38973D - Sheppard

g T'?; ' 9,,4 '% 2
0 CAMA / DREDGE & FILL
aENERAL PERMIT
Previous permit#
>Z _ _New ill 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 5A NCAC 7H'//00
Q Rules attached.
Applicant Name ,ev/a c. t t 5h-c,>i CZLd Project Location: County 8,t,r?S'LJ/CA-
Address -'// .ad,' At GY'G Street Address/State Road/Lot#(s) / / 1
City ir{cE r-, /5-CG ch State A/C ZIP . / 2- JeC, 5 ii or-c
Phone # ( ) Fax#( ) Subdivision
Authorized Agent CGt-r Se.-r1 Ta�h5 City age/c/Cn 13ea c/ ZIP .Z8t/(e-2
Affected -.CW ❑EW ❑PTA JS ❑PTS Phone# ( ) River Basin L L,m tle.,.L
AEC(s): E IDEA ❑HHF El IH E UBA ❑N/A Adj.Wtr. Body /4/(<<>(_c (nat 4), nkn)
❑ PWS: ❑FC:
ORW: yes trio.l PNA yes /( s� Crit.Hab. yes / no Closest Maj.Wtr. Body Al r 1.--(---)"--)
Type of Project/Activity Cc—r 571nr c 7‘ 75[-c 1k. /7..exi S
(Scale: / 20 ' )
Pier(dock)length �
7
Platform(s) <—"*--.41 U/1,0 '--2f
Finger pier(s) I
Groin length - -
number ;--- 1.Yt'/.11
ulkhead/Riprap length SO/ - { Y tS 7-7A.,6
i • i� .1
Thvg distance offshore I • I ,` ,
max distance offshore . . i f .
Basin,channel �- •— — f -> --+
cubic yards
Boat ramp i .
Boathouse/Boatlift
----
ill
Beach Bulldozing i 'V V v .v �' " �% �'
V V
Other — ,J. ✓ ` 1� 4- y \( V.
,, / A , : I ti...." '1 -..----All- f 1 i
Shoreline Length Sr I 41'
— 50 -i ��.
SAV: not sure yes no --- --- ---• ���
•
Sandbags: not sure yes no f'`'" "{
i-
Moratorium: n/a yes . 1 1
Photos: yes no - '
ikirH 5 1
Waiver Attached: yes ca.') -- �____- _ -- —
A building permit may be required by: 'f/n Icier) 66ac-Li . H See note on back regarding River/Basin rules.
Notes/Special Conditions .QZ( C#-)7a/S7r1-r /75 c 7/-/ ii G'o f 2p-i . 5ce 4hec1 -1-007C
r--''7. - L,c�P_c+/ el-5 571- k(7O J Lei-r.,�/‘c1c. .-d O� cT�// !,.='G)Lla.--)0l.S
a ., ,- , /el e < 45 /.F"K/rii.<<<i.e... ✓QC 4 b5 (�4-1_•( t-C� 4.x- .P C-4' -
Agent Applicant Printed Name Permit Officer's Signature
S re 'i"Please.read compliance statement on back of permit** Issuing Date Expiration Date
.
ti /c0c(-) f-h-Cdcr1 5G.4�G) /Vc 4 2-3 /34
Application Fee(s) t UkA Local Planning Jurisdiction Rover File Name

t
•
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: [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
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 I0/05/0I
www.nccoastalmanagement.net

GENERAL PERMIT COMPUTER FORM
APPLICANT NAME:
ADDITIONAL NAMES:
AEC DESIG: e"5 DEVELOP AREA: .C_` / PROJ DESC: - if
(Will onlytake 6) (Will only take I)
WORK: i-1 St)
(Will only take 4)
MAINT:
(Will only take 4)
IMP: O'oa
(will only take 6)
ACTION EXPIRATION
DREDGE&FILL REQUIRED: 6.23 • G '23 •D0
CAMA MAJOR DEVEL REQUIRED: -Z3 •ot 9. 23 • CI

g , i( 77/-gg
DIVISION OF COASTAL MANACFMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIE'TCATION/WAIVEV 'ORm
Name Of Individual Applying For Permit: 4/ L,qai_tL_.__72 .
Address Of Property:
r am` . -. . i .
(Lot or Street #, Street dr 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 me as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions,
should he provided with this letter.
1 have no objections to this proposal.
If.- you have objections to what is being _proposed,. .plea,,u ;ti cite the
Division of coastal Management. 127 Cardinal Drive Extension.
Wilmi naton, North Carolina, 28405 or. call 910 395-39Q0 , w;ithin1 0
clans of receipt of this notice. No response is considered the same
as no objection if you have been notified by Certified M,n t1.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, break:Jat!?r, boat
house, lift must be set back a minimum distant..? 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.
T. do not wish to waive the 15'setback requir9.nent.
AO
5 ature DateAWA
Print Name
Telephone Number With Area Code ��� R`

-'
•
roK.j ",'- ' ' }i •i'r";:, r _' „•e. t-.
Alt
., ✓ `
rt
" 4.. .
• .. , , _.
,.
. ., •- •, • i:•i ..., ,, ••., ,.,...,.1-.1:117.. .i.-L_:,..t. •,.. ) ,,,,,r,-,:t.t.,..i.i;
..,.
. ..... .. . . .
. . .
• • . „, . . .
.•-1'....,t=f 1(.' •
.,..,........, ,
..
. __ _ . .... _.. .
. .. .
. .. .. , . ..
. .. - ••.,.• .
•I . ....
. .........
, . .... . . ._ . . ..
. i.. ,... .: ,:.,... -, :... . .,.,„...„. . i . . ,!.. ...,.... :ir s
i .
•
. e
,. • '' r GCS r .if rt. r t 4 �‘y' La :v
•
•
gy .q; :y .:try...- 1 :•� f
•
•
` _ :,i . , a ' 4 ;r
� - f [rat
4' r ' j: 7 'V.. T:' i14-.4 •ii'':i:i4 . ' ,.. .. :.7 't ' . ''lam llittif Z'
P •
` j:"t �;. 4
t 1.- - .5 •. f tTr •_ n. 't.ti$ ' ',./r`- ST M ft;:: r fi 'Y. i'. • i• ' " _
rE`,l1 Lq � i.i. �i ^:a Fl•/f.\• `�tc1 ,,ii ,� '..i 1:r.. �-. :,�., `
Aik J]
• •.. `et . • �,
' '"t':•:-.. -;,..-• -r g 1-4 7L_,„1.'..-..:..1;- 7„ • .. .•..,,.• • ••0.3
r tee, irpr. S - _.•F .
r
l
- .IF_ _a'....4i•..m:.Y.,:.aie-• ...4....14.-: a ,..a .z -<-,.. H. ..- .. ...

KATHLEEN F JACOBS 3111
PH;910-842-6978
1200 STANBURY RD SW
Date 172f/-4 / 66-1215/531
840
SUPPLY,NC 28462 '
Pay to t e Ai/j • "?:4*-
Order f • I $ Me,
Dumb
ri
WACCAMAW
s.wiANK
Forpm
28462 • kciPPe'
uruni.w nienbank.q 6p1
33 111.
1:0531L 2 L521:8000 L556821003 LL
• - . • , . .•. iNTOUCKD CUSTOM CREATIONS'.
•
•
•
•
•