conditions A.ke I l4 e -/ei (/ #i o At-r'-.4 4L/ M.(n ;S 71.4.h ee
f/h/t>11 4/44 ft✓ 6o4 E6 hie.r.0*4+1-E•/ -4-'© .41-(X /l r65 . �r.c.-sA 1,4-c 1-.
ri ed Name t• Permit icer'sSignature
/00,1 •
ZOr
ure Please read compliance statement on back of permit"P--
Issuing ate E irati �-
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_.ion Fee(sl r-�__�,At Mai aim....:....i,...a:..: ..

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
1638 Mail Service Center Elizabeth City, NC 27909 Washington, NC 27889
Raleigh, NC 27699-1638 252-264-3901 252-946-648I
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
733 2293 / 1 888 4RCOAST Morehead City District Wilmington District
Fax: [phone] I5 I-B Hwy. 24 127 Cardinal Drive Ext.
Hestron Plaza 11 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 10/05/0

• G-EN R AL: PERK COMTL.. TER FO M
CANS: ±.N : . euslo d-Lisa 5kipp4tr
--.DDT i0N=?NAMES: t
—-C DES1G: DEN. .OP=.r ".:_ -i if PROJ DESC: / -
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ACTION D: IRATlON
- - ' DREDGE&PALS.REQUIRED:
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C 'vL�MAJOR D .R£QUIR_�D: F

•MAY. 4.2004 4:47PM NCDENR WIRO NO.461 P.7/8`�"""
DIVISION'OF COASTAL MANAGE NAplT
ACENTT RIPARIAN PROPER R NOTIFICA IONi\ 1AIVER FORM
Name of Individual Appiying For Permit: - 7"s ,t- 2,. c -5-k►• er-
r
Address'of Property: /l'l a //•zc-b br,,✓e__
(Lot or Street#, Street or Road)
Dam aS/a.,,al 57 C ans ,,p Co)
. ,
(City and County)
I hereby certify that I own property adjacent to the above-referenced property.
dividual
applying for this permit has described to me as shown on the attached drawine The
they
are proposing. A description or drawing, with dimensions,should be provided with this letter.
___Z 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 pigs,breakwater,boat house or boat lift must be set
bck a minimum distance of 15'from my area of riparian access-unless waived byme.
wish to wain► e setback,you must initial the appropriate blank below.) (If you
I do wish to waive the 15'setback requirement
I knot wish to waive the 15'setback requirement.
_1 .&,j,____A. 'aoi)-tivc: 7—S._-0
Sign Name Date
Aria
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Print Name ----•— NCDENR
72.. .5 0 7 2 �"'
Telephone Number with Area Code
S:IcamalsheuslriparianpxoperCy.$m

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MAY. 4.2004 4:48PM NCDENR WIRO NO.461 P.8i8 -
DIVISION OF COASTAL MA. AGEMENT
ADJACENT PAR A FROPERTIT OWNBR NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: eUr,1-7s 'd 'L/,4- Ski'
Address of Property: l Z �1/'Za/� j-, fe
(Lot or Street#, Street or Road)
00k X5/0.4.d y(C 8ru,,stvick 6;)
(City and County)
I hereby certify that I own property adjacent to the above-referenced r
aPP1Y�8�'this property. The individual
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.
V
y I have no objections to this proposal.
If you have objections to what is being ed, please write the Division of Coastal
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or within 10 days of receipt of this notice. call 91Q,395-3900
p 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 ou
wish to waive the setback,you must initial the appropriate blank below.) y
I do wish to waive the
IS'setback requirement.
- _ I do not wish to waive the 15' setback requireuient
Sign Nam Za 7' V •=
ate
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Print Name '— - P4CDENRTragoff IOL
(qcj &ci 4 owp . OP
Telephone Number with Area Code
S:Icamalshells\riparianproperiy.fim

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LISA ROSS SKIPPER 5744
PH.910 947-3991
1240 DOUBS CHAPEL RD. 7- 8-- U
(� 66-112/531 '�
WEST END,NC 27376 1�rc[c / 88506
to-de weirdAR _A(dc4t...cjAQct
BB&T um�
BRANCH BANKING AND TRUST COMPANY c L w S S I C •
SEVEN LAKES NORTH CAROLINA S/CIAN
I:053LOLL2Ll: 5LL3401, 37Lii' 574l,
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