38515D - Shields

CAMA / DREDGE & FILL
GENERAL PERMIT Previous permit#
' . .New Modification C: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 i .2OO
El,Rules attached.
Applicant Name bfi/}P yf •57;/G /d5 Project Location: County arz/CA:,,k.,,<. A.
Address /.. G / ael/n ✓ 7 Street Address/State Road/Lot#(s) /JO
City 0-4(ch-.-7 ecaGA State /✓C ZIP284"ln2 trio,-hi-2
Phone # ( ) Fax#( ) Subdivision - `
Authorized Agent EJ/'cq 747ecin� _ City +/older) bet c/ ZIP .M/62
Affected E CW XEW PTA ES ❑PTS Phone# ( _) - River Basin Lambe r
s C'OEA 7,HHF 7 IH UBA ❑N/A
AEC ; Adj.Wtr. Body � ✓7�-�
❑ PWS: FC: '!s (nat /jr,9/unkn)
ORW: yes / no PNA yes / no Crit. Flab. yes / no Closest Maj.Wtr. Body �ji/LJLt}
Type of Project/Activity -Y boa 7`Lift 112 eX/jt7r9 f er/Fjo&K
(Scale: /ti ?o' )
Pier(dock)length ,_x/J r 3x/4.-
Platform(s) Exjsr / ,,k/b 1 , `T 1 .1 -` 1 t • i i + I j — ' . _j
Finger pier(s) 7 X/:b Ex rSrl'Y!� — 1
i -I
Groin length — .. ` _ _ :. _ ._ -
number i
Bulkhead/Riprap length 1
t
avg distance offshore 'I' 3 /�• , 4__ _ i
max distance offshore 8
Basin,channel ± 15 .I r/IP
! 7 j
�C4.0
ti
cubic yards ;`.--,,/ ' 0 f T
Boat ramp_ I
4 •
.
— — —
Boathouse/Boatlift /3 y/.3 1 -
i -4-- J/A ,fri. I
Beach Bulldozing •
f I I i I i Ik
Other �! j. I(/ G
1
l r ~_
, 4 ---- _ SG -� —
' I /fry di . I
Shoreline Length_ 50 ' (211
SAV: not sure yes no —, '
5hte ids *14. .
Sandbags: not sure yes no t U' • I
Moratorium: n/a yes (no < I
a
. „ JE�>t (cs t I j
Photos: yes (no _ .
Waiver Attached: yes no I --- --- I -
A building permit may be required by: 4vCcLe.-7 ii.%)e.G.C.. 4 . L See note on back regarding River Basin rules.
Notes/Special Conditions // Cdr,C'/7//7 O-77,S O/ 7 fy 1. 0D
-e• XX-C L,ti
Agent or Applicant Printed Name Permit Officer's Signature
Syr /
(YL-- '57 /2/)v Signature Please rea compliance statement on back of permit** Issuing ate iration Date
Application Fee(s) Check# Local Planningjurisdiction Rover 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(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 252-946-6481
Location: Fax: [phone] Fax: [phone]
Parker Lincoln Building (Serves:Camden, Chowan,Currituck, (Serves: Beaufort, Bertie, Hertford, Hyde,
2728 Capital Blvd. Dare,Gates,Pasquotank and Perquimans Tyrrell and Washington Counties)
p Counties)
Raleigh, NC 27604
919-733-2293 / I-888-4RCOAST Morehead City District Wilmington District
Fax: 9I 9 733 I495 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)
www.nccoastalmanagement.net Revised 10/05/0I

GENERAL PERMIT COMPUTER FORM
.APPLICANT NAME: <� (/6 e (dt
ADDITIONAL NAMES: 661.,i¢ I'e/Id
AEC DESIG: cit./ ,7 DEVELOP AREA: O / PROJ DESC:
(Will only take 6) -—— (Will only take 1)
WORK: f3`L /3 /3
(Will only take 4)
MAINT:
(Will only take 4)
IMP: O/c 2-629
(will only take 6)
• ACTION EXPIRATION
DREDGE&FILL REQUIRED: S//210/ V/2/0 4/
CAMA MAJOR DEVEL REQUIRED: 67/2/0 SL g//2-/OVL

.
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piip g112 .'9s7 .
DIViSTON OF COASTAL MANAGEMENT
•
ADJACENT RIPARIAN PROPERTY OWNER NOTIr ICATION/WAIVER FORM
. Name Of Individual P_pnlyi For Permit: ` / .
L__ ,
Address-' Of Property: /3`62 V. 1A r" d. c.. elk,/ !e .
•
(Lot or Street r, Strut or
Road, City & County) .
i hereby certify that I own- proper= d ac y
above-
referenced r ,--y. The z j ent_ to the above-
F-ooe- � individual applying -for this permit has
described to me as shown on the attached drawing the development
they are proposing. A description or
with drawing, with 2 dimensions,
.should be provided this letter.
,\ • I have no objections to thisr
p_onosal.
If you have objections -
Divicip-i o Coastal cOP.S to what is beinC Or-ODOScd. D1ease 'w-i-ite `}�_ -
Di isio�O'7 . NorthterM tnaceme-n 127 . Cardinal Drive ension ..
Wjldayof o _ _ Ca-olina 22405 or call 910 39 c -
- receipt of this L - 5-3 _00 wi`h;-� 10
notice. No response is considered the same
as no Objection il- You have be =
'" _ e *� notiic
----d lby Ce,-L; f; _r; Mail -
WAIVER SECTION' ' -
derstand
Inthat a tier, dO ck, moo ring of l incS/ breakwater,Er, boat house, lift must be seiback a minimum
from my area of riparian accessunless e distance(Iyou of wish
h
un__ss waived by te. (T wis
to wciVc the Sc-back
you must initial the '�ppr0 p=jots blankE_OW_ )
o i do Wish to waive the 15 'setback requirement.
+�
I do no`L
wish to waive
the 15'setback rEquireent. -
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_: GRIZZLY,REAR "rf Y.
HOLDEN DOCK & BULKHEADS
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GREGORY A & DOROTHY HOLDEN
PH:910-842-9732 j���
1502 STONE CHIMNEY RD SW
SUPPLY, NC 28462 � - f - t� Bf, 1215/531
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PAY70THE ,
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